Telehealth visits skyrocketed during the pandemic. Telehealth has enormous advantages, but to improve care at scale, several challenges must be addressed.
During a featured session sponsored by Nuance as part of Becker's Healthcare's The Shift to Digital: Telehealth, Home Health & Virtual Care virtual event, Jared Pelo, MD, chief medical information officer of ambient clinical intelligence at Nuance, discussed telehealth technologies, including AI-powered automated documentation.
Five key takeaways:
- The COVID-19 pandemic has dramatically increased the use of telehealth. There was a shift during the pandemic to providing healthcare virtually, with telehealth visits rising from 11 percent in 2019 to 46 percent by April 2020; 57 percent of providers now view telehealth favorably.
"We were getting close to where telehealth was going to explode," Dr. Pelo said. "It took the pandemic to show us how powerful telehealth can be." Healthcare professionals who had been reluctant to use telehealth have begun using it. Telehealth allows physicians to see patients remotely — reducing patient no-shows — while still conveying empathy and delivering excellent care. - Telehealth changes the nature of competition. With telehealth, patients are no longer limited to providers in their area. A suboptimal patient experience is not an option when patients are no longer geographically bound and can choose a provider located anywhere. During the pandemic, the rush by providers to use any form of telehealth technology was understandable, as CMS relaxed rules, allowing providers to use (and be reimbursed for) tools like FaceTime. However, coming out of the pandemic, delivering consistent care, providing a satisfying experience, and getting reimbursed requires a comprehensive telehealth infrastructure and technology system. While telehealth poses challenges, such as patient adoption, lack of user support, and reimbursement, the proper infrastructure is a prerequisite for managing these challenges.
- Providers should adopt telehealth best practices. Dr. Pelo suggests good "telehealth hygiene," which includes a high-quality webcam, proper lighting, dedicated space for video visits, and notices for when patients are waiting. To maximize efficiency, it is helpful to create templates for top conditions, step-by-step input voice commands, mobile tools, and voice recognition. Providers interested in telehealth can begin by identifying the right vendor and encouraging user adoption by explaining the benefits (the "why") of telehealth.
- A key component of telehealth is managing documentation. "Every provider has a reason they went into healthcare," Dr. Pelo pointed out. "None will say it's because they wanted to write notes." For every hour spent with a patient, providers spend two hours on paperwork. In addition, 64 percent of payments that are rejected or not reimbursed correctly are due to insufficient documentation. And burnout (often related to paperwork) contributes to a 200 percent increase in medical errors. As telehealth adoption increases, providers are looking for assistance in managing telehealth documentation.
- Managing documentation is easier with the right tools. There are many ways to manage documentation, including basic point-and-click technology, transcription, speech recognition, and now "documentation that writes itself" using conversational AI. Nuance's Dragon Ambient eXperience (DAX) uses AI to capture a clinician's conversation with a patient and create a note. Following a quality review check, the note is returned to the provider with near 100 percent accuracy. A Nuance study found that "97 percent of patients said their experience with DAX was better than their doctor's visit without it," Dr. Pelo said. DAX helps improve outcomes, reduces burnout and improves accuracy, and enables providers to see more patients.
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