Telehealth requires a 'culture of change' — 5 insights on perfecting telehealth strategy

The successful implementation of a telehealth program requires all healthcare players — payers, hospitals, physicians and patients — to embrace a culture of change, which isn't always an easy feat.

In a Sept. 24, webinar hosted by Becker's Hospital Review and sponsored by MDLive, Cynthia Zelis, MD, vice president of ambulatory operations and telehealth at Cleveland-based University Hospitals, and Lyle Berkowitz, MD, CMO and executive vice president of product at MDLive, discussed the evolution of digital health in U.S. health systems during a conversation moderated by John Nosta, president of NOSTALAB.

Here are five keys for creating an effective telehealth strategy:

1. Reimagine how telehealth fits into the broader healthcare landscape. For Dr. Zelis, it's time that healthcare thinks of telehealth as another way to deliver care. To accomplish this, hospitals' telehealth strategies must be reimagined on three fronts: technology, patient and clinician. Technology advances rapidly, but healthcare is slow to adopt it. Dr. Zelis said hospitals should embrace partnerships with technology companies that have expertise with these tools. On the patient side, telehealth strategies must now consider the patient as a consumer, meaning hospitals need to address patients' expectations that they can receive care whenever and however they want it. For clinicians, hospitals' telehealth strategies need to emphasize the physicians' relationships with their patients can be enhanced through telehealth.

"We need to embrace the [idea] that delivering healthcare is changing. I believe it will be a hybrid approach," Dr. Zelis said. "There [will still be] people that like that face-to-face interaction, but it is going to be a balance."

2. Encourage a culture that embraces change. A virtual or telehealth culture is where the U.S. healthcare system is headed, explained Dr. Zelis, but it's a culture the industry needs to adopt now. It is imperative that healthcare leaders align with the telehealth strategy and the cultural change such a strategy will bring, she said.

"Culture is a marathon, it's a journey," Dr. Zelis said. "[You should make providers] understand that [the culture] will change, but the components, whether it be their productivity, or their patient care are unchanged."

3. Continually engage and educate providers. Telehealth scares physicians explained Dr. Berkowitz. They are often concerned that new virtual care offerings are stealing their patients or detracting from the physician-patient relationship. However, he argues this is not the case. Instead, Dr. Berkowitz noted that patients aren't yet aware of these virtual options, but once they are, they keep coming back. Helping providers understand this, he said, encourages telehealth adoption.

Dr. Zelis agreed and laid out UH's threefold engagement strategy. First, it is important that hospitals establish a core group of providers, such as a physician advisory committee, to be the voice of the telehealth program. Next, it is vital to offer an incentive program, such as offering physicians benefits for taking on some of the risks associated with practicing telehealth. Last, hospital leadership must continually communicate the successes of their organization's telehealth programs to frontline providers.   

4. View telehealth as a way to enhance efficiency. An emerging role in healthcare is the virtualist, explained Dr. Berkowitz, which helps facilitate the notion of virtual first so that telehealth is no longer seen as a tool of last resort.

"Today, we focus on urgent care but overtime, we will be able to focus on a variety of other things … [such as the] parts of patient care that are routine and can and should be done online," Dr. Berkowitz said. Injecting telehealth into routine care, he added, not only improves provider efficiency but offers patients greater access to care, which in turn improves quality.

5. Understand there will be challenges. For Dr. Berkowitz, telehealth is healthcare's "blockbuster moment," and a huge barrier to its adoption is patient awareness.

"The patients want [telehealth], but most of them don't even know it exists," Dr. Berkowitz said. "The people that leading it are the large healthcare systems … but they have got to pull along the doctors and make sure they feel comfortable with it while making sure the patients are even aware of this on a day-to-day basis so that it becomes part of routine care."

UH's key to raising patient awareness, Dr. Zelis said, is to target the right people. The health system markets it telehealth offerings to both its established patients as well as those in the community it hasn't seen yet. UH has also reported success with its virtual on-demand offerings, and multi-specialty outpatient telehealth, which connects academic providers with patients they've never met for specialty care.

To access the webinar recording, click here.

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