Electronic Health Reporter

Responses from Stephen Dean, co-founder, Keona Health.

What telehealth should focus on?

First, recognize that telehealth is more than telemedicine. The first needed focus is on the rest of the patient journey outside the 15-minute conversation with the doctor. Patients want ALL aspects of their health journey to be easily handled in the moment, on their smartphone.

Telehealth includes any processes and tasks performed by medical professionals remotely. The Health Resources and Services Administration (HSRA) acknowledges this need and defines telehealth very broadly:

“Any use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, and public health and health administration.” –Health Resources and Services Administration (HRSA)

Examples of what the rest of the patient journey looks like – Finding a doctor, getting a referral, booking an appointment, validating insurance, checking in, processing payments, getting prescriptions, getting related health education, or handling any customer service needs.

The second focus should be on improving the technology within the telemedicine visit itself. The telemedicine visit is typically a video call with the provider. The technology should facilitate the administration, documentation, and operations side of the telemedicine visit. These involve tasks such as facilitating the doctor’s documentation, placing of orders and creating tasks. Current technology too often forces the doctor to focus more on the EHR than on the patient.

The third focus should be on provider training. Standardized training needs to be developed for the providers and their support staff for navigating the extra complexities that telehealth provides. Many organizations have developed their own, but it needs to be standardized and shared across organizations. Telehealth requires advanced training around such things as communication skills, navigating tools and technologies, and decision-making when you detect an unsafe situation, and you don’t have your normal escalation options available.

Challenges in implementing telehealth services in healthcare

The challenges for telehealth are far greater than what you would expect from other industries. First of all, the medical variation and factors to consider alone are highly complex. Add to that the fact that telehealth communication is different. Excellent telehealth communication requires establishing a therapeutic relationship with the patient within 30 seconds.

Clinical safety considerations are different with telehealth than in person, and every telehealth staff member needs to be aware of them. The telehealth work itself is different, in that on one hand it is more isolated and remote, and on the other hand it requires familiarity with more technologies and tools. In healthcare, those technologies and tools are almost certainly fragmented as is the underlying patient data.

None of these challenges is a trivial one. Addressing them takes dedicated focus by a mix of clinical and technical expertise.

The automation of myriad complex processes, which maximizes time for patient care

Customer relationship management (CRM) software is ubiquitous in other industries, but relatively unadopted in healthcare. A CRM automates communication with customers and keeps a unified record of all customer interactions.

A healthcare CRM smooths the entire patient journey by automating patient interactions. Not only does this make the journey easier for the patient, but even more critically, it allows the provider to focus on the patient and less on administration, documentation, and process. It takes work to get there, but when configured appropriately, it makes serving patients a delight instead of a frustrating experience.

This can only be possible when the myriad complex processes of the patient’s telehealth journey are automated. This starts with connecting to all the existing healthcare systems and data on the back end for a unified record of patient interactions. Health concerns can pose health and safety risks, so tools to maintain safety and provide quick and accurate escalation must be built in. A full 360-degree record of the provider’s needs, the organization’s process, and the patient context need to be taken into account. This removes the burden of remembering every single item from the medical professional, and lets them focus on the patient.

The training of providers and other medical professionals can then be greatly simplified. Instead of learning a suite of tools, they only learn one, and this one supports them with automation.

Because of medical complexity, a healthcare CRM has to be more sophisticated than your typical CRM. But it holds much of the capabilities for improving telehealth while addressing the staff shortages today.