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.
By Michelle Davey, CEO and co-founder, Enzyme Health.
Michelle Davey
Today, our healthcare system is changing, and it’s changing quickly.
What’s leading the way for the remarkable shifts we’re seeing in our industry? Record-breaking investments into digital health (more than $14 billion in 2018 alone). Every day, we see digital health leaders working toward more affordable and accessible care for patients everywhere.
However, as we evolve and advance, we can’t ignore the glaring problem that still plagues the industry: clinician burnout. It’s a terrible symptom of a system that’s no longer working. Clinicians are 15 times more likely to experience burnout compared to any other working professional, and they’re killing themselves at alarming rates — the highest of any profession.
I believe the very technology we’re creating to better serve patients can also save clinicians — as long as we’re mindful of how we bring forth change. Here’s how we can do it.
Tech is helping clinicians prioritize flexibility, autonomy and career mobility
Our most recent generation of clinicians are approaching work very differently than their predecessors. Studies show that more Millennials are choosing to stay at home than Gen X before them. Many attribute this to our current economic climate and a changing attitude towards work-life balance.
In healthcare, technology is keeping pace with this cultural shift by empowering clinicians to live on their own terms. How? Currently, one in five physicians use telehealth. That number is expected to triple to more than 60 percent by 2022, with many stating that they plan to adopt new technology because they’re experiencing burnout and want more flexibility.
What does this new work-life balance look like for clinicians? A level of career mobility that hasn’t been available to them until now. For example, with asynchronous medical assessments, the days of darting from exam room to exam are behind us. These software-enabled questionnaires mirror a clinician-patient interaction, so clinicians can review responses on their own time to diagnose and develop a treatment plan in a matter of minutes.
Technology is alleviating the pressure felt from a growing physician shortage
Burnout is intensifying another crucial problem in the healthcare industry: our physician shortage. Recent findings suggest that by 2030, the United States will have a shortage of 120,000.
What does burnout have to do with this? Many clinicians are reducing hours at work to alleviate their feelings of burnout. This is especially true for young clinicians who are starting families. Female clinicians in particular take on a disproportionate share of child care and family responsibilities. To manage this new chapter in life, they’re often faced with taking a “career detour.”
New digital health solutions are shifting this reality, offering options that allow clinicians to work when and where they want. This is a significant win for the healthcare system. We get to retain highly qualified clinicians who might otherwise have no other option but to leave the profession–temporarily or permanently. It’s also a huge win for our clinicians. They no longer have to ask, “is it possible to work,” and instead get to decide “when and how am I going to work.”
Clinicians’ jobs are becoming more and more efficient
One reason we’re seeing the fast adoption of telehealth technology among clinicians is because it’s making their jobs more efficient–not more difficult. We might think it’s a no-brainer that technology should make our lives easier, but in healthcare, that hasn’t always been the case. For example, with past advancements like electronic health records, a common complaint was the cumbersome administrative tasks that came with them.
According to a new report from AMN Healthcare, a healthcare staffing firm, 78 percent of hospital executives believe there is a shortage of physicians nationwide, 66 percent believe there is a shortage of nurses, and 50 percent believe there is a shortage of advanced practitioners. The survey also indicates that the vacancy rate for physicians at hospitals approaches 18 percent, while the vacancy rate for nurses is 17 percent, considerably higher than when AMN Healthcare conducted a similar survey in 2009.
“Change in healthcare is a continuous evolution, but the one constant is people,” said AMN president Susan Salka. “No matter what models of care are in place, it takes physicians, nurses and other clinicians to provide quality patient care, and the fact is we simply do not have enough of them.”
AMN Healthcare’s 2013 Clinical Workforce Survey asked hospital executives nationwide to comment on clinical staffing trends affecting their facilities. More than 70 percent rated the staffing of physicians, nurses, nurse practitioners and physician assistants as a high priority in 2013, compared to only 24 percent of hospital executives who rated staffing these professionals as a high priority in AMN Healthcare’s 2009 workforce survey.
According to a new report from