In today's shifting healthcare landscape, it's good to have some sort of telehealth strategy. But the telehealth goals (and technology requirements) of the solo or small practice will vary greatly from those of a hospital or health network.
It's important to know not only what you want to do with telehealth, but what you'll need to get there.
"I think that everyone's considering it now, but there are a lot of different levels of preparedness," says Sara Russell-Rodriguez, director of clinical services for Honeywell HomMed, which recently unveiled a "Select Services" program that offers providers a choice of three tiers of telehealth support. "When you talk telehealth, you're not just talking about home healthcare anymore. There are different strategies" for inside and outside the hospital or clinic.
Honeywell HomMed obviously isn't the only vendor to sell a tiered product, but Select Services does offer an example of where the market is heading. The levels are described as follows:
Tier 1 – The lowest rung on the telehealth ladder, called the "RN Oversight Model." According to Russell-Rodriguez, this level enables the provider to keep overall control of the telehealth program, usually overseen by an RN, while the vendor offers the technology and operates as a sort of triage program.
Tier 2 – Called the "RN Coordinated Model," this level goes beyond the typical triage approach by giving the vendor control over communications and interventions, while the provider retains control of care coordination.
Tier 3 – Called the "RN Case-Managed Model," this level is for the provider who wants to outsource everything, from program oversight to care coordination. At this level, the provider might be more inclined to hire a physician or administrator who would oversee the program.
"If you're starting with a new program, you probably don't have the qualified staff or the experience," says Russell-Rodriguez.
Russell-Rodriguez points out that each tier isn't "set in stone," meaning providers can start at one level and work their way up as they develop the program and decide where they want to go with it.
But there are questions that every provider should ask before starting a telehealth program. Russell-Rodriguez identifies three key issues that can determine success:
- Do you have a champion? "The one thing that everyone needs is a champion," says Russell-Rodriguez. "They need to have someone … who really believes this is going to improve the delivery of care and is passionate about it." That person can and will drive enthusiasm for the program and serve as a project leader.
- Do you know what population you want to reach? "That's the goal at the end of the day," says Russell-Rodriguez, and it ends up derailing a lot of telehealth projects if it isn't handled properly. Those starting "from scratch" should identify a small population (type 1 diabetics, those with high blood pressure, pregnant women, teens with depression issues, etc.), run a program with very specific limits and goals, and look to scale up or expand only after proving the success of that first program.
- Make it easy for patients. "You need a willingness to put together policies and procedures to automatically enroll people," says Russell-Rodriguez. "There should be no confusion for the front-line staff." And as with the second issue, staff will buy into the project much more willingly if the processes are clearly defined and easy to do, and the goals are clear and reachable. In other words, don't aim for the sun in hopes of reaching the moon.