Why Telehealth Isn’t Enough and the Virtual Care Strategy You Need to Solve It

Why Telehealth Isn’t Enough and the Virtual Care Strategy You Need to Solve It

A communication strategy is necessary to improve outcomes and experiences

By Julie S. Grenuk, RN, MS, RCC and Nurse Executive at TigerConnect

For better or worse, the coronavirus pandemic brought with it a once-in-a-generation opportunity to not only test, but to also successfully deliver new care-delivery models. As a result, telehealth and other forms of virtual care are here to stay.


Key Takeaways:

  • Telehealth alone is not enough to promote patient engagement and resolve care delivery deficits – a communication strategy with video, voice, secure texting and EHR integration capabilities that can be used seamlessly with the interdisciplinary care team, AND with patients and families is necessary to improve outcomes and experience
  • The most efficient, adopted and cost-effective technologies are those that make it easy to support patient and care team communication on a single communication platform
  • Flexible (on-demand), reliable and easy-to-use virtual care and communication solutions help to:
      • Foster the human connection between care professionals, patients, and their families
      • Personalize care and engage patients throughout their care journey
      • Enable more efficient and cost-effective ways of delivering care

While virtual care was previously a nice-to-have, it is now an essential part of our new reality. Whether driven by consumers’ ever-increasing demand for convenience, or the result of changed behaviors in controlling contagion spread, healthcare organizations of every type and size are now more compelled than ever to incorporate virtual care into their delivery models.

But what does integrating virtual care into everyday life and clinical operations really mean?

And how do we solve the bigger challenge of effectively applying the full breadth of virtual care technologies to enhance communication and collaboration across care teams and settings?

It is common for healthcare organizations to implement fragmented solutions such as telehealth to solve one-off problems. Leaders are so intent and pressured to solve each day’s immediate issues that it is easy to overlook the forest for the trees. This myopic focus on one-off solutions to solve today’s issue creates a layering effect where new processes, solutions, and resources can pile up as each new issue demands a response – in other words, we continue to add new work without taking anything off of the care teams’ plates. The result is workflow inefficiencies and frustrating care experiences for both patients and healthcare providers that contribute to clinician burnout.

One answer to this challenge lies in stepping into the worn shoes of both the patient and the caregiver to understand the patient journey and experience. Another critical consideration relevant to today’s situation is that virtual care is much more than a standalone telehealth visit. Let’s delve into these a bit further.

Providing virtual care doesn’t start and stop with a telehealth video session. It also includes the ability of the clinical and non-clinical care team, patient, and family members to virtually collaborate and coordinate care across the continuum of care. Think of your day-to-day life. Before Coronavirus, you likely didn’t communicate with friends, family, and co-workers solely by video. Instead it was almost certainly a combination of texts, phone calls, in-person visits, and maybe Skype or FaceTime sessions that matched the situation and the nature of each interaction. The same can be true for care delivery.

In fact, research has demonstrated that daily texts to patients can improve outcomes such as medication adherence and reduction in complications. And a study published in the Journal of Internal Medicine found that hospitalized medical patients whose care team utilized secure messaging showed a relative decrease in length of stay.

So while telehealth consults are understandably popular at the moment, the power of texting and on-demand video calls to personalize healthcare should not be overlooked. In fact, the more that secure texting becomes a standard of care across the care continuum, the more clinical outcomes and user experiences will improve.

Adapting to a real-time, video, voice, and texting model that integrates with the EHR requires a foundational infrastructure that supports communication within two worlds at once:

  • With colleagues, clinical and non-clinical teams inside the hospital, ambulatory and post-acute care walls
  • With patients and their families in their homes.

This dual-function, single platform infrastructure allows for virtual care communications before, during, and after a telehealth visit which not only enhances the patient experience, but also reduces care team toil associated with ineffective and outdated communication processes.

Why does this matter?

Virtual care communication and collaboration enables better patient experience, more efficient and cost-effective ways of delivering care, and liberates the care team from being tethered to the EHR.

For example:

  • Secure texting provides patients with a familiar way to easily clarify a question after a video telehealth session without playing office phone tag or enduring the aggravation of patient portal log-in
  • The care team can get quick answers in the discharge planning process, or to address infection risks such as indwelling catheters because colleagues inherently respond to texts more quickly than email or phone calls – given that indwelling catheters cause roughly 25% of hospital infections and poor communication is known to delay catheter removal, easy communication is a priority
  • Secure video sessions allow multiple specialists or care team members to confer with a patient in one collaborative virtual visit
  • A nurse can efficiently check in on a hospital-at-home or post-op patient in between other tasks; these virtual texting interactions support native workflow and a video visit can be initiated on-demand to support patient needs
  • The care team can asynchronously communicate with a patient’s family or caretaker once again producing time savings by not playing phone tag and better supporting the family’s information needs
  • A nurse can provide video-enabled virtual (re)education on wound care or equipment operation
  • A worried patient can share a photo of the incision with the surgeon to determine the best course of action and avoid emergency department visit
  • An OR team can message nervous family members in the waiting room of any complications that may be prolonging surgery time
  • Interdisciplinary teams can coordinate care from remote locations to prevent readmissions through secure group texting conversations
  • Inpatient nurses can securely communicate with a patient’s family member about the care of their dying COVID+ parent including video sessions, so the family can see and interact with their isolated parent remotely

These examples of virtual care incorporated into everyday operations aim to improve the patient experience described by the Agency for Healthcare Research and Quality (AHRQ) as follows:

“Patient experience encompasses the range of interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities. As an integral component of health care quality, patient experience includes several aspects of health care delivery that patients value highly when they seek and receive care, such as getting timely appointments, easy access to information, and good communication with health care providers.”

Dissecting this reflection of patient experience highlights significant gaps in current care delivery models, many of which are resolved through effective clinical communication and collaboration solutions:

Patient Experience Components

Current State Reality

Interactions that patients have with the health care system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other health care facilities:
  • Coordinating chronic care across multiple providers continues to be a challenge resulting in duplication of services and medical errors. For example, searching for data from an outside EHR system can take so long that it is often faster to redo a test.
  • Pre-authorization and coordination of health benefits with health plans require time-consuming phone tag and wait time, resulting in care scheduling delays, and patient and care team frustration.
  • Clinical teams in the hospital use legacy pagers to contact physicians and other specialties to address patient needs. This process results in lag time, inefficient call-back processes, and even instances where staff does not discover they are paging the wrong person until multiple pages and significant time is wasted. The associated patient treatment delays can influence care outcomes and length of stay in the hospital.
  • Physicians struggle to manage EHR message baskets, often not reading important messages until the end of the day when the people necessary to resolve the concern are already gone for the day. This often results in patient care needs not being addressed until the following day.
  • Healthcare facilities and clinicians play merciless rounds of phone tag to coordinate patient care. It can take hours and even days to make post-acute care and durable medical equipment (DME) arrangements. Remaining in the hospital while such arrangements are made increases the risk for hospital-acquired conditions (HAC) and increase the cost of care.
Patients highly value getting timely appointments, easy access to information, and good communication with health care providers:
  • Communication challenges are not just a patient and staff dissatisfier; information silos and poor communication leads to demonstrable challenges across clinical and financial performance indicators. For example, 70-80 percent of medical errors include gaps in communication as a root cause, and communication failures are a contributing factor in 30% of medical malpractice claims.
  • When patients have a question or concern about their health or medication it typically results in phone tag with the provider office which can go on for a couple of days, as the staff is rarely available to speak at the moment a patient calls.
  • Patients prefer texting over logging into a patient portal, yet texting is not widely available between patients and care teams.
  • Patients express frustration regarding the time it takes and the process for receiving test results. For example, negative test results may be mailed to patients; patients may be asked to use a portal to view results with little guidance on the timing of result availability which results in patients frequently logging into the portal to check, and recheck until results are posted.
  • Scheduling appointments often requires long wait times or online portals ill-designed for patient ease of use
  • Communication and collaboration across the patient care team are fragmented and dependent upon manual processes vulnerable to delays such as pages, calls to nurses station, use of answering service and daily huddles; many care teams have yet to implement secure messaging to quickly and easily reach the right person at the right time.

These gaps are not insurmountable and it is safe to assume that patients will have increasing expectations for virtual care long beyond the pandemic. As healthcare organizations reimagine the way care is delivered by enabling virtual care communication and collaboration technologies, investments in proper implementations and purposeful focus on patient and clinician experience will bring an organization closer to achieving higher quality care at a lower cost that doesn’t come at the expense of healthcare staff’s well-being.

Remember, the goal is not simply to provide a virtual video visit, it’s to effectively enable the entire care team to operate efficiently, safely, and in a more human-centric way within this increasingly digital and virtual world.

 

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Simple and secure virtual communication for providers and patients

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What about strategy?

At the heart of healthcare are human beings caring for human beings and virtual care technologies empower the compassion of care as well as clinical excellence. As your organization establishes a blueprint for virtual care, consider these guiding principles to increase opportunities for human connection, to reinforce mission and purpose, and reduce clinician burnout:

  • Make communication convenient for patients, families, and the care team. For example, the ability to secure text with one or many, and to switch from a call to a secure on-demand video when a face-to-face conversation is needed to provide more personalized care
  • Avoid tethering clinicians to the computer; rather integrate key EHR and monitoring alerts into more mobile-friendly options
  • Unapologetically embrace human-centric technology – appreciate human behavior trends such as patient preference to text versus using portals, and the preferred convenience of virtual care
  • Utilize flexible technology that allows seamless communication internally across all clinical and non-clinical staff and externally with patients and family in a single, vendor-agnostic application that allows integration with the various systems such as scheduling, lab, and EHRs

Finally, consider virtual care as a way of life and not merely an isolated telehealth video visit.

Seamless care experience can only happen if nurses, physicians, patients, and the entire care community are connected and collaborating. Click here to explore how TigerConnect helps healthcare teams to get the right information to the right people, at the right time to make virtual care and patient engagement a sustainable reality.

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