An Overview of Telehealth

A telehealth program involves much more than technology. To save time, effort and money, plan ahead to make sure your organization is ready. Begin with these elements:

Understand who is championing the effort. This will help establish the initial focus of your program. For example: If the person promoting telehealth services is your ER physician, one of the first areas for the program will probably be stroke care.

Determine why your organization wants to provide telehealth services—whether doing so supports the organizational mission, provides a competitive advantage, has been requested by patients and providers, and so on.

Conduct a wider assessment of your organization to identify what additional services are needed—and whether and how program costs will be shared. This exercise will help determine what equipment you will need to buy.

Decide if your organization will receive services, provide services, or both. Doing this will help you identify where your potential partners are, and the kinds of conversations you will need to have with them.

Learn more about how to move forward.

Best Practices for Success

The availability of funding and equipment help make telehealth programs possible—but to succeed, a telehealth program must align with the goals and purpose of the organization that implements it. Your project should support the organization’s strategic initiatives, and the overall culture of your organization should encourage a successful implementation. You must have reasonable confidence your providers will use it, and that any external partners will be involved and committed.

You will need to carefully consider these and other best practices to determine whether you and your organization are ready to begin a telehealth program or project.. Telehealth has been identified as a viable component for many of the healthcare services now being considered at local, state and federal levels.   Once you are confident about your decisions and direction, you must also evaluate the way telehealth services are being used to meet needs and eliminate disparities.

Technology Requirements

To determine what equipment you will need to buy, start by understanding what your initial program services will be, as well as your planned service growth. A survey among your stakeholders, or an organizational needs assessment, will help you identify what functionality you need, which will make your equipment requirements clear.
Always begin with your goals, never with the technology. Here is an example that shows why an electronic stethoscope may be a good choice, and why it may not:

If you plan to provide or receive clinical services, an electronic stethoscope will be a valuable part of your telemedicine equipment. If your first service is mental health, however, you can probably wait on the stethoscope. But if you plan to receive infectious disease services, a stethoscope is important to include—and so is an additional camera that will allow for close-up pictures.

Many organizations have purchased equipment that is not as productive as they expected, usually because their needs have changed or they were not clearly identified in the first place. If this describes your organization, you are not alone; this is very common. Review the information below for ideas that can help you make more effective use of existing equipment.

Moving Ahead with gpTRAC

Once you have determined that providing telehealth services will be valuable and you have an idea how those services align with other activities, what is the next step? One of our main responsibilities is to help you find the right starting point.

gpTRAC can walk you through a readiness assessment, help identify technology options, find others who provide similar services, answer reimbursement questions, and more. If your organization is not within our service area (ND, SD, NE, IA, MN and WI), we can connect you with the telehealth resource center (TRC) that serves your region. And if your area does not have a designated TRC, we will provide whatever assistance we can. No matter where you are in the United States, we can help.

Patient Perspectives

It is all about patient care! That is the MAIN reason why organizations are providing telehealth services. AND…patients love it! When a patient is able to receive the care they need in the community where they live from providers they know and in a facility they know how to navigate…what is not to love?!

Healthcare services provided using telehealth technologies have offered patients greater flexibility to manage their health and care. Patients are able to avoid some of the expenses (travel, time away from home/work/family) and challenges of receiving enhanced specialized care. In some cases, accessing services via telehealth may be the only option for receiving the care they need, because traveling in-person to receive their care is simply not an option.

Laws & Regulations

Telehealth services are covered by several laws and regulations. This includes licensure, credentialing and reimbursement, appropriate scope of practice guidelines, prescribing laws, and more. These may vary by state, making a multi-state program complex and challenging. Some information about these topics is available online, but general references may not answer your specific questions in sufficient detail. Call us with your questions about legal requirements. We will be glad to help.

Procedures

It is important to have a plan in place to successfully implement your new services. Understanding that telemedicine and telehealth are viewed mostly as tools to providing quality care, it is still important to establish a structure to work within to encourage long-term success and to plan for on-going service improvement. If people don’t understand the expectations, it is really difficult to meet them. That is where clinical and operational policies and procedures are helpful. Here you will find ideas and examples of procedures and policies that might be helpful to consider as your own services are developing.

Operating Structure

No two telehealth programs are exactly alike. Most are designed to meet needs based on factors such as geography, demographics, and medical specialties. This often means their operating structures are very different.

To determine how a telehealth program will operate within your organization, begin by identifying who will perform central tasks. These roles must fit within the workflow and structural hierarchy of your organization, and the person who initiates a component of the program may be different from the person who maintains it. Start by assigning names to these roles:

• Administrative champion
• Clinical champion
• Day-to-day operations manager
• Remote (patient) site coordinator
• Patient care/clinical services coordinator

You will also need to consider the physical location of your telehealth operations. You may decide to integrate them with on-site services to consolidate functions, or you may choose to create a more autonomous department.

Financial Planning

Telehealth can be considered a service or a tool. Defined as a service, it would likely be expected to track its own revenue and expenses, and to show a positive impact. Defined as a tool, however, it may be viewed as a component that helps support and improve the overall quality of patient care services, within already established service lines. The effect would still need to be positive, if indirect.

Depending on the way your organization views telehealth, you will need to track different factors:

• If telehealth is viewed as a way to support facilities and providers located in rural areas for your region, you will want to track the impact telehealth has had at these remote facilities by knowing the number of in-patient visits, out-patient visits or ancillary services performed.
• If telehealth is viewed as a method for strengthening referral relationships, you will want to identify current referral patterns, and whether have they changed.
• If telehealth is viewed as a tool in your organization’s overall quality improvement goals, you need to ask what the goals are, and how telehealth will be incorporated.

Once you have determined which questions are most important, and have enough information to provide sound answers, financial planning for your telehealth program development and implementation will be clearer. When you know the goals your telehealth program will support, you will be able to better determine, and plan for, the long-term financial impact.