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You promised a telehealth revolution after Covid-19. Don't backslide now.

By Rachel Woods

July 1, 2020

    In addition to hosting our podcast, Radio Advisory, my role at Advisory Board allows me to converse with health care executives across the country—and since Covid-19 hit, nearly every single one of those conversations has involved telehealth. But watching how this conversation has evolved from the start of this crisis to where we are today—and where we'll go in the future—has raised a critical, uncomfortable question: If leaders should never let a crisis go to waste, why would we allow this moment—when we are literally still in a crisis—to allow ourselves to backslide to the "normal" way practicing medicine?

    Ready-to-use slides: How Covid-19 is transforming telehealth⁠—now and in the future

    A 'real change'—and then a 'startling decline'

    Let me explain: During these conversations with executives, even in the worst moments of the crisis—when some organizations had only days' supply of personal protective equipment (PPE) remaining—executives were eager to tell me: "Covid will absolutely transform the way we deliver care," or "We've innovated more in the last few months than we have in the last few years."

    And for several weeks, the data reflected a real change. March and April saw exponential increases in telehealth use: Plans processed hundreds of thousands of telehealth claims, and providers added hundreds of physicians to rapidly built platforms. And at the time, health care leaders told me they expected telehealth to be 50% of their business going forward. (To be clear: These weren't scientific predictions by any stretch, but goals based on the explosion of interest and use of telehealth.)

    But time went on. Priorities began to shift, and some longstanding barriers to telehealth came crawling back into the conversation. Questions remained about long-term reimbursement and clinical appropriateness. Physicians wanted to come out of their home offices and into their practices. And everyone (including me) felt exhausted by the pace of change.

    By mid-May, these rough estimates on the future of telehealth had shrunk from 50% of volumes to between 25% and 30%. And in June, as I continued to push leaders on telehealth, few had any specific target in mind—and those who did still considered that goal merely a reasonably thought-out guess.  

    This rapid decline in the willingness to carry crisis-driven innovation into the future is startling. And as we enter July, I hesitate to think how leaders will approach their efforts to implement and scale telehealth.  

    To remain competitive, providers can't return to the 'old way' of practicing medicine

    The first priority for most providers was to deliver some type of telehealth, even if that meant using platforms such as FaceTime or Zoom. But soon (if not already), organizations will have to compete in a market where delivering virtual care better than a competitor will make a difference—especially when that competitor can be local, national, or even global. Some backslide may be inevitable, but leaders and providers must to resist the gravitational pull of reverting to the way they've always done things. 

    The truth is, Covid-19 was never going force you to do telehealth. At least, not in the long term. The only way to carry the momentum of telehealth profitably into the future is to ground telehealth innovation in an existing business goal. Don't ask, "What should my telehealth strategy be?" Instead, ask, "How can I embed telehealth into the new or evolving business goals of my organization?"—and keep in mind that business goal might look different across patient demographics, reimbursement models, and physician specialties.

    How to take telehealth from pilot program to profitable solution

    But an A+ idea with C+ execution will fail every time. Once leaders have grounded that innovation in a business goal, they must take several steps to ensure success—chief among them an overinvestment in implementation. That means charting a phased implementation plan that maximizes existing resources and fills gaps where necessary—and it absolutely means using every opportunity available to engage providers, generating buy-in and holding them accountable for telehealth adoption and performance. And it means getting to a real and defensible goal for telehealth volumes. 

    Broken down into six steps, leaders aiming to implement a successful telehealth initiative should:

    1. Ground telehealth in an existing business goal;

    2. Identify an innovation leader who can helm the effort—and support that leader in implementation and leadership;

    3. Conduct an internal resource audit to leverage areas of strength, identify areas of weakness, and strategize about how to invest accordingly;

    4. Overinvest in a phased implementation plan, one that—as discussed above—is easily adaptable based on feedback;

    5. Ensure your telehealth initiative is seamlessly integrated in the EHR; and

    6. Never stop selling to your physicians—remain flexible, open to feedback, and communicative as the innovation matures and changes.

    To learn more about how to develop and implement a successful innovation—in telehealth and beyond—download our infographic.

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