It's tempting to think that the explosion of telehealth over the last year and a half has converted even the most reluctant physicians into telehealth advocates. External telehealth surveys report that 80% of physicians have used telehealth during the pandemic and 70% of physicians expect to use telehealth in the next three years.
At the same time, leaders tell us that it's primarily reimbursement (whose future is still unclear) that will determine how physicians will use telehealth in a post-pandemic world. If there's parity or close to parity, physicians will continue offering telehealth as an option to patients. If not, they'll largely move back towards in-person care.
But we can't let reimbursement be the only factor that dictates the future of telehealth in a world where patients are demanding high quality digital experiences and disrupters are ready to provide those experiences where incumbents fail to do so.
Even in the absence of guaranteed reimbursement parity, health care organizations can use telehealth to further strategic goals which means they'll need to make telehealth an attractive option for physicians. Not only can physicians torpedo any initiative they don't support, but they also have the most influence over a patient's decision to use telehealth.
Leaders need to address technical and adaptive challenges to get physicians on boardGetting physicians' buy-in is widely known as the first step of any successful initiative. Yet it's easier said than done. There are countless examples (EMR implementation, open scheduling) that show what happens when organizations fail to win physicians over. Some of this difficulty can be attributed to organizations' choosing to focus on technical challenges at the expense of adaptive challenges
The tendency to focus on technical challenges is understandable. Technical challenges are valid and need to be addressed, and they are also often the "table stakes" of change management.
For example, telehealth solutions should fit into physician workflows, integrate with the EHR, and ensure security and patient privacy. But too often leaders choose to focus on technical challenges alone because they're easy to identify and easier to address than adaptive challenges.
Adaptive challenges are not only more challenging to solve, but harder to identify. Physicians often have trouble verbalizing the adaptive challenges they're facing—loss of autonomy, reluctance to change, and fear of the breakdown of the patient-physician relationship. Culture, specialty, and patient mix also factor into what kinds of adaptive challenges exist for each physician.
Executives and clinicians appear to diverge on adaptive and technical barriers. Clinicians more readily agree that adaptive challenges are just as important as technical challenges; executives are more likely to assert that technical challenges are the only barriers.
This difference in perspectives makes overcoming adaptive challenges difficult because it often means shifting organizations' decision-making protocol to be inclusive of physicians and frontline staff from the beginning—rather than the more common top-down leadership style that was especially common during the beginning of the pandemic.
This is a reminder to leaders to think about all types of challenges—even the ones that are difficult to identify. You don't want to solve all the technical challenges and be left wondering why physicians still won't use telehealth.
We are currently researching this topic. If this is a topic of interest and you'd like to participate in our research, please email email@example.com.