The Growth Channel

Direct-to-consumer telehealth do's and don'ts from early adopters


Direct-to-consumer telehealth has had to overcome some significant bumps in the road. While many health care organizations see its potential to meet the needs of a consumer-driven market, policy hurdles and operational challenges have made it a difficult aspiration for many providers to pursue. But things are about to turn around.

Telehealth policies are looking up in 2016, and many of the operational roadblocks that once prevented most organizations from adopting virtual capabilities are eroding—in fact, predictions indicate virtual visits will exceed 25 million by 2020. As these barriers deteriorate and more players enter the market, an increasing number of best practices are emerging.

Direct-to-consumer telehealth is a relatively new territory. Many of the earliest adopters have fared well in the landscape, but as with anything new, there have been lessons learned. As we enter a new era of health care, one where most organizations will soon be redesigning care to include virtual capacity, I wanted to share what I’ve seen work—and not work—so far.

Don’t view virtual care as its own strategy

When I’m meeting with a health care executive who’s interested in offering virtual visits, they often describe it as “a strategy they’re pursuing.” But a virtual care program (or set of programs) should not be positioned as a standalone strategy. Rather, it’s a capability that can enable strategy, and is often best used as a stepping stone for achieving a larger goal. So it is important to first focus on the strategic goal(s) the organization is trying to meet, and then map out how virtual visits can efficiently enable those goals to be met.

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Flipping the view of virtual care from a strategy to an enabler also helps organizations better identify the full value such a capability can provide—which is something many leaders struggle with when they see paid ER or primary care visits (on the face of it) being replaced with virtual visits that yield lower reimbursements.

Do strike a balance between too much, and too little

I generally see virtual care programs that fall flat go in one of two directions: efforts were either too broad, or too narrow. More often than not, I’ve found that those in the latter group are focused only on virtual urgent care—a great supplement to a consumer strategy that can be brought to market quickly, but can be overly narrow in focus. By not thinking through how virtual care fits into the overall consumer strategy, these organizations miss out on other critical pieces to the consumer loyalty “puzzle” that virtual capabilities can help solve, like follow-ups and in-network referrals—leading those organizations to fall short of their goals.

On the other side of the spectrum, however, I’ve also seen organizations struggle with taking on too much at once—usually because they’re so passionate about how virtual visits can impact patient care. While it’s exciting to see these organizations so motivated, they often try to implement too many virtual programs simultaneously, from urgent care and primary care visits, to telepsychiatry, teledermatology, and so on. With so much support needed in the early stages of these programs—including clinical workflow mapping, technical support, education, and marketing—working across too many programs at once means resources get spread too thin to make a sustainable impact, or sometimes even notice an impact.

I find organizations can find a “sweet spot” between the two by creating a virtual care plan that is a means to multiple ends that tie back to the core strategic opportunity the organization is trying to capture. For example, many start with a focus on urgent care, and clearly outline the intended care pathway and linkages—but then also make sure the roadmap and technology used for the urgent care pilot are broad enough to be adapted to other virtual capabilities down the road, like primary care, specialty follow-ups, and chronic care management. Additionally, they ensure there is a clear focus on measuring—and balancing—the clinical, strategic, and financial goals of their programs.

Do educate everyone, and more than once

While it may seem second nature to the executives that live and breathe this every day, the concept of direct-to-consumer telehealth is still relatively new to both providers and consumers, and few understand the appropriate uses for it yet. For instance, when is an in-person visit more useful than a virtual one, and how do patients go about finding the right providers virtually? Introducing these new service categories creates an outsized need for both consumer and provider education, and the quicker providers latch on to the idea of the virtual visit, and staunchly promote it, the sooner they will yield the intended outcomes for adoption and program growth.

Looking ahead

While the policy-challenged era of direct-to-consumer telehealth may be coming to an end, we still have a lot of work to do to get to a place where virtual visits are being used to their full potential. Right now, virtual care initiatives need to balance out strategy, provider passion, and financial stewardship to be successful—but as more organizations take the virtual path, we will undoubtedly find more methods to fine-tuning the approach.

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