Framework for a Successful Telehealth Implementation


Few would argue that today’s healthcare landscape is a bit unpredictable, with ever-changing demands from regulatory bodies placing immense pressure on provider organizations. No sooner do providers adapt to existing healthcare policies before new legislation is passed and they are forced to pivot. Small provider groups in particular are struggling to keep up with demands to increase patient access to care while continuously decreasing costs. In addition, with the transition of the patient to the “consumer”, patient choice is driving patients out of their own doctor’s office and into the waiting room of providers with shorter wait times, increased availability and on-demand visits. As a result, many small providers are struggling to effectively manage their resources, meet industry guidelines, and remain financially viable.

In an effort to keep up, many providers today are turning to Telehealth as a way to attract and retain patients, reduce the cost of care for routine visits, increase patient and provider satisfaction, and increase patient access, volume and throughput. Yet, despite the abundance of information available to providers about the various Telehealth technologies and implementation strategies, many providers struggle to implement a “successful” Telehealth program, often failing to either see a return on investment, adoption, or both.

So what can healthcare providers do to build and launch a successful Telehealth program? The answer may vary from provider to provider; however, there are a number of key steps that can be taken to ensure a smooth and successful Telehealth implementation.

Note: For the purposes of this article, the term “Telehealth” refers to synchronous video consults between a patient and a healthcare provider.

Define Success
First, providers must determine the goals of the Telehealth program and define what “success” means. What is the problem you are trying to solve? For some, it may be increasing cost savings by decreasing the number of missed appointments. For others, it may be converting “on-call” moments or “triage” calls into telehealth visits to drive new revenue. For others still, it may be reducing the cost of care for patients, lowering readmission rates, or improving patient satisfaction through shorter wait times and greater flexibility. Whatever your goals are, they must be clearly defined, quantified, and agreed across your organization to ensure program success.

For example, when CMS mandated that healthcare providers implement an EMR, the goal was often clear – to meet Meaningful Use criteria. When implementing a Telehealth program, organizations are left to define these goals for themselves. Just like any other instance of goal setting, the outcome should be measurable and achievable. For smaller provider organizations, it’s often best to focus on specific milestones that can easily be met and celebrated. Provider organizations should not set out to achieve every goal at once, rather they should prioritize these efforts and maintain focus on one or two manageable goals at first.

Determine Strategy
“Investment” Planning: When designing the strategy, it’s best to focus on “how” you will achieve a successful Telehealth implementation. Like all other projects and initiatives, a Telehealth implementation should be viewed as a significant investment. Whether you are spending millions of dollars to build a homegrown solution or implementing a small-scale program with little financial investment, organizations must understand that there are major time, resource, and energy investments that cannot be overlooked. How much time are you prepared to invest across the organization? Who will be involved? How difficult will this implementation be as an organization and for individuals? Ensure your organization is prepared to endure the implementation and committed to its success.

Scheduling: One of the most critical steps in building an effective Telehealth strategy will be to identify the scheduling model. Fundamentally, there are two different approaches that can be taken: provider-directed scheduling or direct to consumer. In the direct to consumer (DTC) model, patients decide when and with whom they would like to see, requiring providers to open up their schedule to patients, often times limiting the amount of control they have over what patients they see. In a provider-directed model, the provider maintains control over what patients they see, for what reason, and when. Because the provider can more easily control the visit parameters, this is typically a more suitable model for initial stages of the program. This model gives providers a chance to figure out what works and what doesn’t, to identify what types of patients and use cases are best suited for their practice, and to adapt to a new technology in an already familiar workflow. Once providers become more comfortable with Telehealth and as more patients become aware of the service, then it is easier to implement a DTC model.

Use Cases and Patient Identification: Once the scheduling model has been worked out and agreed with the program leaders, organizations should identify specific use cases and patients who will likely be a strong fit for Telehealth. Tech savvy, younger patients needing a prescription refill or routine follow-up visits are great examples. Start small and focus on quick wins. However, in order to achieve the goals of the program, it will be critical to evaluate progress often and expand scope as the program matures.

Patient Engagement: The final component of the Telehealth strategy is to design a patient engagement strategy. Even in a provider-directed model, adoption and increased utilization will be driven by the patients. Whether it is through email campaigns, website marketing, or posters in the waiting rooms and exam rooms, it is essential that provider organizations discuss which approach to take, how engaged they want patients to be, and when to begin. Since many smaller provider organizations don’t have a dedicated marketing team, it’s worth noting that many Telehealth technology providers offer marketing support or can provide recommendations for how best to engage patients.

Prepare for Organizational Impact
One of the most common reasons that Telehealth implementations fail is because organizations often underestimate the amount of time and resource commitment needed to stand up a Telehealth program. It isn’t just the care team who must be trained and engaged, the schedulers, billing teams, and administrators (among others) are equally crucial to the success of the program. Often small provider organizations don’t have the financial means of bringing on a dedicated resource to manage the program, so they must decide who will take responsibility for patient engagement, program management, marketing support, customer support, etc. when everyone in the clinic is already at capacity.

Further, organizations must ensure that any changes to the people, processes and technology underpinning the Telehealth program are realistic, achievable, and clearly communicated to the responsible parties. Think through the technology requirements, possible organizational changes, impact on provider workflow and staff training. For example, if the schedulers are used to scheduling in an EMR and now they need to schedule in another system, how large of an impact will that become? Will there be resistance? Similarly, can providers be easily trained on the new technology or will it be cumbersome, causing resistance? Make sure people understand their future role and set expectations.

The Telehealth transition can be a bumpy road for some providers, so it’s important that strong program leadership is established early on and maintained throughout the implementation. To achieve this, it’s crucial to identify key providers who will champion the program. These individuals should be engaged and “forward-thinking”, willing to endure any obstacles early on as the kinks are worked out, and capable of enabling organizational buy-in through effective communication and leadership.

Change is difficult – for both people and for organizations. Understanding the full scope of this change and planning for risks ahead of time will be crucial to the program’s success. Look to the past for examples of recent projects or technological changes that your organization has endured. What can be learned from those experiences and applied to the Telehealth program to ensure it succeeds?

While Telehealth does have the potential to solve many challenges facing healthcare providers today, it can be risky and frustrating if not done thoughtfully. While there isn’t a single formula for success, if organizations spend the time defining the program goals, strategy, and preparing for potential organizational impacts, challenges can be intercepted before they become issues. Keep it simple, commit the necessary time and resources, engage stakeholders, and be patient. Organizations that follow this simple framework can and will achieve success.

About The Author

Ashley Amaral
VP Commercial Delivery
OTTO Health

Ashley came to OTTO Health with over 10 years of experience in the healthcare space. Most relevant was her role as Telehealth implementation manager at American Well. More recently, Ashley worked at a management consulting firm, helping healthcare clients implement value-based care programs to improve access to affordable care for patients, such as building ACO strategies and designing and implementing IT transformation programs.