The candy-colored wearables…the souped-up medical carts…the algorithm-enabled triage and cockpit-like dashboards! Telemedicine technology and tools available today are so appealing and so clearly useful that you may be tempted to just buy something now and then figure out how to fit it into your organization. On the other hand, you may feel afraid to make any decision, overwhelmed by the sheer number of virtual medicine options out there. Here’s a tip: before you make a move, ask yourself these questions.
1. What will success look like when you have achieved it?
Maybe you want to avoid penalties for post-op patient readmissions, or load balance your practitioners across multiple facilities. Maybe you see an opportunity to win contracts for providing urgent care to Skilled Nursing Facilities by preventing unnecessary trips to the Emergency Room. Or as an Accountable Care Organization, you want to improve outcomes and reduce the expenses for your highest cost outliers. These are great projects! Take the next step and write down simply and clearly what “done” and “accomplished” will look like. (Share it broadly within your organization, too.) Being really clear about your outcome will help you achieve it.
2. How well is your virtual medicine project aligned with what you currently provide?
When adding a virtual care element to your current program, it’s best to work within your existing workflows as much as you can. Your staff (and patients) will find it much easier to accommodate something new if the process is familiar. So, for example, if you can keep the scheduling process the same, whether the visit is virtual or on-site, that’s a win. On a related note, try not to wall off or separate your virtual care program from the other things you do. Integrate it. Make it clear delivering virtual medical care is destined to become part of “the way we deliver care here.”
3. How comfortable is your staff with technology? Your patients?
The technology that supports virtual medicine, from the simplest e-consultation to a telemedicine assisted surgery, is very exciting to many people. But some people are not yet comfortable with virtual medicine. A nurse may be reluctant to look foolish at a patient’s home if she struggles with a device. A patient may not have the confidence to successfully use telehealth devices to monitor her hypertension. Make sure you address and mitigate these very human concerns as part of your implementation plan.
4. What is your virtual care program’s impact on your bottom line?
In considering the financial impact of providing, or utilizing virtual care, start by getting a handle on your cost of care delivery today. Then you can compare it to the new cost of care using a virtual solution. Here are 6 primary elements of that cost equation, and a sampling of associated line items, which vary based on your specific situation:
- Start-up investment in the solution (equipment, peripherals, software, tablets, cell phones, consulting, training, initial supplies)
- Ongoing cost of operation of the solution (new or reassigned FTEs, travel reimbursement for telepresenters, transaction fees, maintenance fees, language translation fees, changes to billing fees)
Then consider the revenue and benefits:
- Direct revenue produced by the solution (e.g., Fee For Service reimbursements, Per Person Per Month payments, based on your contracts and entity type)
- Indirect revenue (hospitals: lower ALOS and more inventory for highest value hospitalizations, clinics, and practices: follow up visits)
- Savings or avoided costs realized as a result of the solution
- Intangible benefits (more attractive to patients and providers, preparation for value-based payments, stabilized patients, greater appointment capacity, etc.)
To be sure, these four questions – and many others! — will arise in the course of your project. But if you take time in the beginning to consider them and their implications, you will be likely to design a better virtual care solution, and enjoy greater success.