Why the Rapid Rise of Telehealth Demands New Solutions for New Silos in Care

COVID-19 has rocked the nation, putting extreme pressure on providers to field a tsunami of urgent, virus-driven illnesses while still maintaining access to routine and acute care. In the early days of the pandemic, telehealth swooped in as the answer, transforming a venerable but underutilized strategy into the new face of the healthcare system.

Video calls and remote patient monitoring offer providers a way to limit exposure as we grapple with keeping patients and providers safe without compromising high-quality care and exceptional experiences.

But the benefits of telehealth go beyond the immediate needs of social distancing. Telehealth can improve convenience and increase access, especially for vulnerable populations. If there is a silver lining to such a terrible event, it’s that stakeholders across the care continuum are beginning to think about remote care as a permanent addition to their health IT toolkits.

Approximately two-thirds of patients would like to continue using telehealth after the pandemic as a complement to in-person care, The Harris Poll found in late 2020. Providers seem similarly happy to take some of their relationships online, with 68 percent signaling increased motivation to integrate telehealth into their practices and 55 percent noting improved job satisfaction, according to a separate Mayo Clinic survey.

There are a few problems with telehealth, however. Licensure protocols and reimbursement frameworks haven’t caught up with the explosive adoption rate. Neither have our health IT workflows and data delivery strategies. If we are to maximize the opportunities that telehealth presents to us, we need to act fast to improve integration, sustain high satisfaction rates, and avoid creating new silos of care.

If there is a silver lining to such a terrible event, it’s that stakeholders across the care continuum are beginning to think about remote care as a permanent addition to their health IT toolkits.

The growing pains of a telehealth ecosystem breaking out of its shell

Telehealth has been around in its basic form for decades. Up until the early 2000s, it evolved slowly and haltingly, similarly to the rest of the health IT environment. Early EMRs were little more than digital copies of existing paper-based charts, and telehealth was just a regular visit transposed to a computer screen.

The limitations of both, however, have become painfully obvious as the industry’s needs – and adoption incentives – have accelerated.

Just as the EHR Incentive Programs were the catalyst for EMR improvement, the COVID-19 pandemic has become the spark that is prompting telehealth companies to rapidly proliferate.

Hundreds of innovators are vying for a piece of a pie estimated to be worth $43 billion by 2026, trying to become the next must-have partner in the quest for better outcomes and lower costs.

Some of these companies are designed to work within the existing primary and specialty care settings, but others are targeted straight to the on-demand consumer, offering easy access to low-acuity care and prescription drugs without the direct involvement of an existing care team or health plan.

It seems likely that we will see the same consolidation among telehealth companies that we have seen in the EMR landscape. As the market shakes out, however, we also risk seeing the same lack of meaningful integration with existing infrastructure, leading to overly convoluted workflows, undue cognitive burdens for providers, and frustrating experiences for patients.

Do telehealth workflows really work for providers and patients?

Unfortunately, telehealth and EMRs are evolving in parallel, not in synch. With telehealth largely viewed as a one-off for bringing in a specialist or connecting with a homebound patient, there have been relatively few efforts to make it a standard part of the EMR or the data analytics engines that underpin provider workflows.

In the same Mayo Clinic survey, 58 percent of respondents said they still lack the tools to access, schedule, and launch telehealth visits within their EMRs. This may force providers into shadow workflows that require switching back and forth between the telehealth platform’s documentation screens, the EMR’s documentation features, and the video picture of the patient they’re supposed to be treating. Combined with the physical stresses of staring at a computer screen for hours at a time, providers using these fragmented, duplicative strategies are subject to unnecessary cognitive pressure and potential burnout.

There is also a significant risk of data being lost or siloed during these visits, leaving care providers in the dark about what exactly happened during a telehealth consult. The risk is even higher with the no-insurance-required, on-demand companies that can make diagnoses and prescribe medications without even generating claims data.

With telehealth comprising nearly a third of all visits in 2020, we must develop better methods of generating, storing, retrieving, synthesizing, and presenting telehealth data to providers.

Without an integrated, precision approach to documenting and sharing information – and making decisions based on that data – we will never achieve true parity between virtual visits and in-person care.

There is a significant risk of data being lost or siloed during telehealth visits.

Devising new solutions for a new era in telehealth

We have previously discussed the idea of the “new destination” in healthcare IT, where access to precise, personalized, comprehensive care is not restricted to a single modality. To reach the new destination, we must transform our isolated pockets of data into a seamless healthcare knowledge supply chain that treats virtual visits exactly the same as face-to-face consults.

We already know that intelligent information access is the key to reducing cognitive burdens, preventing walled gardens of information, and activating care teams to collaborate proactively with patients in person and online. Now we have to put it into action.

Doing so will require meaningful investment from across the healthcare system, from regulators and professional licensing boards to health plans and health IT companies. There must be clear and sustained incentives (both financial and clinical) to adopt interoperable, integrated telehealth technologies, whether these tools are provided by the EMR vendor or a third party.

These technologies must be based on widely accepted standards and offer intuitive workflows that help providers feel in control while keeping patients at the center of care. Adding functionalities to collect and synthesize data from home-based remote monitoring devices, smartwatches and fitness trackers, and other critical data sources will only enhance the patient-provider relationship and foster informed decision making.

To bring all of these capabilities together, we need a new generation of tools to sense, retrieve, and precisely deliver relevant, contextualized, and timely data directly to providers when and where they need it most: directly within the EMR workflow.

Even after the pandemic is over, telehealth use will likely be here to stay.

Fortunately, we have a chance to learn from our past and avoid repeating the mistakes of the health IT adoption cycle. We don’t need to suffer through another round of fragmented data, burnt out providers, and aggravated patients. We can act immediately to make the regulatory, cultural, financial, and usability changes required to turn telehealth into a seamless component of a coordinated care continuum.

If we take advantage of today’s emerging technologies for simplifying and enhancing access to precision insights, we can successfully bring telehealth tools into the fold and architect a silo-free environment for the future of virtual care.