As health care costs increase and reimbursement rates decrease, health care organizations are realizing the need to establish flexible and sustainable care models for the future. New, innovative care models are needed to improve access to care that also can extend care beyond current patient markets without the high costs of traditional bricks and mortar. With a low barrier to entry, many clients are leveraging telehealth to address these needs.
While many organizations have implemented telehealth over the years, some are realizing significant value while many others are failing with low physician/patient adoption rates and little-to-no realized benefits. The difference between telehealth success and failure can be directly attributed to how quickly the organization accelerates to an advanced and mature telehealth program.
Organizations have realized the limitations with independent, departmental telehealth services. The utilization of telehealth is shifting to a more centralized, enterprise-wide, program-based approach. A mature and advanced telehealth program can provide organizations with a more flexible and sustainable care delivery model that offers increased market share, improved patient population management and increased revenue potential. The value can be realized, but the challenge is determining where to begin and how quickly to scale to an advanced and mature telehealth program.
Health care organizations that want to advance their telehealth program should first evaluate their current level of telehealth maturity and then target where they want to be in the future. In working with many different telehealth clients over the years, I discovered a wide variance in how Telehealth was implemented and the associated results. There was a need to develop a Telehealth Maturity Model to define the various stages of maturity and then help clients advance their programs to success. The diagram that follows illustrates our five stages of telehealth maturity along with the associated criteria that define each stage.
What Stage of Maturity is Your Organization?
Stages 1 and 2: Organizations in Stage 1 and 2 have independent, department-level telehealth solutions. Telehealth in this stage is typically department funded and utilized disparately for specialized clinical cases. This is where a large percentage of healthcare organizations using telehealth are today. These telehealth services are often independent systems that are not integrated with the hospital’s EMR. Unfortunately, these organizations typically are not realizing much tangible value from telehealth and often have physician/patient adoption issues.
Stage 3: Organizations in this stage represent the advancement to a central telehealth program. A telehealth program consists of multiple Telehealth services that are aligned with the needs of the local/regional market. A telehealth program in Stage 3 must have a strong foundation to support the advancement of the program, including:
- Scalable strategy that is aligned with the direction of the organization
- Centralized and dedicated service-oriented telehealth organization
- Clinically and operationally focused enterprise governance to help guide the direction of the program
- Executive-level sponsorship to ensure support and ongoing investment
- Standardized technology and processes that are flexible to support the diversity of care needs, while ensuring a common technical architecture, standards, data integration, quality and outcomes
These foundational items above will directly impact the level of provider adoption and patient engagement. Stage 3 organizations are able to measure and manage their financial, clinical, and operational results and realize much higher physician adoption, patient engagement, and financial returns. Many organizations in the market today are working to advance to this stage of maturity.
Stages 4 and 5: Organizations in Stages 4 and 5 have the most mature telehealth programs. These programs are focused on a flexible and results-driven, go-to-market strategy. Telehealth programs in this stage have an adaptable, comprehensive portfolio of market-driven telehealth services that can scale and grow based on strategic needs and business goals. To build a successful and balanced portfolio of telehealth services, it’s important to align with your organization’s strategic direction and associated timeline. Your portfolio of services should support your organization’s short- and long-term goals and target patient populations, and focus on your organization’s clinical strengths.
Stage 4 and 5 programs view their telehealth services as a self-sustaining business model with metric-driven clinical and financial goals. Each service in the portfolio must be measured against those goals to ensure they meet quality standards, improve productivity, and manage costs.
Ideally, all telehealth use by physicians and patients will be accessed through a virtual “front door” to provide a digital storefront for patient-centric services that promotes their brand. Stages 4 and 5 are what many leading healthcare organizations are targeting to achieve in the near future.
Not all organizations will advance to Stage 5, but those who do are focused on expanding into new, broader markets outside their state or internationally. These organizations will have flexible, consumer-focused services that can even be productized and franchised to other health delivery organizations.
As mentioned previously, healthcare organizations must establish more flexible and sustainable care models, expand care beyond current patient market boundaries, develop net new revenue streams, and better manage patient populations. Many organizations are investing in telehealth as a solution to address these needs, however, only those that can accelerate to advanced stages of the Telehealth Maturity Model will be successful and realize the most value.