There are lots of telehealth initiatives happening. Just not many that seem to be financially sustainable or effectively integrated into consumer service delivery. At the start, many telehealth initiatives were funded with grant funding – without long-term planning around sustainability with health plan-based funding.
But funding is only part of the challenge. The issues around telehealth are complex, and we’ve reported on many of them before: Clinical effectiveness issues (see Bad Telehealth Without Telehealth Guidelines and Is Telepsychiatry Equivalent To Face-To-Face Psychiatry?). Health plan reimbursement issues (see Moving Telehealth Beyond Grants and The State Of Telehealth In The U.S. Guidelines, Legislation, Reimbursements, & The Future Of Telemedicine). Professional licensure issues (see For Telehealth, More Movement To Cross State Lines and Military Removes State Licensure As Behavioral Telehealth Requirement).
If your organization is grappling with these challenges, a recent report, “Shaping Your Telehealth Strategy,” from Ernst & Young offers an interesting four-step process for evaluating the potential of telehealth:
- Analyze your market – This is the most fundamental of feasibility analysis considerations. Will reimbursement in your market facilitate a sustainable telehealth program? Who are the payers and how do they pay for services? If there is not direct payment for telehealth services, can telehealth be used to decrease the cost of services? To understand your market, you’ll need market intelligence on not only your, payers, but also your consumer base, your state’s regulations, and your competitors. This analysis will allow you to determine if a telehealth initiatives are feasible and the best way overcome the challenges of your market.
- Define what telehealth success means for your organization – This is a strategic issue. Does telehealth “fit” with where your organization is headed? Once you understand the realities of your market, it’s time to examine your own organization. First, determine if a telehealth program aligns with your mission, vision, values, and culture. Second, consider how a telehealth initiative will influence your organization’s operational, clinical, and financial goals. A telehealth initiative will only work if you factor it into your organization’s strategic positioning.
- Design your program details with input from a multidisciplinary group of stakeholders – This is an issue of buy-in – from both your customer base and your team. Input from internal stakeholders (executive team, board, front-line staff), is just as vital as external stakeholders (consumers, payers, partnering provider organizations). Considering the input of a variety of stakeholder groups when it comes to technology selection, staffing models, funding, and performance metrics will ensure that your telehealth initiative is accepted by your team and your community.
- Implement the program slowly – This is an issue of operational planning and project management. Start slowly and create an implementation timeline that allows ample time for securing executive and clinician support; ordering, installing and troubleshooting equipment; training staff; and ensuring required credentialing. Test the model in a pilot program; revise the protocols as needed before the full launch. After the program is “up and running,” evaluate its progress and outcomes, and make changes based on consumer and staff feedback.
The telehealth market in the U.S. is expected to grow from $240 million in revenue in 2013, to $1.9 billion in 2018. Whether or not (and how) your organization is part of this market change depends on how you assess and the market and approach incorporating telehealth in your service system. For a more in-depth discussion on telehealth, be sure to join us for the 10-year anniversary of The OPEN MINDS Technology & Informatics Institute in this November in Washington D.C.