The telehealth revolution has transformed how the doctor and patient interact. During the epidemic, almost 75% of the consultations were held via telehealth. There are many benefits- convenience, reduction in overhead clinical costs and new insights.
At the same time, there are certainly unintended consequences for patients, clinicians and society. Clinicians experience video fatigue, longer workdays all threatening the health for a profession already facing high burnout. In the longterm telemedicine can lower overhead costs.
The telemedicine transformation may seem unprecedented but in the USA the adoption of electronic health records could provide lessons on how to manage the current one. Four main strategies could help prevent the unintended consequences of telehealth
Protect the clinician-patient relationship
The main barrier to acceptance of telemedicine is it disrupts the direct connection, the relationship between a patient and clinician by introducing a digital device widening the existing gap in access.
Among the many interventions, facilitating equitable access include providing digital assistance and language interpretation, lending the required hardware and access. Adequate language interpretation may remain a challenge due to costs and availability.
Engage patients and families
There may be resistance to giving access to patients for their medical records, it would be better to permit the same thereby empowering and improving care.
Mobile technologies and Bluetooth enabled devices are bringing remote monitoring to patients who need extra attention. Hospitals can send text-based symptom monitoring program for patients who need close follow-up. This remote monitoring, patient education and engagement software can help patients monitor and report symptoms, which could prompt further action if the alert is worrisome.
There are many opportunities for engaging patients in measuring their vitals, symptoms.
Telemedicine also provides opportunities to engage the families and understand the home environments.
Avoid creating extra work.
Ensure that the clinicians, physicians do not have to spend extra time managing the data that will be generated by telehealth. If not managed carefully telehealth could reshape a clinicians workday by adding virtual visits on top of his regular schedule.
You can have dedicated virtual visit sessions instead of adding to the regular workday schedule. You could have assistants/ interns admitting patients to the virtual rooms, take histories, make preliminary checks and notifying the clinicians when the patients are ready to be seen. Hospitals can also allow patients to come in before the virtual session to carry out lab, vital or other care that cannot be done virtually. Operational creativity on an ongoing basis is required to reap the benefits of telehealth and ensuring clinicians are not overworked.
Do not build walls.
Interoperability between digital service providers could become a major issue as telehealth adoption increases. As health systems develop their solutions to compete in a digital landscape, they must avoid creating incompatible tools that clinicians and patients are left to struggle with and lock up the rich stream of data within one application or system.
The proliferation of telemedicine companies could pose an additional interoperability challenge. On one hand, it would improve access to patients and at the same time increase the barriers for information sharing.
As the expansion of telehealth continues, we need to ensure that new systems of care improve communications between patients and service providers, enhance relationships and improve health care quality.
The Pitfalls of Telehealth — and How to Avoid Them
by Lisa S. Rotenstein and Lawrence S. Friedman
HBR 2020/11
Comments
Post a Comment