Operations Reporting – a Critical Success Factor for Telehealth Programs
Increasing the availability of telehealth software, medical devices, and clinical services is an important component to achieve the triple aim in US healthcare systems.Telehealth adoption has accelerated across the industry because of:
- Favorable reimbursement
- Alignment with Government regulations
- An increasing body of positive Medical evidence
- Increasing Patient and provider acceptance
Enterprise accountability – in resource management, operational efficiency, provider productivity, and total cost of technology – is critical to scaling and sustaining the growth of telehealth services.
What is the current state of Enterprise Telehealth Operational Performance Reporting?
Plenty of siloed data
Recent investments in multiple, single-purpose telehealth applications for each use case in individual care settings have created data islands within health systems. Telehealth consultations and other community-based virtual encounter data have been siloed.
Virtual care documentation is often:
- Limited in its availability
- Variable in scope and quality
- Fragmented by service lines or clinical departments
- Tracked manually
- Not coded unless it is directly reimbursed
Consequently, an organization does not have a true enterprise view of all the clinical services it provides and cannot achieve economies of scale.
Lack of automated tracking
As a result, telehealth data is often not included in EHRs, coded in financial and billing systems, or incorporated in enterprise data warehouse repositories. Therefore, the telehealth data is not represented in routine or ad hoc operational performance reports. This results in under representation of telehealth services in corporate reviews and analyses and low prioritization of telehealth activities in the budget process.
The Path Forward – standardization and what do you measure?
Next step – data transparency
Telehealth programs will only become fully integrated and financially supported at scale, when their operational performance is documented and highlighted more consistently and accurately in enterprise and departmental performance reports. ViTel is offering this to its clients with the vCareCommand platform.
Data governance and documentation standardization
An aligned and streamlined standardization is emerging for virtual visits and teleconsultations. Recent advancements in multi-service line, centralized telehealth platforms leverage:
- Consistent data governance for enhanced data sharing and longitudinal care tracking
- Structured and branching logic documentation for improved, more efficient workflows
- Procedure and diagnostic coding of services in the telehealth documentation for better reimbursement
The more streamlined clinical workflows – with tighter integration with other corporate systems and data repositories made possible using current telehealth platform capabilities – provide:
- Better enterprise resource management for complex specialty care and primary care
- Timely, more accurate business investments and staffing decisions
- Enhanced patient access – with reduced network leakage for complex specialty care
- Higher telehealth reimbursement at a lower delivery cost
- Improved productivity by leveraging internal providers, where possible
- More transparent external professional services contract management, when needed
Automated and Integrated Performance Dashboards
Consistent, readily-available access to real-time dashboards and reporting services is possible by embedding configurable operational, financial, and administrative reporting tools in an enterprise telehealth platform. Having the the appropriate import and export connections is necessary. This integrated, layered, platform data sharing framework delivers an enterprise resource and financial performance situational awareness – across care settings and delivery modalities.
Process and Outcome Metrics
Healthcare organizations need to create and use internal and external key performance indicator dashboards and reports. The reasons are two-fold:
- The shift of payment models from fee-for-service and from volume-based to value-based
- Alternative reimbursement incentives are implemented to reward better quality outcomes.
For example, enterprise balanced scorecards emphasize telehealth operational measures of:
- Staffing efficiency/productivity and streamlined workflow processes
- Technology affordability, high availability, security and protected patient privacy
- Medical outcomes during single encounters and for longitudinal episodes of care
- Patient safety
- Patient and provider satisfaction
- Return on investments for NEW innovative service delivery models
Dr. Karen Rheuban, UVA Professor of Pediatrics and Senior Associate Dean for Continuing Medical Education & External Affairs, provided insight regarding such tracking – watch here.
The National Quality Forum has published its framework for measure development for telehealth benchmarking enabling comparative analysis for patients, providers, governments and payers.
Conclusion
While hospitals and Integrated Delivery Networks have increasingly embraced telehealth services, some are finally beginning to harness the incremental value of this new data by properly integrating them into their enterprise health IT infrastructure.
Leveraging the enterprise telehealth platform to capture, aggregate, display, store, transport and evaluate virtual visit encounter data provides the critical foundation for telehealth data analytics today and into the foreseeable future.
Prepared by Dr. Richard Bakalar, MD, FATA
