Developing and Operationalizing a Telehealth Strategy. Cone Health s Story \370127(pptx)-E2 DD

Transcription

1 Developing and Operationalizing a Telehealth Strategy Cone Health s Story 0

2 At the conclusion of this presentation, attendees should have developed a comfortable understanding of the following: Learning Objectives Telehealth as a vehicle for acute care delivery The necessary steps in planning and deploying a telehealth program The ways in which different use cases and telehealth offerings interact with and impact each other Specific tactics for building a use case for telehealth with patients and providers at your organization The strategies in this presentation aim to boost provider adoption of telehealth to deliver convenient, high-quality care to patients in the community. 1

3 Cone began its telehealth journey as a result of specific calls to action. Patient Expectations for Convenient, High-Quality Care Options Our Calls to Action Competing Telehealth Programs and a Need to Improve Patient Access Total Cost of Care Reductions for At-Risk Patient Populations The considerations above prompted Cone to begin developing a single telehealth strategy. 2

4 Telehealth is an Investment Strategy in Population Management The overall goal of healthcare reform is to bend the rise in the cost of care. Telehealth is a keystone in that strategy. WHY? It s the cost of doing business (Kano Model) It will reduce the total cost of care Most of our customer s choices are driven by convenience. COST SERVICE CONVENIENT ACCESS Advisory Board

5 Acute/urgent care is the simplest entry to the telehealth marketplace. The benefits of quick, convenient care at a lower cost are easy to see. Comparative Wait Times and Visit Costs Telehealth and the Acute Care Use Case $400 $350 $300 $250 $200 $150 $100 $50 $0 $370 ER Extensive testing costs High wait times (5-hour visit) Follow-up referrals common $150 UC Up to 1-hour wait time (3-hour visit) $100 Office 2-day wait (1- to 2-hour visit $59 Retail Walk in $49 Video Minutes Asynchronous $30 Asynchronous Cone decided to build its initial offering around acute/urgent care and then develop additional specialty use cases over time. Asynchronous 4

6 Cone had previously undertaken isolated telehealth initiatives across the organization. Our first step was to consolidate these initiatives and operate under a single governance structure. Our First Move: A Single Governance Structure Marketing Work Group Communication plan for employees/ patients Content and graphics for websites and landing pages Patient research and education VIRTUAL HEALTH STEERING COMMITTEE Technical Work Group EHR build requirements Integration between solutions Configuration of websites and landing pages Clinical Work Group Clinical protocols Provider buy-in and training e-visit delivery and video/phone visit care Operations Work Group Scoping and work flow development Provider scheduling and support Registration and billing Website and landing page design Although each entity has its area of expertise, an open communication structure prevented each group from operating independently. 5

7 Telehealth is a wide-reaching concept. Cone s stakeholders conducted due diligence on all potential use cases and decided to take a gradual approach to entering the market. Planning the Approach and Offering E-VISITS Asynchronous/ questionnaire-based visits Advanced practice providers (APPs) Defined list of appropriate conditions 1-hour turnaround time VIDEO/PHONE VISITS ADVANCED USE CASES Live video/phone interaction Physicians and APPs Broader list of covered conditions Patients seen and treated on demand in real time MDLIVE Remote patient monitoring Behavioral health monitoring Postsurgical followup Chronic patient management The remainder of this presentation reviews the meaningful attributes of Cone s telehealth program as well as the lessons learned in achieving them. 6

8 With e-visits and video visits being a brand new offering, properly sequencing the rollout was key to patient adoption. Sequenced Rollout Pilot Populations Gradual Scope Expansion Cone tested the e-visit offering with employees as a pilot population and learned from their use of e-visits before expanding the offering to the entire community. Cone began with e-visits because they were already built into Epic s MyChart. Development of the video visit offering occurred while learning from the e-visit experience. Speed to Market Cone was able to achieve speed to market by beginning with e-visits, the most technically simple solution, before developing more detailed use cases. As organizations begin to plan their telehealth offering, sequencing is something that must be closely considered as something that drives adoption. 7

9 Below are attributes of the Cone telehealth work groups and the lessons learned in achieving project goals. Impactful Work Groups Efficient and Empowered Decision Making Clear Communication Between Work Groups Cone stakeholders set expectations for the types of decisions made at the Steering Committee and work group levels Cross-membership of certain work group members was encouraged, and each meeting concluded with work group reviews. Influence Across the Organization Work group members were carefully selected to reach across diverse functional areas and communicate clearly with their colleagues. Taking time at the beginning of the project to carefully develop work group rosters and protocols is the key to getting fast, impactful results. 8

10 Telehealth is a new concept to many providers. Cone achieved the following in encouraging provider buy-in: Provider Buy-In Involvement in Work Groups A Provider- Assisted Build Cone populated the clinical work group with providers who would actually be using the offering to deliver care. Providers were involved in developing the clinical protocols and guidelines used to deliver care through telehealth. A Provider- Friendly Solution Features such as notifications and templates were developed. Providers were given access to on-call support during off hours. Involving the providers in every step of the planning process ensured that Cone would have an offering its providers were excited to use. 9

11 e-visits and video visits are new ways of receiving care, so patients understanding and finding value in both offerings was valuable in gaining traction. Patient Adoption Communication of Patient Preferences Patient Feedback in Real Time Patient advocates attended marketing and operations work group meetings to provide feedback on the offering. Cone began with a small pilot population and solicited feedback through post-visit surveys and patient testimonials. Delivering a Message of Convenience Cone developed a solution that is highly accessible and effective. Marketing communications were created around this concept. Patients played an equal and high-profile role in helping Cone develop ways of driving telehealth adoption. 10

12 Cone realized such a novel solution would be difficult to perfect on the first try. Therefore, the work groups met to review daily metrics in order to make incremental improvements to the offering. Data-Driven Improvements Insightful Reporting Detailed Clinical Metrics Before go-live, Cone had a strong understanding of which reports were available and how they would be used on a daily basis to improve the offering. Cone extracted clinical lessons learned from each encounter and created new use cases and adjusted existing ones from this data. Data-Driven Marketing Cone utilized demographic data to communicate the offering to targeted patient populations who would find the most value in telehealth capabilities. Detailed metrics proved vital to making improvements to the offering and demonstrating its value. 11

13 The Right Care at the Right Time from the Right Provider at the Right Value. The Outcomes 96% % 92% 62% Number of Patient Survey Responses Received Care Within 1 Hour Received Expected Level of Services Net Promotor Score Would Otherwise Have Visited Urgent Care/ER or Walk-In Clinic The successes of the e-visit program have allowed Cone to establish its live video visit program and continue to build telehealth use cases. 12

14 Beyond the success of the e-visit offering, Cone has either implemented or is planning the following expansions: The Long Game For Direct to Consumer Telehealth Live video visits on the MDLIVE platform Acute Care integrated into a retail and consumer access strategy Virtual space in every provider s day for scheduled management visits Post surgical and chemotherapy monitoring Readmission reduction through home device monitoring Build a seamless customer experience between patients and ALL of their providers Intelligent patient decision support through smart applications and real time touch points The planning and operations decisions that enabled Cone s e-visit offering set a platform for future telehealth expansion. 13

15 Telehealth as a System Strategy Inpatient Services e-icu Telemetry Tele-ECG Tele-sitter Tele-stroke Tele-psych to ER Tele-woundcare Tele-translators Tele-hospitalist Care Transitions More!! Specialty Consults Provider to provider or care delivery site Oncology Cardiology Consults Care management Telehospitalists to SNHF Pediatric specialist Tele-psych OB Dermatology More!!! Home Monitor Disease state specific Population management with Wellsmith mobile application Care management Integrated medical devices Integrated Patient devices Hospital in home More!! Outpatient services Virtual acute care Kiosks Virtual scheduled care Medication management Stable problem monitoring All Specialties Virtual health coaches Virtual mental health Care Transitions More!! 14

16 The following are our lessons learned throughout the development of Cone s telehealth offering: What We Learned Before anything else, establish a governance structure that involves decision makers across the organization. Create metrics and goals for what you hope your telehealth offering will achieve. Listen to providers and patients, as their feedback is what will make your offering successful. Empower the work groups to make quick, informed decisions about how the offering is structured. Create a central marketing story and clearly communicate benefits. The marketing needs to be educational for the patient. Spend considerable time analyzing program data and deciding how it impacts your next steps. 15

17 Questions and Contact @JakeFochetta 16