Various reports indicate that physician adoption of telemedicine has boomed over the course of just the past few months, with virtual healthcare interactions set to surpass 1 billion by the end of the year. Similarly, in 2019 just 8% of patients surveyed had sought care via telemedicine, but as of April 2020, that number had increased to over 50%.
“Due to the COVID-19 crisis, what was a five- to ten-year organic technology adoption cycle got compressed down to five months — naturally creating a lot of chaos among healthcare organizations,” said Andrei Zimiles, CEO and Founder of Doctor.com. “Prior to the pandemic, many providers regarded telemedicine as a novel technology that was not essential to their business, often serving as just one of a series of possible interventions to steer patients toward the right care. Then the coronavirus hit, and elective procedure departments were shut down, the ER was overflowing, and patients were either unable or unwilling to go to the hospital due to COVID-19. Health systems had to pivot.”
Physicians are quick to corroborate these trends. “If there’s one thing our experience with COVID-19 has taught us, it’s that telemedicine is no longer an option, but a necessity,” said Howard D. Krein, MD, PhD, Associate Professor, Thomas Jefferson University Hospital. “It is here to stay, and it’s only going to become a larger part of medicine as we continue to innovate. And patients are hungry for this kind of innovation.”
Organizations that adopted telehealth under duress face challenges
While the initial surge of COVID-19 has subsided, the pandemic is far from over. Healthcare organizations must continue to act with urgency to substantially scale telehealth offerings and prepare for what many predict will be a permanent shift in the care delivery model.
Prior to the pandemic, most health systems didn’t have a reliable, scalable telehealth platform in place, and most vendors weren’t equipped to help them get up and running on their solutions quickly. Complex software with heavily customized integrations could take months — or even years — to deploy. When the pandemic hit, healthcare organizations didn’t have time to implement a unified and comprehensive telehealth strategy, often leaving individual physicians to their own devices to choose disparate “quick fix” virtual care solutions.
CMS waived HIPAA restrictions early on and broadened the scope of what could be treated through telemedicine. Medicare beneficiaries have been able to transition to telemedicine using Zoom, FaceTime, Google Duo/Meet, and other platforms that were hastily approved for temporary use.
However, these general-purpose video-conferencing platforms pose significant issues within the healthcare industry, as they may not be sufficiently secure, robust, or HIPAA compliant outside of the pandemic.
Time pressure combined with relaxed regulations led to widespread decentralized adoption — which created a mess that many hospitals are only now starting to address.
“We are seeing a major second wave of reassessment where some health systems are discovering they have 20 to 30 different telemedicine services that have permeated their physician base,” said Mr. Zimiles. “Obviously this presents a host of problems — security concerns, fragmented and siloed patient data, poor records keeping, increased overhead, and inconsistent patient experiences, to name a few. Staff will have to be retrained on a more secure, centralized, and durable system in the future. IT has to take control and make sure patient records are going to the right place and their platform stands up to regulatory requirements for healthcare use. Hospitals must now find a more robust and future-proof long-term solution. Most importantly, it has to be easy for the patients to adopt, and that’s where many of the incumbent services have failed.”
Dr. Krein has firsthand experience watching this play out at his hospital. “When the pandemic hit, it was a bit of a free-for-all in terms of how various departments adopted telemedicine,” Dr. Krein acknowledged. “The hospital did a great job of supporting us, but we still ended up rotating through different telemedicine solutions, including ones that require downloading an app. Unfortunately, a difficult installation process dampens the patient experience, and we have learned it should be simple: It should be click, verify, and join.”
Combining telemedicine and patient reviews to increase patient adoption and acquisition
“Simplicity is so paramount when it comes to patient adoption,” Mr. Zimiles said. “When you look at what has been successful with patients, it has been services that are generally much ‘lighter weight’
and easier to use. It’s important that enterprises carefully balance user experience with the feature depth, security, and personalization necessary to meet their needs. Done right, telehealth presents a great opportunity for organizations to reinforce their brand by providing a delightful patient experience that is comfortable and reassuring.”
In a third-party survey of 1,800 patients funded by Doctor.com, 69% of patients said they’d be more likely to opt for a telemedicine appointment if the technology were easy to use. Any service that requires the patient to download and install an app can pose a significant barrier to adoption. This is especially true when telemedicine features are integrated as part of a larger patient portal application. In some cases, patients have signed up for the wrong hospital’s app due to it having a similar name in the app store. Mr. Zimiles advises hospitals to choose a platform that can work on any device and does not require the patient to download anything or create a new account.
Because much of healthcare research today is conducted online, telemedicine is set to become an integral fixture in the patient journey.
“Healthcare providers have an incredible opportunity to engage patients at key moments in their research process — for example, the moment where they are typing keywords into Google or browsing a site like Healthgrades or WebMD. Providing a clear call to action for patients at this ‘last mile’ of their journey to schedule a virtual visit is a very effective way to drive acquisition, especially at a time when many people are still hesitant to visit medical facilities in person,” said Mr. Zimiles.
By integrating telemedicine capabilities with online patient feedback and reviews, hospitals have an opportunity to accelerate patient adoption and growth. For example, by prompting “early telehealth
adopters” to share reviews and comments about their positive experience, hesitant prospective patients searching for care online are naturally more encouraged and motivated to book a telemedicine
appointment. Health organizations can garner a higher volume of feedback and automate this virtuous cycle by choosing a telehealth platform that captures and syndicates reviews within the app itself.
Collecting reviews from the first wave of post-lockdown hospital visits, and publishing these reviews online, will also be critical to gradually returning to pre-pandemic volumes of in-person visits and
“When patients leave comments about their recent in-person visits, and the fact that they felt safe and comfortable — this is by far a more effective marketing campaign than messaging coming from the
hospital,” said Noel Coleman, President of Enterprise Revenue at Doctor.com.
Exploring new telemedicine models to differentiate and drive growth
The pandemic has surfaced telehealth’s undeniable benefits. Remote care delivery not only gives patients more control over their health and safety, but the convenience and flexibility of telemedicine means patients can potentially access more physicians in the course of care. Thanks to the proliferation of online information and patient reviews, patients can decide on their physicians and care providers based on technical skill, reputation, and ease of access. Geography and distance are also less of a barrier as regulations have been relaxed during the pandemic, creating new opportunities for health systems to reach patients that might not otherwise have sought to engage.
While most organizations’ telehealth strategies have been primarily focused on delivering care to existing patients, cutting-edge hospitals are uncovering growth opportunities that tap into newfound demand from patients for virtual care. They are realizing that telemedicine can be a powerful tool to attract new patients, especially those who are anxious to pursue care canceled during the pandemic but still nervous about visiting a facility in person.
“A great example of how telemedicine can be used to drive new growth is around second opinions: A world-class specialist at a top hospital in a major city can leverage their brand and credentials to attract patients who’d normally be too far away to easily come in for an in-person consultation. We are seeing orthopedic surgeons, cardiologists, and others doing this quite effectively. They are using virtual visits for initial consultations with patients outside their geographic area. After they’ve established a relationship, they are finding that many patients are willing to travel to see them for a surgery or other significant procedure. With the right patient acquisition strategy, hospitals can leverage virtual visits to reach patients outside of their geographic area and ‘intercept’ them when they are shopping for care online,” said Mr. Coleman.
In another use case, clinicians can use telemedicine to see patients for initial consultations, and when the time comes for surgery they can give patients a virtual tour of the office and operating room so the patients know what to expect before their in-person visit. They can also share policies and protocols virtually and show them what the hospital is doing to keep patients safe.
“This is another example of how telemedicine can be a powerful and innovative way for health systems to communicate with patients during a time of uncertainty — it can be such a valuable tool when it comes to getting patients comfortable with future in-person visits and procedures,” said Mr. Zimiles.
Hospitals focusing on growth, both in the short and long term, should begin to think more holistically about their virtual care delivery, the virtual patient experience, and how their brand is represented throughout. While choosing the right telemedicine platform is an important first step, healthcare organizations should consider investing in quality video equipment and lighting, and provide guidance on physician telemedicine etiquette (e.g., on-camera demeanor, dress code, office setting, etc.) in order to ensure a consistently smooth and impressive patient experience. In the near future, the quality of a patient’s virtual interaction with a hospital will become critical to retention, referrals, and acquisition.
“There is no reason that your virtual experience can’t be world class. This is a chance to make a ‘new’ first impression, and that should not be taken lightly,” Mr. Zimiles said.
Planning for the future
According to Doctor.com’s telehealth survey, more than 80% of patients said they were likely to continue using telemedicine even if they didn’t use it before the pandemic. Health systems need to secure and scale their initiatives, and there’s no time to waste as a potential second wave of COVID-19 looms over much of the country.
Over the next several months, there will likely be a hybrid period focused on both in-person and telehealth visits that will put patients more at ease.
“When there is pressure to evolve, there is potential to speed up the usual bureaucratic machinery,” Mr. Zimiles said. “Any hospital that implemented suboptimal solutions under duress should feel a similar urgency to choose a scalable platform that will meet their needs for the future. If anyone is looking for a strong reason to accelerate the transition to a better solution, it is the potential leakage of patients who are going to a different health system that offers a more convenient and higher-quality telemedicine experience.”
When considering which telehealth vendors and digital tools to rely on for maximum growth during the reopening phase, health systems should consider whether the platform:
• Is fully HIPAA compliant
• Functions without requiring users to download an app or log into a patient portal
• Has a built-in solution to capture patient reviews
• Can integrate with third-party websites and applications
• Includes advanced features relevant for healthcare such as front and rear camera support, screen sharing, annotation, text chat, and integrated patient intake forms
Finally, transitioning to telemedicine is also an opportunity for providers to change their reputation within the community. Hospitals that may have struggled with their image in the past due to negative PR, staff issues, long wait times, or dated facilities have an opportunity to reinvent their brand with a thoughtful virtual care strategy.
Telemedicine has become a revelation for both physicians and patients across demographics. As the industry shifts more permanently in this direction, health systems have realized it will have a powerful impact beyond sheer care delivery. When folded in with communication and reputation-building tools, as well as a patient-centric mindset and focus on the user experience, a successful telehealth platform can be used as a critical marketing differentiator as well as an essential strategy for long-term growth. Thinking past the reopening phase will allow health systems to establish the necessary framework now to meet current patient demands, and realize significant ROI in the future. For hospitals that have not yet begun this exercise and identified technology solutions to support such an effort, now is the time.