Best Practices for Telehealth Cybersecurity During COVID-19 and Beyond
Best Practices for Telehealth Cybersecurity During COVID-19 and Beyond
Many healthcare providers who implemented telehealth services weeks or days after the coronavirus pandemic struck may have put telehealth cybersecurity issues on hold as patient needs and the delivery of remote services took precedence. In 2021, telehealth is continuing its ascent, increasingly becoming woven into the fabric of our healthcare delivery — yet cybersecurity threats are also on the rise. Now, it is time for healthcare organizations and medical groups to give telehealth cybersecurity the attention it deserves to safeguard the privacy and security of patient health data.
There are compelling reasons for doing so. Telehealth visits grew 350-fold in April 2020 compared to pre-pandemic levels, according to the Department of Health and Human Services. The trend shows no signs of slowing, and as telehealth and telemedicine usage increases, so will the exposure of patients and healthcare organizations to cybercrime involving personal medical information.
“A rush to develop and implement telehealth technology and a host of other digital health services could make it even easier for cybercriminals looking to gain access to private medical records in the coming year,” cautions consumer credit bureau Experian in its most recent Data Breach Industry Forecast.
Noting that telehealth providers experienced a 30% increase in cybersecurity findings per domain in 2020, the organization predicts that breaches involving personal medical information will be a major data breach trend in 2021.
Although providers were given flexibility during the pandemic in using non-HIPAA-compliant platforms for telehealth services through the Emergency Use Authorization, hospitals and medical groups should still be doing everything they can to protect their patient’s health information as their telehealth services gain traction.
Here are some recommendations to avoid breaches in privacy and security even as telehealth continues to expand:
- If you are currently using a consumer videoconferencing tool, plan to transition to an enterprise video conferencing product designed specifically for healthcare. The consumer video conferencing platform Zoom experienced a 10-fold increase in usage with the onset of the pandemic, much of it by healthcare providers. With that growth came increased incidents of “Zoom-bombing,” the disruptive intrusion, often by trolls, into video conference calls.
- Posing additional risks are the potential for eavesdropping on patient visits stemming from inadequate encryption and the possibility that an eavesdropper could capture a screenshot of patient health information that is being shared during a virtual visit.
- Enterprise grade products may include security features such as encryption or a waiting room with every teleconference that allows the host (clinician) to control when a participant joins the conference. These security features can be standardized across the organization.
- Implement multi-factor authentication for providers as well as for all patients who have online accounts with the provider. This is one of the simplest and most powerful actions providers can take to boost cybersecurity using any one of several easy-to-install MFA systems currently on the market. Industry research shows that an account is more than 99.9% less likely to be compromised when MFA is used.
- Consider updating your encryption. Though most organizations are encrypting patient health information, the goal with encryption is to make it computationally harder and more expensive for hackers to spend the time and energy attempting to compromise the data that is being encrypted. This goal can be achieved with software that uses some of the more powerful and modern encryption methods developed in recent years.
- Apply the principle of least privilege, limiting access to telehealth and telemedicine platforms to the minimal level users require to carry out their duties and responsibilities.
- Change default passwords to strong passwords for all devices and systems.
- Educate and regularly re-educate clinicians, staff and patients on privacy and security best practices and sources of telehealth security threats. (A recent study published in the Journal of Medical Internet Research found that workload had the strongest impact on the rate of clicking on phishing links by employees.)
- Because healthcare hackers tend to target older legacy systems with insufficient security, consider updating your network security. Though replacing your network infrastructure may seem daunting, it pales in comparison to the costs of a data breach that could compromise your patients and their private medical information and jeopardize your organization’s reputation and trust within the community.
- Should an incident or data breach occur, be prepared with a thorough response plan that has been tested and practiced in advance to minimize the negative consequences.
- Use white hat hackers and penetration testers to find holes in your cybersecurity approach. This form of “stress testing” will help you discover your company cybersecurity’s strengths and weaknesses.
For more information, download our white paper, “Telehealth Video Application Security.”Learn More
Hospital-at-Home Programs: The New Frontier for Treating Chronic Conditions
With hospitals strained to their breaking points with COVID patients and people across the country wondering whether it was wise to go to the emergency room, many systems turned to hospital-at-home programs as part of the solution.
Remote monitoring and telehealth tools effectively extended the triage process for COVID patients into the patients’ own homes, easing the burden on hospitals and helping make sure only the patients who were most sick came in to get care.
Now, the growing hospital-at-home model is showing promise for addressing another critical health problem, one that is the single biggest driver of U.S. healthcare costs and mortality: chronic conditions.
According to the Centers for Disease Control and Prevention, 90% of healthcare spending is on patients with chronic and mental health conditions. Moreover, chronic diseases such as cardiovascular disease, diabetes, and chronic obstructive pulmonary disease are responsible for more than seven out of 10 deaths in the United States and are the leading cause of disability.
Despite widespread awareness of this problem, the healthcare system has struggled to find an effective approach to chronic conditions in part because healthcare accounts for only 10 to 20% of populations’ health outcomes.
Social determinants of health — the environmental conditions in which people live and work — play a much bigger role in causing and reinforcing chronic conditions.
By combining telehealth with a care-at-home program, hospital systems can begin to develop an awareness of and data on patients’ environmental circumstances.
“Normally it’s hard to uncover data on social determinants of health. But we think that telehealth will make collecting this data a little bit easier,” explained Peter McLain, Caregility’s Chief Strategy Officer and SVP of Business Development.
Vision for the future of care for chronic conditions
In the near future, care for those with chronic disease will rely not only on social determinants data but also patient data points that go well beyond the standard measurements of blood pressure, weight, and blood oxygen levels to include other relevant physiological data — all of these gathered from hospital at home products.
Meanwhile, telehealth home care will provide the connective platform to leverage that data through the patient’s entire care journey.
Using these health records and the information gathered during the initial consultation, providers will be able to create a personalized care plan for the patient, automatically generate customized workflows, and schedule video check-ins that correspond to the care plan.
Meanwhile, with the patient at home, remote telehealth devices or hospital-at-home equipment will be able to collect new patient data and automatically transmit it through the platform.
A combined hospital-at-home and telehealth program will allow providers to conduct video appointments via the telehealth platform and then use those appointments to gather information about the patient’s social and environmental circumstances, such as the patient’s transportation options, proximity to grocery stores selling healthy food, and the safety of the local neighborhood.
The patients would also get an easy-to-understand overview of their health via a patient dashboard. If the patient for any reason was beginning to deteriorate, that would set off an alarm or notification, and the provider could initiate a video call with the patient to investigate further and get the patient back on track.
In short: a robust telehealth hospital-at-home program would facilitate preventive care that nips problems in the bud.
Telehealth home health care for chronic conditions would be efficient and effective
Another advantage of care-at-home models is that providers could check on more patients via video per day than they would be able to see if traveling to different nursing homes and assisted-living facilities.
In addition, a platform that incorporates social determinants of health data would enable providers to more effectively guide patients toward better health. Specifically, the social determinants data would reveal factors that were impeding patient compliance with the care plan.
For example, if the patient wasn’t following a recommendation to eat a plant-based diet, environmental data might reveal that the patient lived in a so-called food desert, where access to healthy food is limited. To address this problem, the care team could identify a program or service that delivers healthy food to the patient’s home.
Or, if the patient lacked transportation to a pharmacy, the care team could arrange for low-expense mail-order prescriptions.
In other words, the care model would enable a holistic approach to care that eliminates barriers to good health and even reverses chronic diseases.
Learn more about how we’re building the future of care for chronic diseases
If you’re interested in learning more about this new hospital-at-home model, please contact us.
As McLain explained, “The paradigm of care for chronic conditions has shifted to a telehealth model, and this new frontier is wide open for innovation.”Learn More
Combining the Future of Telehealth into a Virtual Care Platform
2020 brought the crucial nature of virtual care to the forefront of healthcare delivery. From mitigating the spread of the coronavirus to connecting isolated patients and providing care for non-COVID patients, we have seen validation of telehealth under the most extreme circumstances as healthcare organizations grapple with the COVID-19 pandemic. Telehealth is now a critical component of care delivery, not just a “nice-to-have.”
How Telehealth is Shaping the Future of Healthcare
As we look ahead to the future of telehealth medicine, virtual care will continue to lay the fundamental foundation needed to enable agile and effective care with the right clinician, at the right time, and in the right location for patients. Inpatient care will increasingly be imbued with virtual components that improve productivity, patient outcomes, and provider experience.
A wide range of patient engagements will employ a digital-first strategy designed to bring costs down, improve patient satisfaction, and make the entire experience more convenient for the patient and caregiver alike. Telehealth will be reinforced with a new era of predictive tools and applications that augment the information available to improve overall outcomes.
In 2021, the blending of artificial or augmented intelligence (AI), wearables, and two-way video will advance virtual patient care. The combination of these technologies into a comprehensive virtual platform will help providers improve population health and outcomes across more patients as they extend the hospital room outside of the physical facility and into patients’ homes.
First and foremost, virtual care will continue to drive efficiency in inpatient care. AI will play a tremendous role in enhancing clinical insight and enabling care for more patients, in spite of challenges related to limited staff resources. Although artificial intelligence gets the lion’s share of attention in the world of healthcare innovation, it is essential that we do not underestimate the importance of the human element in the marriage of healthcare technology and care delivery. Rather than refer to it as artificial intelligence we prefer to focus on the concept that, in reality, it is augmented information.
Investments in augmented information are equally important as a steppingstone in complementing and enhancing the existing workflows of clinicians. Nothing can replace a knowledgeable, experienced caregiver, but how much more effective can they be if we augment the information they have at their fingertips? Continuous virtual monitoring of patients, data capture through wearables, and access to predictive algorithms that can help providers anticipate conditions affecting the patient’s outcome can combine to improve care.
Hospital at Home
The acceleration of telehealth and virtual care to address how to provide services to patients unable to visit their doctors during the pandemic has proven virtual care is not only viable but often the preferred option. As a result, hospitals are looking for ways to extend the healthcare engagement experience into the patient home. While this has largely been pursued out of necessity in order to reach patients isolating at home during the ongoing COVID-19 pandemic, it is also fueled by evolving patient expectations around easier access to care.
Virtual care models represent the modern-day equivalent of the home visit or house call of the past. Technology platforms and an array of connected devices will become permanent fixtures in our homes, as common as connected thermostats or doorbells. These virtual care solutions offer a cost-effective means for reducing some of the overhead commonly associated with hospital stays, as well as increased convenience and comfort for patients. Home-based care has the added advantage of minimizing exposure to infected patients by the healthcare staff.
Wearables in Healthcare
The proliferation of Internet of Things (IoT) devices and wearables as a growing trend will have an impact on virtual care an telehealth in coming years. Wearables such as smart watches, fitness trackers, biosensors, ECGs, and blood pressure monitors represent some of the first home-health devices to approach ubiquity. Remote technologies that consistently measure and monitor patient vitals can accelerate provider insight into patient risk factors.
By proactively alerting care providers to warning signs, clinicians are able to intervene earlier to prevent adverse or catastrophic events—again offering patients the right care at the right time. These interactive devices can also encourage patients to make better health decisions in real-time. The rise of these “digital medicine cabinet” technologies will unearth previously untapped avenues for healthcare providers to advance the shift from responsive or reactive care to more proactive and preventive medical interventions. Management of access to and the security of these devices will be paramount.
What is the Future of Telehealth?
Each of these components have had varied success to date in individual use cases, but the real power and benefit will come from combining them into a comprehensive virtual care platform. Over the course of the past year, utilization of telehealth has clearly reached incredible levels and has established a new normal which is anticipated to remain even after the pandemic is over. Now is the time to optimize these technologies and prepare for growth.
Not only has virtual care helped us deal more effectively with the pandemic, but we have been given a glimpse of what the future of telehealth and telemedicine can be. The digital revolution in healthcare has begun and leveraging two-way video, wearables, and augmented information will enable us to create a better patient experience, improve outcomes, and be more prepared for the next challenge that might come.
The benefits of virtual care have been on full display in 2020 and as we move into 2021 and beyond it is clear that there is no limit to the ways telehealth can positively impact the overall experience and outcomes across the entire healthcare continuum.
Want to learn more? Check out our post on Augmented Intelligence in Telehealth.
This post was originally published on Population HealthLearn More
Developing an Inpatient Virtual Care Strategy That Works
Healthcare organizations are moving beyond the ad hoc implementations which characterized virtual care and telehealth during the earlier stages of the COVID-19 pandemic. It’s now time to transform the stopgap tactical telehealth measures they deployed when COVID-19 first hit into cohesive, forward-looking, patient-centered care strategies that support their long-range goals.
The Benefits of Developing an Inpatient Virtual Care Strategy
An interoperable, platform-focused approach will provide a framework for an inpatient virtual care strategy that is scalable, secure, reliable and capable of evolving and adapting as an organization changes and grows.
As part of a comprehensive telehealth services plan, platform-based inpatient virtual care can help healthcare organizations with a number of challenges, beginning with improving safety and quality. Telehealth at the bedside can enable care teams to deliver quality inpatient and virtual medical care and expand observation while reducing contact exposure and conserving PPE.
Similarly, inpatient virtual care can reduce the care team burden. By providing interoperable solutions and an “always connected” platform, care teams are freed to focus more on meaningful contact with patients and less on redundant, time-consuming tasks.
Inpatient virtual care can shape patient engagement, by providing digital tools at the bedside, preparing for them for discharge, and minimizing the risk of readmission.
And finally, inpatient virtual care can address health inequities. Virtual remote interpretation (VRI) capabilities can be integrated into existing platforms to reduce health inequities for deaf, hard of hearing and limited English proficient patients. To overcome disparities for patients of lower socioeconomic backgrounds who do not have access to devices, organizations can provide devices to enable equitable access to virtual services.
Multi-phase plans based on scalable technology can help organizations overcome common stumbling blocks as they incorporate an inpatient virtual care strategy into their overall telehealth capabilities.
These factors include:
- Legacy facilities and infrastructure. The answer here is to focus on key opportunities for digital solutions in patient rooms, with an eye on phasing in capabilities using modular platforms.
- Capital expenditure. Healthcare providers are under more financial pressure than ever. The key is to look for partners that offer cost-effective virtual care solutions and a pathway to the future. This might mean starting simply with tablets at the bedside and planning for large wall displays, cameras and microphones down the road when budgets allow.
- Patients’ own devices. Patients’ personal devices are not a reliable solution for virtual care, and not all patients have devices. Organizations should look instead to interoperable platforms that run on any device available, including enterprise hardware.
- Security and trust. The loosening of HIPAA restrictions during the beginning of the pandemic is not the way of the future. Organizations must plan for inpatient care solutions that ensure HIPAA compliance.
- Care team adoption. To ensure acceptance and consistent use by care team members, virtual care solutions should work seamlessly together to share context so clinicians can easily connect to patient rooms without additional passwords, interpreters can be instantly connected, and specialist visits can be documented in the EHR without extra steps.
- Change management. The implementation of an inpatient virtual care strategy involves some changes in routine practices. Designating an executive sponsor to introduce the platform and champion implementation can help smooth the transition.
The 4 C’s of an Effective Virtual Inpatient Care Platform
Healthcare organizations developing or searching for a virtual inpatient care platform need to keep in mind the four C’s of an effective platform: Consultation, Communication, Connection, and Control.
The platform must have the ability to consult with specialists in remote locations, as well as the ability for care teams to communicate safely with patients who are quarantined. Patients must also be able to communicate readily with care teams, and connect with friends and family, even if quarantined. And finally, a virtual inpatient care platform should deliver technology in the service of engaging and empowering patients and families during the hospital stay with everything from meal ordering and room lighting to personalized patient education and discharge planning.
Gauging the Success of Your Virtual Care Strategies
Organizations should plan to measure the effectiveness of their inpatient virtual care strategies using metrics such as:
- Language access. What percentage of encounters utilize language access? How long do patients wait for an interpreter? How do staff feel about using the solutions?
- HCAHPS scores. How do scores for patient satisfaction and experience compare before and after implementation?
- Average length of stay and readmission rates pre- and post-implementation.
- Compliance with current regulations regarding security, privacy and language access.
- Care team satisfaction. Do clinicians find the technology helpful and easy to use? What do they like and not like and how can problems be addressed?
Despite the pandemic, current technology combined with new care strategies makes it possible for providers to significantly broaden their telehealth capabilities now and to begin delivering enhanced digital resources to the bedside for the benefit of patients and care teams alike.
Expanding telehealth but don’t know where to start? Read our post: 6 Musts for Choosing a Mobile Telehealth SolutionLearn More
Ease of Use: What Does It Mean, Really?
Every telehealth vendor will claim their telehealth solution is easy to use — but how many have truly designed their platform for both patients and providers? And how many telehealth vendors have recognized the myriad constraints of different clinical environments, including during the pandemic, and chosen designs that address these challenges?
We recently created an eBook that provides a deep dive on ease of use in telehealth, including concrete examples of how a well-designed user experience in telehealth technology can address clinical challenges.
Below we share a few of the eBook’s critical concepts and insights:
The pandemic introduced three principal constraints in using telehealth technology
During the pandemic, hospitals and providers have faced three principal challenges in implementing and scaling up telehealth technologies:
- Constraints facing clinicians
- Constraints facing patients
- Constraints inherent in clinical facilities themselves
To achieve true ease of use, telehealth solutions must address all of the above categories.
For example, an effective telehealth solution must address the challenge that clinicians have to continually monitor patients with COVID-19.
Similarly, a telehealth solution must consider that patients with COVID-19 often have very limited energy (or are completely incapacitated) and thus need a very simple telehealth interface that, when necessary, can function without the patient having to do anything.
In addition, given that patients with COVID-19 are often isolated from family and friends, it’s critical to patients’ morale that they have an easy means of communicating and connecting with loved ones.
Ease of use is also critical in responding to a facilities challenge that has arisen during the pandemic: specifically, many hospitals have had to repurpose existing spaces, such as gift shops and conference rooms, into patient rooms.
A telehealth technology that requires a time-consuming installation would not be ideal when trying to quickly set up these converted spaces.
What user-friendly telehealth looks like from the perspective of patients
Given the fatigue many patients experience, the interface on telehealth technology must be intuitive and clear.
In this example of an easy-to-use mobile telehealth interface, there is one large red button for help, and one large green button to reach family and friends.
With just that one button, the interface automatically routes the call to the correct pre-programmed party. There’s no need for the exhausted patient to remember phone numbers, punch in numbers, or go through several screens.
Another design choice that contributes to ease of use for telehealth technology is not requiring a patient’s family to download a specialized app to interact with the patient. Instead, the patient’s family can receive a video call from the patient simply by clicking a link in a text.
Practical examples of telehealth that is easy to use for providers
Just as user-friendly telehealth technology must anticipate a patient’s constraints, so must it address a provider’s needs.
For example, providers sometimes need to communicate with a patient who is too weak to pick up a video call request from a provider. That’s why a feature like auto-answer at the patient’s bedside is key.
Or consider a provider who needs to remotely monitor a patient at night when the lights in the patient’s room are dimmed or off. A telehealth solution that shows the provider only a darkened room wouldn’t be of much use. But a camera with night-vision will enable the provider to watch the patient, while enabling the patient to properly rest in the dark.
Overcoming facility challenges
With so many hospitals having to repurpose spaces as hospital rooms, imagine if a telehealth technology required drilling through drywall to mount specialized cameras and monitors. That would not be an easy-to-use system.
Instead, ease-of-use means that the telehealth technology is device agnostic. It can work on smartphones and tablets, or simple carts with small cameras and screens can be rolled into a room.
The telehealth technology should also be reliable but able to reduce its wi-fi use when feasible to preserve bandwidth for other critical network-connected devices.
Ease of use in telehealth saves time
When a telehealth solution takes into account all of these real-world issues and others, its ease of use facilitates quick care, and fast, efficient care in a hospital setting can often be the difference between life and death.
If you’re interested in reading more about how telehealth design choices facilitate ease of use and promote effective care, you can download our eBook What Ease of Use Really Means in Telehealth.Learn More
Augmented Intelligence in Telehealth Holds Promise for Health Systems
If 2020 was the year that health systems embraced telehealth out of necessity and then discovered its many benefits, what might 2021 and beyond hold?
For health systems looking to further improve the cost savings and other advantages of telehealth, the new horizon is augmented intelligence: or, the use of artificial intelligence (AI) tools, such as machine learning, to assist and augment the capabilities of medical teams.
These tools can help with both routine administrative tasks and higher-level work, such as diagnosis, treatment, and patient monitoring.
Below we look at just a few of the helpful augmented intelligence tools that already exist in telehealth, preview potential future applications of augmented intelligence, and advise health systems on how best to take advantage of this new era in medical innovation.
Examples of augmented intelligence tools in telehealth and remote patient monitoring devices
The last few years have brought to market many remote patient monitoring devices that utilize augmented intelligence, enabling both hospital care staff and physicians to focus on other tasks while knowing that their patients are being continuously evaluated.
For example, EarlySense offers a sensor that is placed under a patient’s mattress and tracks multiple data points, including heart and respiratory rates. The sensor uses AI to analyze this continuous data stream and to detect early signs of deterioration, which the care team can then correct.
Similarly, Myia collects data from at-home patients with chronic conditions and uses machine learning to surface patients needing a clinical intervention.
Somatix offers the SafeBeing system, which is a remote patient monitoring device that relies on a wearable that uses AI to monitor gestures and passively collect biofeedback data. Somatix’s cloud-based system analyzes this data in real time to provide insights and alerts, such as an increased fall risk, for the care team. Somatix’s system works well for nursing homes and long-term care facilities.
Other companies are using AI to develop a more holistic portrait of patients’ health. Recognizing that clinical care accounts for only a small percentage of a patient’s health, with social determinants of health and behavior being major factors contributing to wellness, Innovaccer developed an AI-driven social vulnerability index that helps health systems see a fuller picture of both individual and population health.
We have also seen this type of technology being used to help with administrative tasks throughout various AI healthcare workflows.
For example, natural language processing, augmented by AI, can be used not only to transcribe patient-provider conversations during phone or video visits, but to assess which were the most salient points of the interaction and worthy of further attention. The resulting notes inform the provider’s care plan and also remind the patient of what was discussed.
In addition, as the Advisory Board wrote last year, at Providence St. Joseph Health in Washington and other health systems, system administrators have deployed chatbots to screen patients and direct them to the right resources, thereby discouraging the so-called worried well from unnecessarily coming into hospitals.
Future possibilities for augmented intelligence in healthcare
The possible future applications of augmented intelligence or AI in healthcare workflows are limited only by our collective imagination.
A Government Accountability Office Report envisioned that dermatology video visits may one day involve augmented intelligent patient care that assesses the patient’s skin for lesions and assists dermatologists in detecting precancerous and cancerous growths.
In this Becker’s Health IT article, a technology and data specialist with the University of California, Irvine, predicts that in the future individuals will have a digital health “twin” made up of all the data about an individual’s health. This twin’s data will continually be updated, and augmented intelligence tools will reveal health trends and trajectories for the individual as well as suggest personalized steps to better health.
Here, at Caregility, we predict that combining augmented intelligence with wearables and two-way video will be a game changer for virtual care, specifically when it comes to remote patient monitoring. Each of these components has had varied success to date in individual use cases, but when they are combined into a comprehensive virtual platform, providers will see the greatest benefit in improving care and reducing costs.
Taking advantage of the augmented intelligence revolution in telehealth systems
So, how can your health system benefit from all the latest applications in augmented intelligence in telehealth and be ready when new innovations reach the market?
To build a foundation for telehealth-enabled augmented intelligence technologies, the most critical step is adopting a flexible telehealth platform, capable of integrating with third-party apps and systems. Those who don’t start planning for the coming augmented intelligence healthcare transformation now may find themselves suddenly out-smarted and out-maneuvered: not by a human competitor, but by a learning machine.
For more on trends coming in the new year and beyond, check out our latest telehealth news roundup.Learn More
6 Musts for Choosing a Mobile Telehealth Solution
COVID surges around the country have shown that sometimes hospitals and healthcare providers need to get a mobile telehealth solution up and running or expanded quickly — and in times like those, the best telehealth solutions are often ones which don’t include the need to bring in carts or extra telehealth equipment.
Mobile telehealth systems offer a less complex, less time consuming and less costly alternative to dedicated hardware networks for organizations aiming to develop a stronger telehealth presence and harness virtual technology to enhance the efficiency, safety and quality of care.
Besides virtual visits, mobile technology which can run on the devices on hand provides opportunities to support remote patient monitoring, bolster communication and collaboration among clinicians and specialties, replace lost revenue due to fewer in-person visits, and explore new patient-centered revenue streams such as subscription concierge services.
Following are six things for healthcare leaders to look for when evaluating an effective mobile telehealth solution.
Evaluating Telehealth Mobile Solutions
A long-term telehealth solution flexible enough to support future expansion
A mobile solution may be quicker to stand up than the alternatives, but don’t lose sight of your organization’s larger, long-term view. Consider a multi-faceted solution flexible enough to accommodate a variety of inpatient and outpatient services and which can expand as your organization’s goals, priorities and services change.
Putting technological band-aids on a variety of different problems as they arise can create the same kind of fragmentation that virtual technology is designed to prevent.
In addition, approach the evaluation and implementation of a mobile telemedicine solution with an expanded view of telehealth’s possibilities. Telehealth is more than virtual office visits in ambulatory environments. Mobile platforms can also be used in a variety of inpatient settings to support remote consults between clinicians within and across facilities. It can also facilitate safely distanced communication with patients in infectious environments and much more.
A telehealth solution that is purpose built for healthcare
Work with a telehealth solution provider who understands the complex and unique workflows, processes and procedures of a clinical environment.
When the pandemic began, many organizations scrambled to cobble together systems using a variety of platforms that were not designed specifically for healthcare. Many of these makeshift telehealth systems raised concerns about privacy and caused other glitches, not only because they were rolled out quickly, but also because they were never intended to be used in healthcare. It was like trying to fit a square peg into a round hole. Look for a telehealth platform whose developers, staff, telemedicine software and devices all have a solid grounding in how caregivers work and how healthcare organizations function.
A user-friendly interface which doesn’t require patients to download an app.
Telehealth software or mobile applications that aren’t simple won’t be used. They’ll be resented, and that resentment could end up interfering with care.
Asking patients to set up an account and fill out forms online to download an app only adds unnecessary clutter, time and frustration to a process that should be streamlined, uncomplicated and even pleasant. Ideally, you want to be able to send patients a direct link on their mobile devices that allows them to connect to their doctor or nurse with a single click. Patients, including those who are less computer savvy, may avoid an appointment altogether rather than face the hindrance of trying to make a connection.
Clinicians also appreciate, and work more effectively and efficiently with, a simple, intuitive interface with high quality video and audio that reliably connects them with their patients and colleagues in remote locations.
Clinician involvement in implementation and workflow development
It’s a fundamental truth of health information technology that any system must be designed with input from and consideration for the needs of the end users. The same holds true for the best telehealth solutions for healthcare.
In which departments will you be using the technology now and in the future? How does the technology need to be adjusted to fit the specific needs and workflows of different departments and locations? Are the telehealth devices at the patient’s bedside going to be used by patients, by staff or both? Do you want the patient to be able to call to request a video visit? How do these factors vary across units?
HIPAA-compliant security features
Though healthcare providers are not subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur in the delivery of telehealth services during the pandemic, cybercriminals have been working to take advantage of the vulnerability in the current environment, which means healthcare organizations must protect their systems and their patients from these rising threats; hence, the need for a vendor whose offerings have HIPAA-compliant cybersecurity features baked in.
A partner that is a cultural match for your organization
Is your health system more independent or do you prefer a closer, more collaborative, long-term partnership? Some organizations prefer to take a product and run with it, handling testing, implementation and training primarily on their own. Others prefer a vendor that’s joined at the hip with them and prepared to be deeply involved every step of the way.
Know your organization’s and your potential partner’s culture and expectations for the relationship in deciding whether you’re a good fit for each other. A mismatch can cause discomfort and jeopardize an implementation.
The rapid expansion of telehealth services kickstarted by the pandemic has forever changed the face of clinical care and patient expectations for how that care should be delivered. Healthcare providers would be wise to weigh the potential benefits of incorporating mobile telemedicine solutions into their larger telehealth expansion plans.
To see how Caregility in expanded telehealth for two organizations, check out our Resources page, and click “Case Studies.”Learn More
Tips for Expanding Telehealth Services
Telehealth interactions could exceed 1 billion by the end of the year, according to Forrester Research. Now that providers and consumers have experienced telehealth’s convenience and potential for enhancing efficiency, connecting specialists in remote locations, and bringing healthcare professionals and patients together, virtual visits are on track to become an integral part of healthcare.
Patients are a major force driving the demand for telehealth services. According to a national survey conducted by The Harris Poll and commissioned by Change Healthcare, 89% of consumers said COVID-19 made telehealth “an indispensable part of the healthcare system,” 65% plan to use telehealth more after the pandemic, and 78% said the pandemic showed the extent to which more telehealth options are needed.
The following tips can help organizations expand and implement successful telehealth programs on a larger scale.
Assess and prioritize opportunities for expansion.With COVID-19 safety protocols in place and patients once again seeing their doctors in-person for more appointments, organizations and individual clinicians can begin the important work of defining the optimal mix of office and virtual visits for specific patient populations. Important questions include: Which health conditions and needs are best handled virtually? What worked well for clinicians and patients across specialties during the first few months of the pandemic? Where were the glitches?
Providers are finding that some specialties, such as behavioral health, are a natural fit for virtual visits, while others, such as orthopedics, may be suited to more of a hybrid of in-person and virtual care.
In addition, some organizations have recognized that telehealth can help win competitive advantage when they provide a valued service that other organizations lack. For example, one institution gained market share by offering tele-neurology for patients with multiple sclerosis.Successful telehealth programs can also support goals around population health management and reducing disparities by increasing access to care in remote communities and for patients for whom travel is difficult.
Understand clinicians’ concerns. The best opportunities for expanding telehealth services aren’t always related to specialty. Some physicians are more technically adept than others, and some physicians simply adapt more easily to connecting with patients virtually, regardless of specialty. Recruit clinical staff who show a knack for and ease with telehealth to assist in developing new services within their specialty and in sharing their experiences and advice with colleagues.
Some physicians fear they won’t be able to develop rapport with patients through videoconferencing, but then discover that the technology doesn’t interfere with relationship- and trust-building at all. A 2018 survey by Deloitte found that physicians tend to feel good about virtual care technologies once they use them, and large proportions (58–69%) said they expected to use them more. Some physicians report that video visits enable them to interact with patients in a more thoughtful and focused way because there are fewer distractions during the videoconference.
Other clinicians have found that telehealth works best for them when they incorporate virtual visits into their practices as a scheduled part of their day, rather than moving back and forth repeatedly each day between modalities.
Monitor reimbursement trends and updates.The Centers for Medicare and Medicaid Services (CMS) paved the way for widespread telehealth adoption during the pandemic when it announced that it would pay the same rates for telehealth visits as for in-office appointments for many healthcare services.
In October, CMS expanded telehealth services that are reimbursable during COVID-19. Cardiac rehabilitation, pulmonary rehabilitation, and certain neurostimulator analysis and programming services are among the services added to the list. The agency is also providing additional support for telehealth services to state Medicaid and Children’s Health Insurance Program (CHIP) programs.
Educate patients.Although telehealth services will never completely replace the need for in-person appointments, healthcare organizations are discovering that patients who use telehealth tend to become repeat users once they recognize that they don’t have to take time off work and they can have an effective interaction with their providers through their tablets, laptops, or mobile phones.
Create a simple guide for patients that covers how to log on to the platform and how to configure their webcam to make sure they can clearly hear the physician and that the physician can clearly see and hear them. Include a reminder to find a private, quiet location for the visit. Ask patients to make a list of symptoms, track pertinent health data, and have a list of current medications available for the appointment. Develop a brief script for office staff to use to introduce patients to a new telemedicine service, explaining, in brief, why the physician would like to schedule the appointment as a telehealth visit.
Telehealth is ripe for expansion beyond the pandemic. The current high interest in telehealth services among patients and physicians creates an excellent environment for providers to start exploring ways to leverage this technology on a larger scale.
To see how Caregility helped expand telehealth for two of its clients, see our Resources page.Learn More
The Importance of Telehealth for Chronic Disease Management
Chronic diseases, which affect six in 10 adults in the United States, are a leading driver of the nation’s spiraling healthcare costs. Medical providers often struggle with the barriers to effective chronic disease management. The crux of the issue: Finding cost-effective ways to reach out to patients and provide them with sufficient support to do what they need to do to stay well as they work to manage conditions such as heart disease, cancer, and diabetes.
The good news? Telehealth is now a proven tool for helping healthcare providers provide effective health management. The Community Preventive Services Task Force (CPSTF), an independent panel of experts, has concluded that telehealth strategies can reduce chronic disease risk factors and help with managing common chronic conditions.
Telehealth for Chronic Disease Management
When it comes to chronic disease management, telehealth can take many different forms:
- Virtual visits with providers
- Electronic reminders of upcoming appointments and when to take medications
- Remote patient monitoring (such as patients monitoring their own blood pressure, then sending that information to their provider)
- Educational outreach
After reviewing a wide range of telehealth interventions, the CPSTF concluded that telehealth can effectively help patients with chronic diseases do better at properly taking their medications and sticking to their healthcare goals.
The CPSTF now recommends using telehealth for chronic disease management. These strategies can help patients manage a wide range of conditions, including cardiovascular disease, high blood pressure, diabetes, HIV infection, end-stage renal disease, asthma, and obesity.
Telemedicine Methods to Manage Chronic Disease
Telemedicine applications continue to become more reliable and more sophisticated.Live videoconferencing makes it easy for providers to examine patients from afar — which is particularly valuable in this age of COVID-19 and for patients with mobility and transportation barriers. It also allows specialists, in stroke cases, for instance, to examine and oversee the treatment of patients at home, in nursing homes, and in critical access hospitals.
There is also store-and-forward videoconferencing, which allows providers to quickly share lab results, imaging studies, and other reports with patients and/or specialists.
Remote patient monitoring allows patients to use electronic devices to check their own health benchmarks, including weight, blood pressure and blood sugar, and send the results directly to their providers. And mHealth helps patients use mobile devices to set up reminders for themselves and/or monitor progress toward their health goals.
And, of course, patients and providers can also stay in touch from afar the old-fashioned way: over the telephone.
The Evidence that Telemedicine Works
The annual cost of cardiovascular disease is estimated at between $273 and $444 billion, according to studies surveyed by the CPSTF.
We know that managing blood pressure and cholesterol and quitting smoking substantially reduce the risk of heart attack and stroke. And the studies the CPSTF reviewed showed that telemedicine interventions are helping cardiac patients adhere to medication protocols, more reliably follow up with their providers, set goals, and successfully manage their risk factors. The panel found that interactive digital devices have proven effective at helping patients manage their own blood pressure — and even found that patients who use telemedicine are more likely to stay in cardiac rehabilitation programs.
The CPSTF also found strong evidence that text messaging interventions help patients with asthma, diabetes, HIV infection, and cardiovascular disease better adhere to their medications. Sent through mobile phones, these messages vary — from weekly reminders, to texts that actually remind patients at the time they are supposed to take their medicines. Some messages are personalized and some even involve the possibility of two-way communication, with patients being able to text their providers. One meta-analysis found that text message interventions doubled the odds of medication adherence among patients with chronic disease.
There is also evidence that telehealth interventions helped patients with cardiovascular disease, end-stage renal disease, and diabetes improve their diets by lowering their sodium intake and upping their intake of fruits and vegetables, the panel found. Benefits of these chronic care management interventions through telehealth included weight loss and better blood pressure control.
Why Telehealth Works for Chronic Disease Management
When patients have complex, long-term medical conditions, proper management is a marathon. Telehealth can help provide better access to specialists and improve communication, not only between patients and their providers, but among all of the members of a patient’s health care team.
Telemedicine just makes it a lot easier to communicate. It makes it easier for healthcare providers to keep close tabs on patients with complex illnesses and to convey information those patients need. And it makes it easier for patients to stay in more frequent contact with their providers and even manage their own conditions, without the hassle and expense (and the deterrent effect) of traveling to appointments and waiting in consulting rooms. The result of using telehealth for chronic disease management: improved health and better quality of life for patients, and significant financial savings for patients and the healthcare system, through reduced emergency room visits and hospital utilization.Learn More
10 Steps to Secure Your Patients’ Privacy When Using Telehealth
The onset of the coronavirus pandemic in the United States quickly brought telehealth center stage as an alternative mode of health care services delivery.
The technology has shown its viability and effectiveness on a wide scale, and large numbers of providers and patients have discovered its convenience, which means telehealth is likely here to stay. As CMS Administrator Seema Verma put it, “Countless clinicians and beneficiaries received important care while avoiding unnecessary exposure to the virus. Now that providers and patients have had a taste, it’s difficult to imagine the telehealth genie going back into the bottle.”
Indeed, a new report by Doximity, an online networking platform for physicians, notes that more than 20 percent of all medical visits — representing $29.3 billion in medical services — will be conducted by telehealth in 2020. Further, as much as $106 billion of current U.S. healthcare expenditures could be virtualized by 2023, according to the report.
Security Concerns in Telehealth
Telehealth is having a moment — a moment that is likely to become a long-term solution for issues related to cost, access, increased demand for services and convenience. But the upswing in telehealth utilization presents challenges, too, notably around the privacy and security of patient electronic protected health information (ePHI). As more patients and providers connect with each other more frequently online, telehealth privacy and security risks rise as well.
Cyberattacks, including attacks on health systems, have risen alarmingly during the pandemic crisis, revealing the appetite among cyber-criminals to strike when institutions and individuals are at their most vulnerable. Data show a direct connection between the pandemic and rates of cyber-crime. For example, on January 30, the day the U.S. announced its first case of the novel coronavirus, cyberattacks rose by 48 percent, according toComputer World.
Telemedicine Security Safeguards
What can organizations do to safeguard their patients’ ePHI and address security concerns in an environment in which telehealth visits are becoming the convenient and cost-effective new normal?
- Conduct a third-party risk assessment on any telehealth service you’re using.
- Review any software or policy changes your organization has made since the onset of the pandemic and evaluate whether they are still necessary.
- Build encryption into every aspect of telehealth implementation, including storage, transmission and access.
- Invest in an encrypted, password-protected platform and a service agreement that ensures a maximum level of security. Ideally, partner with a vendor that offers a HIPAA-compliant, secure telehealth platform that can connect patients and clinicians securely across a variety of environments and whose security controls match or exceed those within your organization.
- Frequently update all apps and operating systems, including telehealth programs — and restrict access to apps only to those who are directly involved in using them.
- Run virus and malware scans at all times.
- Stay current on new and emerging trends in cybercrime.
- Educate and regularly re-educate clinicians, staff and patients on privacy and security best practices and sources of telehealth security threats. As often noted in health information technology circles, a healthcare network is only as secure as its weakest link. Often, that weakest link is a human being. (A 2016 study by Verizon, for example, reported that 30% of phishing messages were opened by the targeted individual and 12% of those individuals clicked on the malicious link.) This means everyone must play a role in ensuring the privacy and security of ePHI.
- Employ continuous identity authentication tools to ensure that only authorized individuals have access to data. Two-factor identification, for example, has been shown to block 99.9% of automated cyberattacks.
- Pay attention to the workflows and logistics of telehealth scheduling to avoid problems such as patients inadvertently gaining access to the system when a clinician is in the middle of an appointment with another patient.
Although the Office of Civil Rights gave providers latitude in using non-HIPAA-compliant platforms, for the provision of services via telehealth during the pandemic, ensuring the privacy and security of ePHI should be a priority for healthcare organizations.
Organizations that had to launch telehealth services quickly still can and should establish strong telehealth security safeguards, procedures and practices.
Learn more about keeping your telehealth video application secure. Download our white paper, “Telehealth and Video Application Security.”Learn More