Many U.S. hospitals are asking about how to set-up telemedicine because their competition is realizing strong returns on their telemedicine investments. Staffing gaps are filled, patient transfers are reduced, and Leapfrog scores as well as other metrics are on the uptick. And by the way, their staffing costs have gone down.
Despite the success stories, other hospitals struggle, for a variety of reasons, over the question of whether to implement telemedicine. In this new series of blog posts, we’ll cover the strategic and tactical challenges that often arise when a hospital is considering a telemedicine program, and we’ll offer tips on how to meet them. In this first installment, we discuss some of the strategic challenges involved in making the case for telemedicine and encouraging its adoption by a hospital or health system.
How to Set-up Telemedicine: Strategic Hurdles
Implementing a telemedicine program requires detailed planning and preparation. As with any new program in a hospital, there are hoops to jump through. Budgets must be worked out, billing questions resolved, and staff members trained and oriented to the new system. In addition, the contractual process is much more complex than it used to be.
Working out these details can slow the momentum of any new program’s implementation. But in our experience, it’s usually not the tactical details that prevent a hospital from implementing telemedicine. It often boils down to one factor: focusing on the barriers more than the strategy.
If you are a clinical staff member of a hospital or an executive who sees the promise telemedicine can offer your hospital, the first step is to convince your colleagues and your board of directors that telemedicine isn’t about rocking the boat; it’s about making the boat more stable, and equipping it to withstand the growing challenges all hospitals are facing today.
How to Set-up Telemedicine: Vision is the Difference
As a business development executive with Eagle Telemedicine, I’ve seen hospitals span the spectrum when it comes to acceptance of telemedicine, from the early adopters to the slow ones, from those who say, “How to set-up telemedicine as soon as possible?” to those who insist, “It’s just not for us.” They might voice security and privacy concerns, or question quality of care and/or patient acceptance. They might be turned off by the ambiguity regarding insurance coverage, and by their state’s view of telemedicine versus face-to-face physician encounters.
I understand their concerns. I was a hospital CEO myself not too many years ago. I know well the reasons for resistance. Brian Hunt, MD, one of our top telemedicine physicians at Eagle, tells the story of his initial apprehension about technology overtaking the work physicians do—from the advent of the Electronic Medical Record (EMR) to the rise of telemedicine. He just didn’t think those types of technologies had a place in his person-to-person profession, but now he is one of our strongest advocates.
I also understand—and I think Dr. Hunt would agree with me—that fear of change lies at the heart of a great deal of the initial resistance to telemedicine.
Let’s face it: Implementing new models of care in a hospital requires a shift in culture. What are the typical speedbumps along the way? We’ve identified five major obstacles, and we’ll discuss all of them in our blog series. Here is No. 1 in our book:
How to Set-up Telemedicine: Failure to Put Strategic Value First
One of the most valuable lessons I learned during my years as a hospital CEO was to stop letting barriers dictate our overall strategy. We had a dynamic chair of the hospital’s board leading. He would see great ideas presented from Business Development on how to grow business for the hospital—truly innovative ideas—squelched when a finance committee member would say, “We don’t have the money” or “We don’t have the time to learn how to set-up telemedicine.” After a series of those responses to good ideas, he challenged the board: “Are we going to let finances dictate our strategy or are we going find ways to fund good strategies?” Maybe a bit simplistic, and I appreciate the great job our finance committees do for our hospitals amid very challenging times, but the question he raised is more broadly made, “We shouldn’t let barriers dictate our strategy; we should commit to solid strategy and work through the barriers.”
True, a telemedicine program requires an initial investment, but as a strategy for long-term savings and successful performance, it’s a smart one. And it is working for hospitals whose boards and executive teams have the foresight to put strategy foremost in their efforts to build a future of growth for their facilities.
In a 2015 article in the Harvard Business Review titled “You Need an Innovation Strategy,” Gary Pisano, professor of business and member of the U.S. Competitiveness Project at Harvard Business School, writes that an innovation strategy “should start with a clear understanding and articulation of specific objectives related to helping the company achieve a sustainable business advantage.”
He suggests that a robust innovation strategy should answer three questions:
1. How will innovation create value for potential customers?
2. How will the company capture a share of the value its innovations generate?
3. What types of innovations will allow the company to create and capture value, and what resources should each type receive?
I know that Pisano is writing about business enterprises, not hospitals, but the principles he outlines still apply. And the value equation that telemedicine brings to the facilities we work with makes it easy to answer his three questions. It’s value in terms of patient satisfaction. Value in terms of greater revenue from increased admissions and lower staffing costs. Value in terms of long-term staffing stability.
The A-B-Cs of presenting new ideas
In my experience, most medical staffs, executive teams and hospital boards are made up of people who view the prospect of telemedicine in one of three ways: They are either: A) early adopters; B) would be willing to adopt with a little traction; or C) are sitting on the fence. Frequently, the As and Bs will convince the Cs to support the program if they make a strong enough case, present success stories from other similar hospitals, and illustrate how the program will work for them.
In most cases, it’s a matter of helping everyone see the bigger picture—the benefits of avoiding patient transfers, for example, or the advantages of telemedicine in healthcare is bringing in specialists to support current staff and add new services to the hospital.
Patient acceptance metrics also help. In our surveys conducted over the last 10 years, 95 percent of patients and families who have experienced our program say they would recommend it to a relative or friend. Figures like that make it clear that telemedicine programs are a win-win for hospitals once they are prepared to overcome their fear of change, understand the true strategic benefits, and make the leap to a new, sustainable model that works not just for today, but for the long term.
In Part 2, we will take a look at four other practical challenges hospitals face when considering how to start telemedicine at your hospital.
In Part 3, we address the tactical challenges involved in adding remote physicians that deliver a successful telemedicine program.