Telehealth had a massive explosion in 2020 and by all accounts, it’s here to stay. However, surveys indicate that provider satisfaction has dropped precipitously. This is understandable when you consider how many organizations had to adopt the new technology very fast, underestimating the complexity of their own workflows. Unfortunately, this has resulted in more work for fewer visits.
We predict that 2021 will become the year of telehealth burnout – and even backlash. Learn more about these alarming trends and how to avoid them in your organization.
The amazing growth of telehealth is encapsulated in a single statistic: telehealth went from 2-3% of all visits in 2019 to 15-25% of all visits in 2020.
Frost & Sullivan research predicts a growth of nearly 20-25% in patient engagement management solutions in 2021. If so, telehealth usage will be 30-35% by the end of 2021
Patients love telehealth; 83% of patients who have used telemedicine in 2020 said they will continue to use it even after the COVID crisis is over.
But not so fast. Before the leaders get ahead of themselves, they need to take a closer look at what is happening on the front lines. That picture isn't as pretty.
In 2019, studies showed a majority of providers were satisfied with telemedicine;
In 2020, only 26% of providers were satisfied.
While consultants and CEOs are bullish that 25-35% of visits will be telemedicine in 2021, providers are not; some 80% of physicians expect that telemedicine use will be under 10%.
Telehealth has turned out to be more complicated than providers were expecting. Many experience telehealth as more frustrating, taking longer, and requiring more steps.
While leaders will be focusing on building the most effective PR strategies to stay relevant, it will be years before healthcare develops the infrastructure to deliver on turnkey solutions. This exacerbates the burnout.
The future of telehealth is likely in between those bullish on telehealth and those skeptical. In any case, telehealth is not going away. What's more, the recent move to telehealth has far-reaching implications across healthcare. Nearly every role inside provider organizations is facing increased work and complexity.
Clinic websites are getting more traffic
Telephone queues are more likely to be backed up
Scheduling changes happen more often
Workflow changes happen more often
Nurse triage guidelines change rapidly
Billing has new complexities and uncertainties.
This means that nearly every role within healthcare is affected, whether or not they are ever near a virtual visit themselves. Schedulers are affected, nurses are affected, billing is affected, contact center agents are affected.
Do you see any of the following?
Not every organization faces the same level of burnout. From supporting staff to boning up on change management, here are things your organization can start today to make the move to telehealth easier on everyone.
Telehealth is more stressful and staff turnover is higher in telehealth roles. Most providers are familiar with fast-paced work, but telehealth adds even more stress. The inability to physically be with the patient add complexity. In addition, most telehealth workflows don’t give practitioners time to prepare for the visit; they have to figure out who they are talking to and what the issue is on-the-fly, compounding stress.
Part of the reason that telehealth is more stressful is because both patients and staff are more blunt and easily irritated over electronic communications. Another is the fast-paced nature of telehealth. Prepare your staff for these with training and support. See some of our articles on telehealth training and management:
The Top 13 Patient Experience Metrics
See the Telehealth category in the Care Desk Blog for a wealth of training, tips, and strategy.
A recent study found that 73% of change-affected employees report experiencing moderate-to-high levels of stress. This is why proper management is so crucial during the transition.
As outlined by Smarp, a few key concepts are:defining clear goals;that everyone understands; building trust with honesty and transparency about the process encouraging communication; listening to your employees’ concerns; and implementing lots of training to help them get over the learning curve.
However, every organization is made out of people with differing personalities that can cause obstacles and/or resistance to change. Therefore it’s important to have an effective strategy to achieve your goals. But as article in the Harvard Business Review notes the most common mistake is to have a limited approach. It goes on to recommend tactics such as co-option – offering those that are resisting an important role in the process – as well as consistency with messaging that can help deal with any roadblocks.
Employees who are dealing with depression or anxiety may be having difficulty feeling that they fit into the workplace. This also means they tend to withdraw or are silent about their issues, leading to a high level of turnover if not a general malaise. Therefore, you should do everything you can to bring to the surface discussions of what is going wrong and what can be done to improve the situation. Since this is healthcare, we are literally dealing with life-or-death situations and low morale can only make things worse.
When change increases, it is incredibly hard not to fall into unrealistic expectations by leaders. Periods of relative stability allow for greater efficiency and perfection to be honed. In times of change, doing the same things that were done before result in less and less desirable outcomes. Prior levels of performance become harder and harder to maintain, which drives up stress.
Research in telehealth indicates that workflows created with staff input are far more effective than ones created from top-down approaches, such as management design and consulting. Be sure to incorporate advocates from every role in the implementation process.
Part of the solution is recognizing their efforts for solutions that help the entire organization.
During times of rapid change, it takes more effort to accomplish the same workload. Nothing drives burnout faster than expecting even more. Greater productivity will be the eventual result of your investments in digital health, but don't expect it from day one!
If you can’t measure the source of stress it will be more difficult to solve. That's why it's a good idea to invest in a healthcare CRM that can give you a holistic picture.
a. It can alert you when your appointments are starting to pile up
b. It can determine whether your appointments are running late
c. See trends in encounters that are lasting longer than normal
d. Pinpoint steps in the process that are causing backlogs
Operations solutions identify the largest sources of stress and modify the workflow accordingly.
Telemedicine problems associated with burnout: Telemedicine tends to create more work than previously required. These are some of the problems adding to difficulties:
1. Less team support. Budget cuts at some facilities has made it difficult to maintain staff at optimum levels. This means more work for fewer people, leading to higher stress and quicker burnout.
2. Extra work. Virtual visits have added another layer of work to already burdened staff; some physicians now report spending half their day filling out EHR documentation.
3. Too many tools. It seems like every interaction is now in a separate app. Staff have to use the EHR for orders, visits via the telemedicine software, connect via secure VPN network, knowledge base through document management, coordinate with coworkers through text messenger, etc.
4. Lack of integration. When the rush to telemedicine occurred, many systems were quickly developed or implemented that are unable to connect. This has lead to duplicate tests, difficulty collaborating with other providers, and more time spent collecting external records.
5. Meeting documentation requirements. Compliance has been an essential part of patient services and is now even more complicated with telehealth and Covid. All patient paperwork must be secure, private, and accessible.
The patient’s virtual visit should be just as quick and easy as in-person. Carefully planning the visit workflow is key. Consider the following to make it easier:
Having someone besides the practitioner check the patient in and review notes means that technical hurdles will usually be addressed before they show up.
If the connection is poor, both parties should turn off the camera unless/until needed. If the visit is reimbursable for audio only, there may be no reason to turn the cameras on at all.
The more applications that staff must juggle, the more problems they have.
You want a solution that automatically saves documentation to the EHR and integrates orders as well as allowing the practitioner to be able to do everything in one place easily with minimal distractions from the patient.
EHR integration from a web-based solution helps practitioners host visits while they are also remote or in areas where VPN isn’t available.
Many solutions tout EHR integration but don’t actually offer enough to make it valuable. Instead, the following integration features should be supported:
COVID has meant both more and longer phone calls, as patients need extra education and reassurance. This combination has been a double blow for practices not prepared for telehealth.
The problems associated with telephone burnout:
Patients are upset if the nurse is unaware of what was said in the previous visit. If nurses are relaying inconsistent information or advice, patients lose trust. You need tools you don’t have in order to address these.
Solutions to Telephone Burnout
COVID has thrown much of traditional scheduling out the window.
Scheduling problems that result are -
Solutions to scheduling
A. Centrally document all new scheduling requirements
B. Integrate scheduling into your telephone scripting tool
C. Automate scheduling to alleviate the mental burden, improve accuracy, and save time
D. Let patient schedule even complex visits themselves with patient self-scheduling
Care Desk is a healthcare CRM and telehealth platform that provides a single place to implement all the workflow optimizations listed here. In this new era of digital health, a healthcare CRM will be just as important as your billing and EHR systems.
Reach out for a FREE consultation in how to address your burnout challenges.
CMS is likely to reduce the rate for telehealth visits. It will be easier to tackle these barriers while CMS is still reimbursing telehealth.
Even while telemedicine is growing, hospital visits have remained flat. Therefore, the pressure to invest and reduce burnout is very high.
Ultimately, government action is needed to give the industry more time to adjust. If telehealth reimbursement is cut too soon, rural and vulnerable populations will be the hardest hit.
"Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020" is a bill introduced by Representatives Dr. Ami Bera, D-Calif., and Dr. Larry Bucshon, R-Ind., that would temporarily maintain physicians' reimbursement in Medicare at 2020 levels for the next two years.
If reimbursement drops, the organizations who didn’t solve these problems will almost certainly de-prioritize telehealth as a strategic focus. On the other hand, organizations who addressed these issues will have long-term benefits, including increased patient access, longer growth, and better profit margins.
Contact Keona Health for your Telehealth consultation today.
At Keona Health, we believe that relationships matter. We know that a clinic’s triage system can test a patient-doctor relationship, especially if a patient cannot easily get the help he or she is seeking. Keona Health offers healthcare software and automation solutions to ease the burden of telephone triage on medical practices and help medical professionals better communicate with patients.