Telehealth and long-distance clinical healthcare (online healthcare) is essential in the modern telemedicine environment.
Most providers have been building their telehealth vehicle while driving down the COVID highway; they haven’t had a blueprint for consumerism and the digital front door. Their telehealth practice is still not up to speed.
The truth is, exceptional patient experiences only come from beautiful team experiences. The realities of complex healthcare service is that you cannot focus on the patient unless you've first focused on your team. This model identifies the path your digital transformation must take for your team to deliver on an amazing digital front door. Keona’s Telehealth Maturity Model will help you accelerate from zero to 100.
A maturity model is a roadmap to excellence. It shows the path that must be taken to adopt any new telehealth need & outlines the core competencies for continuous improvement.
Like any skill an entire organization must develop, exceptional delivery in telehealth is like eating an elephant: it is easy to quickly feel overwhelmed. One of the key purposes of a maturity model is to help break the giant down into “bite-sized” pieces.
Ultimately, however, it is a process improvement tool. If you’re interested in other maturity models in healthcare, check out these other models
Executive Summary
The Telehealth Maturity Model is about your organization’s core capabilities & adaptability.
CONSOLIDATED
Your organization has determined that telehealth is a strategic priority. Consolidation is the process of bringing all support processes together under unified leadership and a consistent toolset, including a Healthcare CRM.
Why: Telehealth needs to be a strategic goal from the top of your organization including investing in the tools to support it. If the consolidation step is skipped, the barriers to coordination will still be in place and the telehealth change project will fail or take a VERY long time.
COORDINATED
Coordination is the process of manually linking all the workflows together and training a small team on performing them end-to-end. You are able to take into account the full patient context & service is delivered with continuity. Team members are cross-trained in other functions. Service delivery is federated or centralized. See below.
Why: Breaking down barriers between silos in data, roles, & medical specialty is critical to holistic telehealth. This structure of coordination is what makes it possible to deliver on the 4 principles of telehealth delivery. The manual work of mapping out and documenting the workflows is the most difficult for many healthcare organizations, but also the most important. Until you have figured out how to coordinate & consolidate workflows, you will be automating the wrong things.
AUTOMATED
Automation takes the coordinated workflows and makes them more efficient, consistent, and safe. The improved, coordinated workflows defined in step 2 are simplified within a unified workspace. Training time is reduced, quality and interaction time are improved, as are documentation and tracking. Management is simplified across all channels.
Why: If Automated is skipped straight for patient access, patients will be given online tools, but they will be frustrating and clunky. The patient won't feel like they have the same support they get when they call in.
ACCESS
The above automation is made available directly to patients. Service delivery is agnostic, so patients & staff move between channels with minimal disruption.
Why: Patient satisfaction goes way up when you give patients the flexibility & control of self-service. Costs drop as patients handle tasks themselves that your staff used to perform. Developing multiple channels are key to increasing patient access & organizational flexibility.
OPTIMIZED
The organization is ready for continuous service improvement to any patient trend. Staff cross-training is deep, allowing maximum flexibility. The organization can shape demand management & even confidently offer satisfaction guarantees.
Why: Rapid analysis, response & implementation make practices more flexible, more adaptable & more streamlined. It is the key to confidently facing changing circumstances.
The organization is now ready for continuous service improvement to any patient trend. Staff cross-training is deep, allowing maximum flexibility. The organization can shape demand management & even confidently offer satisfaction guarantees.
If you are responsible for implementing a single service, like telemedicine or scheduling, but don’t have the ability to change your organization’s mission & strategic direction, check out Keona's 6-Factor Framework (upcoming)
When most people think of telehealth, they think only of a provider visit over video chat. Telehealth as defined by the US Dept of Health & Human Services is your entire digital front door.
The federal agency defines telehealth as using any remote technology to support long-distance clinical health care. Not just real-time video, this includes telephone, web chat, as well as over asynchronous SMS texting or secure messaging. Even digital scheduling and check-in are part of telehealth. It includes sending pictures along with online applications such as patient portals. What is more, this definition of telehealth includes not only the remote delivery of healthcare, but also preparation & administration of remote healthcare.
To see how broad & deep telehealth can be, follow this diagram. It shows the services that are typically rendered around a single telemedicine visit. A smooth telemedicine visit relies on sophisticated coordination across many services including administration & health education.
For more information on the scope of telehealth, see the The Ultimate Guide
You have probably experienced the benefits of digital transformation as a consumer. When you contact Amazon, your airlines, or even Roto-Rooter, they recognize who you are by the number you are dialing from. The person taking your call has at their fingertips your entire purchase history, your preferences, & instructions on how to handle nearly every request or complaint you make. If, for some reason, they are unable to handle your call & have to forward you to someone else, you can be sure that your notes are available for that next person. The new person may verify key pieces of information, but you can be confident you won’t have to repeat every single word that you said.
When you call your healthcare provider, you face very different experience.
It doesn’t have to be this way. Mature telehealth providers can offer the same advantages of consumerism as what you experience elsewhere.
What are the Patients' Benefits?
What are the Organizational Benefits of Telehealth?
This is just the beginning.
Once an organization reaches telehealth maturity, they are less susceptible to the shocks of unexpected events. This is because the core competencies of managing telehealth workflows make them nimble & adaptable. They are aware of the syndromic trends in their population without looking at the news stand. They can quickly create new health assessments & resulting workflows & make them available to their staff & online. They can create new visit types & customize them for each provider. They can direct patient demand to the most optimal channels for the moment.
Examples of the adaptability of the mature telehealth organization:
To see more details about the benefits of telehealth, please refer to The Ultimate Guide
Summary
Consolidation is the process of bringing all support processes together under unified leadership and a consistent toolset. Before consolidation, the different steps needed to help a patient are performed by different people scattered across different departments. The barriers of too much specialization, different departmental agendas, and just distance and unfamiliarity must be overcome. If the consolidation step is skipped, the barriers to coordination will still be in place and the telehealth change project will fail or take a VERY long time.
Practical Steps
In Depth
Unify service leadership. |
Why centralized service management is necessary:
Steps you should take:
1. Setup a cross-department taskforce for unifying telehealth services & workflows
2. Identify measurable goals
3. Determine if you will centralize (pro’s & con’s)
OR
4. If you will federate (pro’s & con’s)
Capture executive service metrics |
Why capturing executive service metrics is useful
1. Define service mission & goals
2. Define markets & services for focus
3. Create cross-functional leadership team to advocate & review following metrics
Consolidate telehealth services |
Why consolidating telehealth services is crucial
Steps you should take
Consolidate tools: Healthcare CRM Platform |
Why Implementing a Healthcare CRM is crucial
Steps you should take
(Related: Understand the difference between a sales & marketing CRM and a healthcare CRM)
Few healthcare technology companies have optimized their own workflows for consumer-level service & support.
Summary
Coordination is the process of tightly linking all the workflows together and training a small team on performing them end-to-end – basic scheduling, complicated scheduling, nurse triage, payments, case management, etc. Before coordination, it is up to the patient to follow-up and be sure all the dots are connected. If the coordinated step is skipped, your programmers and tools will be automating bad workflows.
Practical Steps
In Depth
Follow the 4 Principles of Telehealth Coordination |
The key to all of this is to transform your team's experience so it is smooth and easy to support patients. This means coordinating between the silos that exist between providers, departments, as well as care staff, and even between sites & specialties. Key tools, such as medical records & pharmacy data should be integrated.
While there are a lot of tasks, the 4 key principles behind great service are rather simple:
Ideally, no transfers or callbacks.
Tightly link all service workflows |
Why coordinated workflows are crucial:
If you automate without this step, you lock yourself into disjointed and painful workflows
Disjointed vs Coordinated workflows
This example is all to common. It violates all four of the key principles:
This large number of steps is due to the care not being coordinated. Harvard professor & management thought leader Clayton Christensen noted in his book “The Innovator’s Prescription,” that healthcare works in batch processing. Services are provided by independent groups that “dump” work to the next group where queues build up behind each one. Every person is trained in just their own tasks and unaware of what others are doing.
Coordinated workflows are designed to take into account the four key principles. The exact same scenario, when following the 4 principles, only takes 4 steps:
The 4 principles are key to coordinated care. Information is not lost & each person's work is closely coordinated with everyone else's work.
Steps you should take:
Real-life Example 1: telephone patient intake immediately following scheduling
With the advent of COVID, providers were having a tough time in the video visits due to the lack of an intake process & pre-visit summary. Some clients have switched to complete the intake process at the time of scheduling. Not only has this change smoothed out their virtual visits, it also has smoothed out office visits as well. There are fewer people in the waiting room & fewer delays throughout the day. This is an example of principle #2 (“each step is aware of steps before & after”) & principle #3 (“provide all the services you can in one interaction – while the patient is online / on the phone”), because the person scheduling the visit is told what the intake process needs to look like for each type of visit & they perform as much as they can on the spot.
>Real-life Example 2: everyone is trained in scheduling
We work with clients to train all staff who interact directly with remote patients how to schedule. Using automation like Intelligent Scheduling makes this possible. Nurses, medical assistants, & even technicians can quickly schedule while talking with a patient. If they don't have time? Just quickly send the patient a link to schedule themselves in real-time! This minimizes patient leakage, saves the patient’s time, avoids transferring the patient, all resulting in higher patient satisfaction & a fuller schedule.
This is another example of principle #3 (“provide all the services you can in one interaction”).
All staff are trained in Telehealth safety, documentation, & soft skills |
Why this is crucial:
Steps you should take:
QA metrics exist for all Telehealth services |
Why QA metrics are crucial:
Outcomes & Safety Metrics |
Why Outcome and Safety Metrics are crucial:
Steps to take:
Summary
Automation takes the coordinated workflows and makes them more efficient, consistent, and safe. This automation prepares the way for fully digital patient access.
Practical Steps
In Depth
Turn workflows into automation |
Why automation is crucial:
Steps to take:
This is a lot easier once the workflows have been built out in the prior steps. Items to automate or semi-automate include:
One of the key principles is that the workflow is aware of steps before and after the current one. Part of this is understanding the specialized skills of staff so that automated routing and handling can quickly match patients to those who have those skill sets.
The best type of knowledge base is the one you don't have to search. You want a system that auto-delivers the relevant knowledge to your users based on the patient, call type, specialty, practice location, or even physician being scheduled.
Learn more about Care Desk Knowledge Base here.
Prioritize safety and escalation automation |
Why this step is crucial:
Steps to take:
1. Incorporate Advanced AI tools & clinical decision tools into the workflow. Key tools:
2. Establish escalation logic & messaging
Captures encounter handling metrics in real time |
Why this step is crucial:
Steps to take:
Summary
Congratulations! If you've reached this stage, you have made it far easier for your teams to assist patients. They are guided each step of the way, and many of their tasks are automated. Now you are ready to throw open the digital front door and bring the benefits of digital transformation directly to consumers.
The key principal for digital access is this:
WHEREVER AND WHENEVER A PATIENT NEEDS ACCESS, THEY OR A CAREGIVER CAN REACH OUT OVER ANY CHANNEL TO FIND REAL-TIME SERVICE.
The Digital Access stage builds on the workflow optimization & automation of the last two phases. It makes services available anywhere over multiple channels with online & AI-optimized cloud technologies.
In Depth
Patient self-service is available for most services & workflows,complete with safety checks & escalations |
Why Patient self-service is crucial:
Steps to take:
1. Take existing workflows & automation built for your staff & put them on a patient-facing web page.
Key workflows:
2. Edit the language to be patient-friendly
3. Add pictures, profiles, maps information & other patient-facing content to add ease & instill confidence
Patients can switch between channels without losing prior work |
Why this step is crucial:
Steps to take:
Service platform facilitates all remote telehealth workflows |
Why this is crucial:
Patient-reported & Cross-Channel KPI’s are captured |
Why this is crucial:
Steps to take:
Summary
The Optimized stage builds on every prior stage. Providers can forecast demand, continuously improve service & quickly adjust workflows & processes in real time to changing circumstances. They are aware early of symptomatic trends across the population & have the tools & expertise in hand to direct dem& to the channels needed at the moment.
In Depth
Track symptomatic & syndromic trends in population |
Why this step is crucial:
Steps to take:
Forecast demand |
Why forecasting is crucial:
Steps to take:
Continuously measure & improve quality & efficiency of all channels |
Why this step is crucial:
Capture holistic patient experience KPI’s |
Why this step is crucial:.
Steps to take:
Offer satisfaction guarantees for your telehealth services |
Why satisfaction guarantees are crucial:
Steps to take: