Patient care has long been a priority of the Quadruple Aims in the US. But a shift in focus has led Executives to turn to new technologies to address the high turnover and burnout rates amongst their staff.
But just how bad is it? Several studies have identified chronic levels of burnout among healthcare workers in the US, with more than 50% having experienced burnout. The numbers are estimated to be even higher in primary care, undermining healthcare provision and the long-term viability of the healthcare industry. Coupled with the ongoing aftermath of the COVID-19 pandemic, recruitment issues, and many leaving the profession, this is a perfect storm of challenges for healthcare executives.
So, with workloads for existing healthcare workers at an all time high, how can they improve the staff experience, and retain staff? One of the ways in which this can be achieved is to give them back more time to deal with the additional demands being made of them, as well as reduce burnout and, ultimately, turnover.
The role of technology in supporting overburdened healthcare staff
As Philips’ 2022 Future Health Index 2022 report illustrated, telehealth is an important technology with the potential to help healthcare workers claw back extra time in their day. With its promise of reduced workloads, and increased access to patients and other clinicians, investment in telehealth offers a viable means of addressing the worrying statistic that three in ten are currently considering leaving the profession - be that HCP-to-HCP telehealth (healthcare practitioner to healthcare practitioner), or HCP-to-patient telehealth (healthcare practitioner to patient). Perhaps unsurprising therefore is that the telehealth market in the US is estimated to grow seven-fold by 2025. But how can such technology be combined with existing IT infrastructure?
While telemedicine and the remote diagnosis and treatment of patients is a well publicised solution, telehealth encompasses a much wider range of technologies e.g. remote patient monitoring (RPM), mobile health, and store-and-forward (the collection and transmission of medical images and records). Other clinical use cases include telepsychiatry, telePT, patient portals, and telehealth nursing. Telehealth can also include non-clinical core services such as training and education, scheduling and meeting administration, and medical billing. These services can be delivered in part or whole by healthcare institutions, or outsourced to third-parties.
EHR and telehealth
Successful telehealth implementation nevertheless requires careful integration with a pre-existing and interoperable electronic health record (EHR) system, in order for the full benefits to be realised. Without it, the introduction of telehealth infrastructure may actually lead to an increase in clinician workloads, as healthcare workers would be required to enter the same information twice (once into each system), in order to ensure details of virtual consultations were adequately captured in EHR systems.
Furthermore, any telehealth technology introduced will need to be supported by some form of high availability solution and impenetrable security protection, for it to be a viable offering for hospitals, clinics, outpatient facilities, and doctor’s offices.
But for those able to achieve this, here are just some of the ways telehealth can save healthcare workers time:
1. Real-time interactive medicine and treatment
HCP-to-patient telehealth provides more timely access to the patient, and delivery of their data. With convenient and efficient access to medical records, and the opportunity for patients to gain more immediate access to healthcare services such as consultations, prescriptions and billing, telehealth empowers both parties in the relationship, resulting in greater process efficiencies. With remote patient monitoring and access to mobile health applications, in some instances patients are able to get more immediate answers to their questions, without the need for any form of consultation at all - virtual or otherwise. That’s definitely welcome news for clinicians and patients when they start to experience a health concern at 10pm on a Saturday evening.
Fewer physical home visits also means less time spent travelling to patients in remote areas, or with limited mobility. Patients are also more likely to recover from illness from within the community, and with remote outpatient care and follow-up made possible, bed blocking is also avoided. This means more efficient workload management for primary and secondary healthcare works, with less need for the patient to return to hospital following treatment, as well as lower costs.
2. Fewer sick days
One of the advantages of live HCP-to-patient video consultations is a reduction in face-to-face contact with sick patients who inadvertently pass on contagious illnesses to their doctor, front desk, nurses and other caregivers. Sadly the number of patient assaults on healthcare workers continues to rise, so staff’s physical safety is also protected through virtual consultations. Indeed, one survey by the International Council of Nurses and the World Medical Association found that 82% of nurses had experienced some form of physical aggression.
Furthermore, the ability for healthcare workers to access what they need, wherever they are, whenever they need it, increases flexible working opportunities, and reduces stress levels and the subsequent need for unplanned days off. In fact studies have found that workers who reported low workplace flexibility were much more likely to experience burnout.
3. Consulting medicine
HCP-to-HCP telehealth also offers significant time-saving working practices. With more team-based consultations and quicker decision making made possible, not only do primary healthcare workers feel more supported in their day-to-day work, but they are also able to consult directly with secondary and tertiary healthcare providers, improving the timeliness and accuracy of diagnosis, and potentially avoiding unnecessary referrals or appointments. Better communication and access to other practitioners (as well as patients) also provides a more immediate support network, offering advice and guidance.
Training and closer supervision of junior doctors is additionally made possible, resulting in fewer human errors, and more immediate access to a second opinion, as well as the ability to monitor prescription and treatment recommendations. In fact, 8% of prescriptions made by junior doctors are known to contain errors, although thankfully most of these are spotted by pharmacists.
The ability to outsource less serious cases and initial assessments to third-parties has the potential to save significant amounts of time. With the ongoing pandemic backlog, and ever-increasing demand for appointments, the introduction of telehealth practices presents further opportunities to streamline in-house processes, and explore outsourcing opportunities. Following the Telehealth expansion bill in US states such as Michigan back in 2020, the introduction of more formal telehealth policies are now being considered. With increasing acceptance of telehealth practices expected over the coming years, healthcare institutions are exploring which components of their telehealth provision may be most appropriate to outsource.
However, concerns over patient safety remain, and will need to be addressed if this is to become common practice. Oversight is still needed so many primary clinical services will need to remain-in house, so non-clinical telehealth services such as managing appointments and schedules, and the processing of technical patient data all seem good places to start. Providers need to be HIPAA certified, have appropriate IT infrastructure, quality control measures, and offer value for money.
5. Quicker referrals
With process efficiencies come quicker referrals and faster treatment times. Long waiting times for specialist referrals puts significant pressure on primary healthcare providers in the interim, with additional appointments often needed to manage the complaint. With some patients waiting more than a year for appointments, operations or cancer treatment, the health of the patient may well deteriorate in the meantime, resulting in further strain on already overwhelmed healthcare services.
In one study by BMC Health Services, waiting times were reduced by 55-89% following the implementation of telehealth management practices. Median waiting times over a six month period fell in two localities from 159 to 241, to 100 and 114 waiting days respectively, underlining the advantages of telehealth in reducing the workload of already overstretched healthcare workers.
Telehealth is not a simple infrastructure add-on and presents a number of significant challenges for IT teams. For example, interoperability, remote working, security concerns, the threat of downtime, and the need for telehealth to form part of a more comprehensive EHR strategy, underline the importance of an integrated service approach. However, if these challenges can be overcome, then there is a substantial opportunity to save clinical and non-clinical healthcare workers time - which ultimately also benefits patients.
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