Authored by SCP Consulting Services

This fall, Schumacher Clinical Partners Consulting Services embarked on a new, binational journey in collaboration with zeb healthcare to create the US Telehealth Experience, a 5-day telehealth education program and site tour for a group of esteemed German healthcare leaders. The experience took participants inside state-of-the-art telehealth programs at three leading facilities in the United States – Carolinas HealthCare System (CHS), Mission Health and University of Virginia (UVA) Health System – and culminated in Washington D.C. with introductions to leaders within the American Telemedicine Association (ATA) and Telehealth and Medicine Today (TMT).

Key topics of interest during opening remarks of the program included:

  • How to drive patient awareness and acceptance of telehealth 
  • Choosing the right technology partner 
  • Trends in reimbursement
  • Measuring Return on Investment (ROI) and other telehealth key performance metrics
  • Program governance
  • The role and future of artificial intelligence in health care and telehealth

As we toured each organization and offered these and other key questions to the organizations we visited, it was refreshing to participants to hear that many answers were unique to the organization and embodied their organizational strategies to approaching telehealth. As a group, we embraced that there is no “one size fits all” approach to building and operating a telehealth program, however, we walked away with a wealth of lessons learned from these leaders in the field.

Day 1: Carolinas HealthCare System

Our first stop was Charlotte, North Carolina to meet with telehealth program leadership from Carolinas HealthCare System (CHS). Guy Glorioso, Assistant Vice President of Virtual Care coordinated our visit and we were welcomed and led throughout the day by Jennifer Villafane, Director of Virtual Care. Leaders of several key telemedicine specialties, including Critical Care, Telestroke, Behavioral Health and Psychiatry, and Primary and Urgent Care presented to our group on the inner workings of their service lines. We also had the opportunity to tour the innovative and robust Critical Care and Telestroke bunkers and experienced Virtual Care teams caring for patients firsthand.

The CHS Virtual Clinical Care program, which began in 2010, highlights a focus on high quality and best practice care regardless of technology leveraged and has intentionally weaved this guiding principle through all aspects of their program. As the program continues to mature and grow, the Virtual Care team is positioning the program as a strategic priority for the organization and further developing current infrastructure, operations, and integration.

We wrapped up the day with the following lessons learned presented by Katie Kriener, Vice President and Chief of Staff, CHS Medical Group Division, who is the executive champion responsible for the CHS Virtual Care Center:

  • Physician leadership is invaluable.
  • Communication and alignment are crucial.
  • Clarity of roles and responsibilities can reduce variability and duplication.
  • Virtual workflows often do not fit within traditional operations; innovation with efficiency and patient care in mind is key.
  • Data and analytics can accelerate the maturity of a program, especially in the direct-to-consumer market offerings.
  • There will always be a “new” technology, so it’s important to lead with your goals and the patients’ needs, not technology.

Consulting team

Day 2: Mission Health

Next, we traveled into the Blue Ridge Mountains on our way to Asheville, North Carolina to visit Mission Health. We were met by program leaders Dr. Steve North, Medical Director of Mission Virtual Clinic, Amy Roberts, Virtual Care Executive Director, and Jonathan Bailey, Chief Program Development Officer of Mission Health, who provides strategic oversight for Virtual Care at Mission Health.

Our group was joined by executive leaders from the Center for Innovation, Behavioral Health and Neurology service lines. We also had the special opportunity during our visit to spend time with the President & CEO of Mission Health, Dr. Ron Paulus. Dr. Paulus is a visionary and a champion for telehealth at Mission since the beginning of Virtual Care in 2011 and conveyed to us that “innovation is messy” but how could you not make the investment, as it is the future of healthcare. He also passionately spoke to us about one of our specific topics of interest – the ROI of Telehealth and Virtual Care. Dr. Paulus stated of ROI, that it should be measured in what you expect to get back from your program, where only one of the returns for the value proposition of ROI is financial. “We’re doing things that are going to position us to be fundamentally lower in cost and higher in both consumer experience and quality care,” said Dr. Paulus.

At the conclusion of the Mission visit, we were enlightened by leadership perspectives and lessons learned, which included:

  • Strategy on how an organization moves toward their program goals is an important component of success in Virtual Care.
  • Many organizations still aren’t positioned to fully support a program under value-based payment, though once they are, the true value of virtual care can be unleashed.
  • Consumer patient demand will outpace payment models, so organizations that wait on payment will be playing catch-up
  • Accelerating the payment transition is a strategic priority for Mission through Mission Health Partners, their accountable care organization, and Healthy State, a new employer benefits provider offering.
  • Venture Philanthropy has been an element of Mission Health’s vision and goals within Virtual Care, partnering with public and private endowments, organizations, and individuals to bolster Virtual Care to service area healthcare needs.
  • “Organizations will know when they have truly arrived at integrating virtual care into their organization when the clinical delivery flow and technology have converged and the teams no longer refer to it as tele-this or that, but rather it is just the way that care is delivered.” – Jonathan Bailey

 Day 3: University of Virginia

Our third and final telehealth site visit led us to Charlottesville, Virginia to tour the UVA Health System Karen S. Rheuban Center for Telehealth. As we entered the Center, we were greeted by the Program’s Director, David C. Gordon, dedicated Systems Engineer, Brian Dunn and Founder and CEO of Telehealth Management LLC, Najib Ben Bhahim, a telehealth big data software company the Center has partnered with to support data-driven management of their programs.

Gordon shared with our group the long-standing presence that Telehealth has had at UVA, where they are global innovators and leaders in the field for over 22 years. Today, the program offers over 60 telemedicine specialty services and has a Partner Network of 153 sites. The walls of the Center are adorned with research, case studies and success stories of the Center. One that Gordon highlighted was affectionately referred to as “Bundles for Babies”, a TeleNeonatal service that reduced length of stay by a full week in the NICU and kept babies from being transferred who could be delivered safely in their local communities. We also learned of the important partnership between the Center for Telehealth and the Information Technology department at UVA. Brian Dunn, the Systems Engineer embedded within the Center shared that from his perspective, “the possibilities are endless.” He shared how he commonly asks their partners to tell him their most innovative ideas when it comes to technology and his response is always “let’s make it happen.” What a powerful perspective!

The knowledge and experience were one of a kind at the UVA Center for Telehealth, and we walked away from the visit with the following key lessons:

  • The keys to telehealth are simple technology, integrated data and analysis and robust training and education programs.
  • Success in telehealth means making it cheaper for payers and more convenient for patients.
  • There is still a large opportunity for health systems in markets such as retail, schools, university systems, and prisons.
  • It’s time to “Say so long to too far”
  • Telehealth does not work as a top-down program. Rather a clinical lead must gain ground at the front line level with medical staff/providers.

UVA Site Visit

Day 4: The Nation’s Capital, Washington, D.C.

We concluded our travels in the nation’s Capital, Washington, D.C., where we had the privilege of hosting Latoya Thomas, Director of the State Policy Resource Center for the ATA. With Latoya, we discussed how far we’ve come and the role that momentum continues to play in moving telehealth policy forward, as well as continued challenges we face as a nation when it comes to reimbursement and licensure. In addition, Tory Cenaj, Founder and Publisher of Telehealth and Medicine Today (an open-access, peer reviewed CME-accredited healthcare journal helping to push innovation and disruption in digital health on a global scale), joined us to share insights and international initiatives.

During our final wrap-up, we took an opportunity to review the barriers to telehealth adoption in Germany to note the similarities and differences present in the US. Attendees expressed a confidence returning home to Germany poised with the momentum and insight to begin breaking down existing barriers and shaping the future of digitization and innovation in their country’s health care system.

Key insights and takeaways at the close of our sessions included:

  • It is less about the technology and more about the services being provided.
  • An enterprise-approach to selecting a scalable technology simplifies operations and maximizes investment.
  • Leading US telehealth programs chose to begin offering telehealth regardless of uncertainties related to financial returns.
  • If you’ve seen one telehealth service, you have seen one telehealth service. There is no one size fits all approach or service.
  • To manage a telehealth program, meaningful data and analytics platforms should be utilized that extracts and normalizes relevant information in an easy to use format.
  • Culture and passion for innovation will drive success in your telehealth program. Mission Health was a great example of this.
  • Find the pain points in your organization that particular service lines will help to resolve with focus on “keeping patients closest to their home”.
  • Clinical and executive champions are necessary to drive growth and acceptance.
  • A well-defined governance structure is necessary for program management and acceleration.

Schumacher Clinical Partners extends a sincere appreciation to the participating best practice telehealth programs and the role they played to share their experiences and knowledge with attendees. The inaugural trip was a major step forward for telehealth in Germany and the attendees can now serve as catalysts for the continued adoption and awareness of telehealth services in their respective organizations.