Optimizing telehealth: Focus on your goals and workflows first rather than the technology

Andrew J. Barbash, MD, founder of Apractis Solutions, says he is often struck by how far behind some medical practices can be when it comes to technology.

Barbash, who has worked settings as varied as private practices, hospitals and even running EHRs for Kaiser Permanente, is accustomed to thinking about other people’s workflows. “Most doctors think about their own workflow,” Barbash says. At Kaiser, “I had to worry about 3,000 people in different departments” and their unique challenges and needs.

That background led Barbash to his current role, which includes telehealth consulting and expertise in areas such as text chat, direct video consults between clinicians and video communication with patients and their family members.

Interviewed for MGMA’s recent Research & Analysis report, Optimizing Telehealth During COVID-19 and Beyond, Barbash recommends that medical practice leaders take a big-picture view when it comes to telehealth programs —  that the focus shouldn’t be so much on the technology but rather on what problem you’re trying to solve and what is your workflow.

Especially given varying degrees of comfort with certain apps and interfaces, Barbash says it’s important “to make the technology part of [telehealth] … seamless, brainless and simple,” though he noted this has been difficult for many healthcare organizations. Historic challenges that prevented simpler means of connecting patients and providers included regulatory barriers that were loosened for the duration of the federally declared public health emergency.

With more options for reimbursement and fewer restrictions on geographic sites that can offer telehealth services, Barbash said that now is the time to rethink what services your practice has and what will make sense for the future.

“Take off your crisis hat and just think of what you want to do,” Barbash says. “You've had a few months of experience now, realizing that some of the traditional obstacles and barriers aren't the barriers you thought they were.”

In many cases, that might mean evaluating what platform you use and the vendor that provides it. “You need a partner who is just as worried about your workflow and efficiency as they are about their own business,” Barbash says. “You don't have somebody selling you a video widget or a messaging widget or something — you want a partner that's looking at how you work and how you communicate with each other, and with your patients and eventually with other colleagues.”

Learn more: Read about telehealth innovation and vendor consideration.

Another key aspect of those considerations should be the ease of use for both providers and your patients. Barbash cautions against any solution that feels like just another app that has to be installed. His sentiments are backed up by a June 2 MGMA Stat poll that found 23% of respondents citing patients’ technological knowledge and access limitations as the top operational challenge in providing telehealth services.

Now is also an optimal time for practice leaders to assess how well providers have made the transition to more virtual visits and the unique ways in which the interaction with the patient has evolved without being physically in the same room, especially in certain specialties.

With video visits where a physician can see but not touch a patient, “we're getting into multi-modality interactions with people, just like if they physically came into the office,” Barbash says, which is where you may begin to see where webside manner differs. “Some people are better at reading body language than others, and some people are better at languages, and some people use interpreters better.”

Learn more: How providers can fine-tune their ‘webside’ manner in the age of COVID-19.

Areas where some members of the team struggle in adapting are merely areas to improve, Barbash says, that there’s still room to experiment with telehealth before settling on a long-term strategy. But he cautions to not let obstacles deter practices from moving forward with telehealth.

“You have to have the confidence that you can’t solve for 100% of something — you’re trying to solve for 90% of it really reliably,” Barbash says, noting that the idea of some patients not having smartphones is no reason to not work toward providing virtual care delivery to those who do. “Don’t let yourself get dragged back.”

Additional resources

• MGMA COVID-19 Recovery Center
• MGMA COVID-19 Recovery Toolkit
• MGMA Stat COVID-19 polls