Telehealth: The dawn of a new era in medical care

Yulia Kogan, Director for IT, Northwell Health
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Yulia Kogan, Director for IT, Northwell Health

Yulia Kogan, Director for IT, Northwell Health

In the last few decades, the technological disruption in the service industry is evident from the success of bellwethers like Amazon, a pacesetter in the retail world and Uber, a transportation behemoth that owns no automobile. Such technological advancement has given us the impetus to create a similar phenomenon for the healthcare industry. To begin with, as healthcare organizations we need to decide between the need to partner and work with other enterprises or acquire our technological expertise. Following this, the idea of technological disruption should be viewed from the customers’ (patients, in our case) point of view, wherein their priority would be to attain healthcare services at their preferred location without the need of traveling or waiting at a clinic. While this case may not necessarily seem achievable for every healthcare service, we aim at bridging the gap by providing more and more services via a telehealth platform.

 In-patient and out-patient cannot be replaced by telehealth services, but telehealth will gain equal prominence  

Healthcare Dilemma

Among all the pain points that arise in the healthcare industry, overall the skyrocketing cost of telehealth products holds an uncomfortably high position. While we address this dilemma, our prime objective is to add more value-based services without letting the costs hit the roof. During the conception and execution of telehealth projects, we look at delivering services that are structured on a value-based model. Although this may not eliminate the problem entirely, its effects can be reduced substantially. Another common concern faced by many of our counterparts is the resistance to change from the support staff. This poses a distinct problem as this resistance to change translates into different arguments, ranging from looking at a technology being comprehensive to why a certain technology does not exist. This point can be addressed purely through better communication with the team while engaging them and ensuring that everybody is included in the decision-making process. Besides, a strong leadership standpoint is pivotal in addressing this challenge.

Ideal Checklist for Telehealth

For any telehealth program to function seamlessly, it needs the fundamental requirements, particularly, the interoperability infrastructure, failing which, more issues are bound to be created than solutions. The presence of interoperability infrastructure can assure that any encounter—face to face or through a telehealth portal—with a customer does not potentially change the way we address their health. Beyond just this, it is essential to have a robust back office support team, which enhances our ability to document patient encounters as we provide remote services to guarantee that there is no difference between the Health Resource Utilization in a physical encounter and a remote one. Looking at the technological perspective, we need to constantly ascertain that the network exists and utilize the devices that we focus on, particularly mobile devices. Another technical aspect that we are turning our focus to is connecting basic testing devices, such as a thermometer, to telehealth technology. Consequently, we can combine multiple abilities by connecting different devices and provide a vast array of services, for instance, using a camera for wound treatment.

Implementation of Telehealth

One of the main examples of telehealth implementation is that of congestive heart failure. We emphasize the utilization of technology to provide better services and enhancing the possibility of monitoring services for a patient remotely. While initially, the patients will have to be physically present in the clinic for enrolment, from the next consultation onwards, the patient can be at his location and weigh himself on a scale that will transmit the numbers to the desired device. This can prove vital, as the most important symptom of Congestive Heart Failure is weight gain and when addressed virtually, the patient’s condition can be diagnosed and treated from the contact center. Through the contact center, a telehealth visit can be triggered or the patient himself can do it by filling out a form. This significantly reduces the discomfort and inconvenience involved in having to travel to a medical facility while being physically unwell. When we did implement this service, we noticed not only a better quality of service and reduction in cost but also a significant improvement in the patient.

Social Determinant Related Services

While looking at telehealth services holistically, it is beyond just providing remote visits. Apart from the clinically related services, we also extend the social determinant related health services. When we address a specific chronic disease, we focus on the challenges faced by the patient concerning the type of residence, food, and water made available to them. These educational, social determinants need to be addressed as well. Overall, we aim to provide social determinant related services remotely, where we can see a large number of vendor companies focusing predominantly in this area.

Analytics in Telehealth

Analytics plays a pivotal role in almost all verticals considering the amount of data involved, as every bit of minute detail is being recorded for further usage and the digitalization of the same. As we remotely monitor and interact with the patient, the humongous amount of data in store for every project should be correctly analyzed to improve the service we provide and also to identify certain details that may otherwise be overlooked. An example of this is behavioral health services, where the interaction with a patient is monitored continuously, and the pattern is observed. If there is no significant change from his or her geographic location for an extended period and/or there is a change in the way of texting or calls, there could be an indication of depression. With the amount of information that we collect and with the right machine learning algorithms in place coupled with a robust analytics infrastructure, we can correctly prioritize the patient that requires attention. With the rise of predictive analysis, we can predict patients’ issue based on the early signs or symptoms and hence, address issues before they can become a potential threat to their well being.

The Future of Telehealth

In today’s day and age, we are dependent on our mobile devices to carry out day to day activities that include communicating with friends, colleagues, and family. Activities that require our physical movement can now be done at the touch a finger, such as, buying commodities or even as basic as getting a cab. Healthcare services are following the same trend. Although remote services give us the feel of having a face-to-face conversation with an actual physician, the landscape is rapidly evolving wherein triage or interacting with pre-designed chatbots can be leveraged to address specific queries. The present scenario is one where the number of healthcare providers is not proportionate to the rising number of people who require treatment and hence, telehealth solves this challenge by delivering medical service to the growing population remotely. Looking at the globalization of telehealth, the ability and process to procure a license for a healthcare provider is easier. Procuring a license in one state allows the service provider to be accessible in other states across the U.S., which increases the possibility of service being provided to even remote locations. These aspects can be seen to drive telehealth visits and shape the future of the industry. I do firmly believe that telehealth services cannot replace in-patient and out-patient care, but it can be seen to gain as much prominence as in-patient and out-patient care.

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