Designing and implementing telehealth: Defining and measuring programme success

Date:  21 December 2022

How can you demonstrate the value of telehealth and its impact upon patients, clinicians, etc.?

On 7 December 2022, the IHF’s Telehealth SIG hosted the third and final webinar in a series of Lunch and Learns in collaboration with Charité – Universitätsmedizin Berlin, Mayo Clinic and Teladoc Health. Across three interactive workshops, the specialist panel provided clinical and managerial hospital executives with practical guidance on the design and implementation of sustainable acute care telehealth programmes.

Chaired by Ed Percy, Teladoc Health, the speakers sharing their expertise were: Dr Jennifer Fang (MD, MS, FAAP), the Medical Director of Mayo Clinic’s Tele-Neonatology Programme; Beth Kreofsky (MBA), Assistant Professor of Healthcare Administration and Operations Manager of Mayo Clinic’s Tele-Neonatology Programme; and Dr Björn Weiss, an Anaesthesiology and Intensive Care Consultant at Charité – Universitätsmedizin Berlin.

Building on the first two sessions, this webinar concluded the series with expert advice on creating the long-term value of telehealth programmes in health systems. Participants learned about programme monitoring and evaluation, applying change management strategies, and how to continuously improve and sustain telehealth offerings.

Measuring value: Key considerations

Demonstrating value against pre-defined metrics enables you to secure the resources and staff for your programme to continue.

Dr Jennifer Fang (MD, MS, FAAP), Medical Director of Mayo Clinic’s Tele-Neonatology Programme

Value can be defined as quality + safety + experience / cost

It is important to predetermine metrics and to monitor the programme’s value in “real time”. The data generated from this analysis can be used to demonstrate that value of your telehealth programme from its early stages.

What metrics will you use to monitor and evaluate your acute care telemedicine programme?

  • reach
  • effectiveness
  • adoption
  • implementation
  • maintenance

What methods will you use to measure these metrics?

Are there existing resources within your organization’s electronic resources that you can take advantage of for automated data collection?

Consider using surveys, individual interviews, and structured focus groups to obtain user feedback. This should include multiple perspectives: patients and families, remote site staff, and originating site staff.

There is helpful guidance in WHO’s Consolidated telemedicine implementation guide.

Measuring quality and measuring effectiveness is paramount because there comes a point when programme funding or phases end – think of the end at the beginning.

Dr Björn Weiss, Anaesthesiology and Intensive Care Consultant, Charité – Universitätsmedizin Berlin

Change management: Applying strategy

Use a change management model that will address barriers and make iterative improvements along the way.

Beth Kreofsky (MBA), Assistant Professor of Healthcare Administration, Operations Manager of Mayo Clinic’s Tele-Neonatology Programme

What groups do you need to engage with for change management to ensure your programme is successfully implemented and adopted?

It can be helpful to use a framework or model for change management to guide individuals through the programme’s implementation. For example, the ADKAR model:

  • awareness: the need for change
  • desire: to support and participate
  • knowledge: of how to change
  • ability: required skills and behaviours
  • reinforcement: to sustain change

How will you apply this model for the change that will be required?

Programme sustainability: Long-term view

Monitoring programme metrics will allow you to identify risks/challenges so you can implement improvements, e.g., sites with high vs low usage, process performance, user feedback.

Continuous improvement demonstrates your commitment to a high-performing, effective telemedicine service.

  • Do you have the infrastructure in place to continuously monitor and improve your telemedicine programme?

Identify institutional resources that may be available to you and automate monitoring plans when possible.

Communicate funding needs early and plan for long-term costs. Consider integration of telemedicine into service delivery packages. Advocate for policies that reimburse telemedicine services.

  • What is the business model for your acute care telemedicine programme?

Explore long-term financial models now before any shorter-term project or grant funds expire.

Programme success and sustainability will require continuous improvement and a viable financial model.

Ed Percy, Vice President of Hospital and Health Systems in Europe, the Middle East, and Africa, Teladoc Health

The key takeaways from sessions 1 and 2 in this series are available here:

                                                    

The recording of workshop 3 is available for catch-up viewing.

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