In addition to its overwhelming impact on people’s health and lives, the pandemic has run amok across the balance sheets of most healthcare organizations. Some of the nation’s most distinguished health systems reported major losses on operations in the first half of 2022. The outlook is for more of the same, as the problems that drove this dramatic falloff in performance may be here for the long run.
Providence, the Northwest juggernaut, started it off by reporting a loss of $934 million in the first half of 2022. The telehealth system attributed the results to inflation, supply chain issues and the workforce shortfall. Boston-based Mass General Brigham reported an operating loss of $949 million, citing higher inpatient acuity and longer lengths of stay.
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It seems that Covid isn’t the root cause of all the financial upheaval in healthcare today. I believe what it did was to expose and dramatically accelerate trends already at play. A national nurse shortage and physician burnout had been slow-burning fires long before to March 2020. I’ve noticed that clinicians of the baby boomer generation were already aging out of their careers, and midcareer docs lamented the workflow demands of the electronic health record and the stricture of the 15-minute patient visit.
In the heat of Covid-19, we’ve seen how caring for patients day and night for month after month took a toll on caregivers that will take years to unravel. As the pandemic waned, patients who had avoided care during the worst of Covid began to return but were now much more acutely ill.
These changes, combined with the loss of pandemic relief funds, have some providers rethinking their business models. I see that many providers are taking a long, hard look at service lines, back-office operations and other areas for budget cuts. Others are being more strategic, informed by data analytics and clear goals seeking new efficiencies and productivity from the staff they are able to find. As Mass General Brigham President and CEO Anne Klibanski, M.D., put it: “We are focused on navigating current market dynamics while planning for the future, transforming our organization to deliver services as a single integrated system and enabling our patients to easily access the full continuum of care that we provide.”
Telehealth ought to be central to these deliberations
From my experience as a founder and CEO of an acute telehealth company, it is my view that every healthcare provider should assess what it needs to concentrate on doing internally and what can be provided more cost-effectively through virtual care.
Telehealth is maturing into something far more than a modality. Forward-looking organizations are seeking to implement a virtual care road map across the care continuum as a lower-cost, more productive and user-friendly option for care delivery. This includes any interactions of the modern healthcare consumer with the healthcare organization—from scheduling appointments to downloading immunization records, from discharge education to obtaining a refill.
The frenzied rush into telehealth during the pandemic left no time for planning or coordination. I believe systems need to bring together or jettison existing platforms to arrive at a telehealth system aligned with their goals. Telehealth shouldn’t be seen as a piece of technology as much as it is a blend of clinical expertise, data analytics, transformational processes and the right technology to deliver the most cost-effective care to patients when they need it, wherever they need it.
Improper implementation of a telehealth service can lead to unforeseen challenges.
Without a mature telehealth strategy, the implementation of a telehealth service may encounter resistance from all corners—IT, finance, billing, nursing and providers and even patients. The numerous downstream consequences for failing to plan, do, study or act cleverly include a disjointed patient experience resulting in patients leaving the network, increased IT support costs, legal exposure and lack of reimbursement from failure to document virtual care.
To succeed with telehealth, rethink your strategy
A growing number of healthcare leaders are embracing the use of telehealth across all clinical areas. This can be supplemental care, filling in gaps in coverage, highly specialized consults on complex cases or all of the above.
One of the most important aspects of a telehealth strategy is to establish a process for evaluating current and future telehealth use cases. With hundreds of potential use cases, each organization should develop its own key performance metrics to quickly assess a proposed telehealth service’s fit with the organization’s overall strategy.
Last, but not least, the telehealth strategy, like any good business plan, must lay out the staffing model to support the launch of new services. Who is doing the consult matters. In working with vendors, either suppliers of telehealth technology platforms or virtual care delivery models, you need to ensure its patient-facing clinicians become an enduring, integral part of your care team.
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