What’s Enterprise Telehealth Within the Hospital Look Like and Require?

When we first started covering the explosion of telehealth thanks to COVID, we saw an explosion of live video telehealth companies.  They were obviously filling the need for doctors and patients to both stay at home.  Then, we started to see a lot of talk about various remote patient monitoring companies.  We also were seeing a fair bit of talk around specialty live video telehealth from the hospital.  We also started hearing about virtual sitters and virtual rounding.  What we quickly realized is that there’s no one telehealth market.  Instead, it consists of a wide variety of different telehealth areas and focus.

As we sit here today, healthcare organizations have a huge opportunity to leverage telehealth, but they’re no doubt overwhelmed by all the various telehealth solutions out there.  Plus, much like we experience in the world of EHR, hospitals and health systems really wanted an enterprise solution and not dozens of point solutions.  This was a big time lesson learned from when hospitals started implementing best of breed in their lab, pharmacy, clinicals, etc and then decided that integrated was much easier to manage.  It seems like many are looking to apply this to telehealth.

The real question is what does an enterprise telehealth solution look like.  Some health systems have dozens of telehealth solutions in their organization.  Can they consolidate down to at least 3-4 instead of dozens?

This was part of the conversation I had with Pete McLain, Chief Strategy Officer at Caregility, at the HLTH 2021 conference in Boston.  What does an enterprise telehealth solution look like and what does it include?  Does it need to include ambulatory or is there enough in house telehealth need that it can be and should be a separate system?  There are some big differences having a camera and audio connection to an exam room than it is a home.  In fact, even within exam rooms, the setup is likely different when it comes to what’s needed in an ICU vs a patient in a regular exam room.

Of course, that’s not the only telehealth that needs to be considered in a hospital.  You may want to deploy virtual sitters to be able to watch rooms more efficiently.  Plus, the technology should hopefully enhance your virtual sitting which is a rather mundane job that can be queued off and improved by the right notifications.  We can throw in remote interpretation as well which has been so important lately as so many studies show how care is impacted when there’s not an interpreter present.  I could keep going, but I think you get the point.

Now you can start to see why even telehealth within the hospital requires a real enterprise solution.  There are so many areas that telehealth can add value and help an organization be more efficient.  In fact, given the staffing shortages, McLain pointed out how important these technologies are going to be to a healthcare organization.  Being able to have one person virtual sit more patients is going to be essential.  Making nurse and physician rounding more efficient must happen in order to provide the best care possible as many organizations suffer from staff shortages.  These telehealth solutions can make this possible.

One question many are considering and even implementing in their plans is do you need a video camera and audio in every room?  Many are coming to the conclusion that they do need to do this.  In fact, I’ve heard that many were interested in this before COVID, but COVID has given them the momentum to be able to get the budget for it.

What I find fascinating about this is when you compare it to a documentation computer in every exam room.  I knew many tech people who pushed for an EHR documentation computer in every exam room.  While nice, they later realized that it was often better to tie the workstation to the clinician rather than the room.  Organizations were wasting money on a computer in every room when a mobile workstation would actually be much more effective.

At first, I thought this thinking would be similar to a video camera and mic in an exam room for telehealth.  However, telehealth is quite different.  In this case, the video camera and microphone are more tied to the patient versus the clinician.  Tied to the patient, it makes sense to push for a video camera and microphone in every exam room.

One thing McLain from Caregility found was that many people didn’t appreciate how important audio is when doing telelehealth to an exam room.  He shared that at Caregility some of their most important work has been figuring out how to ensure that the audio they collect in their telehealth products was working effectively in a wide variety of situations the patient might be in.  Throwing an iPad in the room doesn’t really take into account the fact that many patients may not be able to hold the iPad for example.  If you’ve ever done a video call trying to listen to someone who’s not right in front of the tablet, you know this is a less than an ideal experience.  That’s the situation for many patients in exam rooms.

Another important element to a real enterprise telehealth solution is security.  The easy security question is around encryption and HIPAA compliance.  Most telehealth solutions do this pretty well.  However, how many of them have an enterprise way to manage user access to the various telehealth devices?

In telehealth video to people’s homes, security isn’t hard to implement.  The same is not true for telehealth in a hospital where shift changes require you to adjust who needs access to which rooms.  Not to mention patients who move rooms and throw off who needs telehealth access to those rooms.  Plus, all of this has to be monitored, tracked, and auditable so a healthcare organization can know who saw the patient, when they saw them, and other important details that may be needed later.  Needless to say, many telehealth solutions don’t really take user access, security, and audit logs seriously.

What will the enterprise telehealth solution look like?  I know it won’t be 20 different telehealth solutions.  Although, if healthcare organizations could get to 3-4, I think they’d be very happy.  The good news is that the technology is there and the desire to implement these solutions is there too.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

   

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