VP, Research and Editorial Strategy at athenahealth

Telehealth, so long on the verge of becoming mainstream, got a huge boost in utilization last year from the COVID-19 pandemic. However, in the first half of 2021 we witnessed telehealth visits gradually decrease from those record highs as vaccination rates rose, states opened back up, and patients visited their doctors in person.

Now, as we watch portions of the country head back into lockdown due to COVID-19’s delta variant, it appears that the care delivery measures we grew accustomed to during the pandemic aren’t going away anytime soon. In an environment of ongoing change and uncertainty, virtual care is a powerful, permanent option for patients and physicians alike.

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COVID-19 made it clear that telehealth can replace in-person visits that don’t require lab tests or physical examinations. This was especially true for mental health visits and many primary care vists where most of the appointment focuses on the physician-patient conversation. Telehealth options give patients an opportunity to seek high-quality care without having to be in the same room as their doctor. For virtual mental health visits, patients can get help they may have been too embarrassed or nervous to get by attending in-person therapy.


It’s also clear that patients want and need options when it comes to their health. In some cases, telehealth has given people a chance to see a doctor where they otherwise may not have had access. For example, 

 has shown that while Black and Hispanic/Latino patients were less likely than white patients to visit a primary care provider during the pandemic, telehealth helped reduce the size of that gap.

Physicians hold a lot of influence when it comes to the adoption and usage of virtual care. However, when choosing to utilize telehealth in their practice, physicians must proactively identify where obstacles for their patients exist in order to overcome them. 

Wi-Fi access, technological literacy, resistance to change, and language barriers are all issues that may prevent patients from using the service. If practices can anticipate these obstacles and work to mitigate them, adoption will be smoother and patients will have an easier time adapting to the change.

To address these barriers, practices may, for example, need patient navigators to help patients turn on their cameras and download any required apps for virtual visits. The 

 should also contact all patients before their first virtual appointments to walk them through the process. Clear and proactive communication like this can ease anxiety and ensure that patients make it to their appointments stress-free. In a post-pandemic world, practices can consider dedicating some clinical teams specifically to virtual care services, creating default visit types for clear-cut cases, and incorporating data collected from patients into routine work. 

Some physicians fear that they may further harm their already-precarious work-life balance if they incorporate virtual care in their practice. Since virtual care allows physicians to take their appointments “home” (sometimes after hours), they feel it could create more work for them if not handled appropriately. This fear can be mitigated by giving physicians full control over how and when they use telehealth. For example, letting them decide how to split their time between clinic and telehealth hours (or to do afternoon appointments from home) means virtual care could 

In the athenahealth study mentioned above, physicians also noted that one of their most frequent pain points is when telehealth solutions are not fully integrated with EHRs or do not support check-in workflows or seamless online payment. Additionally, for organizations working without a single-screen, end-to-end solution, the front-desk and billing staff had to create workarounds that slowed their telehealth rollout. By investing in a fully integrated EHR system, providers can alleviate the stress that may come with these virtual visits.

There is no litmus test to answer how much telehealth is the “right” amount or what the “right” use cases are. But one thing is clear, this pandemic has served as a laboratory for virtual care, allowing physicians to use their influence to get creative and innovative around how telehealth is used. Consequently, patient expectations for convenience and access will continue to evolve as well. COVID-19 has taught practices everywhere that they can’t wait for the next pandemic to adapt a well-integrated virtual care service offering. As we look to the future, it’s clear that virtual care should be a permanent complement to in-person care.

Articles

In an environment of ongoing change and uncertainty, virtual care is a powerful, permanent option for patients and physicians alike.

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, the CEO of Optimize Health, discusses some of the main changes to remote patient monitoring throughout the pandemic and how these uses may further change after the pandemic.

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Some of the main changes to remote patient monitoring throughout the pandemic.

Remote Patient Monitoring’s evolution throughout the pandemic

, JD, MBA, advises clients on compliance and transactions in healthcare, cybersecurity, corporate and securities law, while representing plaintiffs in False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website, 

One does not need to work in a hospital to appreciate that COVID-19 has taken its toll on the medical profession. From doctors to nurses to ancillary staff, the toll of the pandemic and the recent wave of admissions due to the Delta variant has, according to the 

 (ANA), exacerbated underlying chronic nursing workforce shortage challenges. Burnout among nurses, physicians, and other healthcare workers was a pervasive problem even before the onset of the COVID-19 pandemic and the staffing shortage continues. This was exemplified in an April 

 from the American Nurses Foundation, which found that the pandemic is causing 92% of nurses to consider leaving the workforce. Nearly half cite insufficient staffing as one of the primary reasons.

 to the Department of Health and Human Services asking the agency to declare the ongoing nursing shortage a national crisis, citing overwhelmed health systems and burnt out staff. According to a 

 from Trusted Health, the COVID-19 pandemic has caused 39% of nurses ages 20-39 to report that their commitment to nursing has decreased.

Even if the ongoing nursing shortage is not declared a national crisis, a solution is still needed. Hospitals are open 24 hours a day, seven days a week. A prudent question is how can technology be leveraged to decrease the strain on nurses and other healthcare professionals, so that they can focus on tasks that technology cannot address?

Artificial intelligence (AI) may provide a solution. Some companies may reduce the burden on nurses by helping to triage patients through a series of questions, which are assessed against an algorithm in order to ascertain the most accurate options—whether for the ultimate diagnosis by a physician or in certain states, advanced practitioner, or connecting with providers remotely instead of in person. In turn, this may reduce the influx of patients into the emergency room, who may be treated in different settings. It would potentially give providers a “heads up” regarding the patient’s risk profile and potential severity of a given situation. It may also assist patients and providers with chronic disease management. Again, enabling more effective and efficient triage and allocation of resources.

In sum, there is no panacea to the current landscape. A variety of factors, including vaccines and monoclonal antibody treatments, have shown to lessen the strain on the healthcare system. AI is just another tool that can help nurses and other medical professionals lighten their respective loads, so that the rate of burnout decreases.

, JD, MBA, advises clients on compliance and transactions in healthcare, cybersecurity, corporate and securities law, while representing plaintiffs in False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at

in Houston. Rachel can be reached through her website,

AI can decrease strain on nurses and other healthcare professionals and allow them focus on the tasks technology cannot address. 

Artificial Intelligence could minimize damage from a growing nursing shortage

Patient satisfaction doesn't guarantee patient loyalty. On the contrary, satisfied patients frequently change doctors because of insurance coverage, convenience, and long wait times among numerous other reasons. Something more than satisfaction is required to achieve loyalty: an emotional connection that makes patients feel valued, cared for, and understood and keeps them coming back.

Making an emotional connection with patients

Establishing that emotional connection, combined with your expertise, will differentiate your practice in ways that will be profoundly meaningful and appreciated by your patients.

is the author of seven books and hundreds of articles on human resources and practice-management topics.

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Establishing an emotional connection with patients will differentiate your practice in ways that will be profoundly meaningful and appreciated by your patients.

Practices relying on word-of-mouth marketing face a hard truth in today’s competitive climate: it simply doesn’t carry the weight it did 10 years ago.

While peer recommendations are still influential, the primary source that patients consult when choosing their provider, according to a 

, is the Internet. In fact, 58% of consumers use search engines like Google over any other online source, including their health insurance’s website or consumer-review portals like Yelp. Mounting 

 millennials are especially more likely to prefer digital means to access health recommendations, and this trend will only accelerate over time as younger generations come of age as healthcare consumers.

For this reason, healthcare providers’ digital personas—their website, reviews, SEO rankings, feedback, and social media activities—are increasingly tied to their professional credibility and success. Today, the quality of an online presence is directly tied to a practice’s ability to gain new patients, keep existing patients happy, and generate profits.

Yet it is precisely in this area of designing a digital strategy where so many well-intentioned physicians, provider groups, and medical practices miss the mark.

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Marketing for the purposes of new customer acquisition is less art and more science in the digital age. It involves knowing how to target consumers in the right way—and leverage the right tactics at the right time — with the right technology.

To generate the best ratings, reputation, and web traffic, physician practices need:

a highly functional, active, eye-catching website that loads easily, feels intuitive, and is easy to navigate;

insight on how search engines like Google rank physician practice listings (e.g., plastic surgeons within a 5-mile radius);

consistent name, address, and phone number across local directories;

a well-established foundation of patient reviews that can form the basis of an online reputation;

targeted content such as blogs and/or thought leadership articles to boost Google rankings;

a working knowledge of best practices surrounding search engine optimization (SEO)

a robust social media presence based on the Internet behaviors of their target demographic.

This working list is just the beginning. Attracting new patients—in the right way, at the right time—is a constant, ongoing effort. It’s not a one-and-done strategy or a quick campaign.

While practices may be aware of the necessity to market digitally, mistakes are still common—even among specialists in more competitive areas.

Some physicians who have been in business for 20 or 30 years, for example, still rely heavily on referrals and patient recommendations to generate new business, but when new patients query them, only a few reviews pop up. Some of these reviews are not positive. Other practices simply lack an organized, targeted, and consistent marketing strategy.

We see this frequently with physician groups that have all the components of an online presence, such as a website, and, perhaps, a Twitter or Facebook account. Unfortunately, these assets aren’t always updated on a regular basis, which results in a digital “home” that is not modern, sleek, relevant, or inviting. For many patients, this is a negative reflection of a practice and can prove counterproductive, ultimately working against a practice.

This isn’t necessarily the fault of a physician’s practice. Many are trying their best to keep up, allocating hours to crafting relevant and informative content, which ends up buried during Google searches.

Unfortunately, most small businesses don’t have the resources to hire a dedicated digital marketing person to address all these pain points.

While each practice’s business priorities vary, the need for a consistent and professional digital marketing strategy is universal. Here are five moves that practices should make to level up:

The first step to making any changes starts with an assessment, in this case, of existing Internet presence. When a physician’s practice searches for itself on Google, Bing, or another search engine, what happens? How far down the first landing page does the practice show up? How many stars show up in a rating?

Answers to these questions can help a practice get a sense of how it is faring. Also, as part of a comprehensive inventory, a practice should also look at the insights from its digital assets such as social media accounts. How many and what kinds of posts are generating high click-through rates to the practice’s site? While these are only basic examples of a full-blown inventory, they’re important metrics.

Competition is a constant reality for owning any business, whether a small practice or a Greek restaurant. Too often, the Michelin-star-worthy eateries — or hidden-gem physicians — aren’t getting the buzz and business they deserve. How does your practice’s web presence compare with those other similar practices in a particular community (or a 10-mile radius)? What kind of social media presence do the top practices in a particular area have?

The easiest way to improve online reputation is to ensure current clients (i.e., patients) are satisfied with the services, care, and treatment they receive. One way to do this is using proactive patient surveys (e.g., text-based surveys) after every patient encounter. This way, practices are alerted to problems such as poor customer service before they turn into poor online ratings. Practices should also follow ratings outlets like Yelp and respond to poor reviews or complaints quickly. This demonstrates to potential patients that a practice is paying attention and committed to resolving issues.

Inevitably, what a practice does with its marketing budget should be tied to specific growth goals. What do you hope to accomplish in one year, two years, or five years? Maintain the status quo? Grow business revenues for a particular procedure by 20%? Every goal influences the direction of marketing efforts and budgeting decisions.

Resource-strapped practices often lack the ability to fix everything at once, so it’s better to tackle the most glaring problems first, such as a website that’s hard to navigate, or poor or nonexistent local SEO. A third-party expert, or digital marketing consultant, can help a practice maximize its resources, and improve any weaker areas of its digital strategy.

To generate new business in late 2021 and 2022, practices need to consider the evolving preferences of consumers and clients. Having the right digital marketing expertise and growth strategy tailored to consumers’ preferences is essential for moving forward and staying profitable.

Having the right digital marketing expertise and growth strategy tailored to consumers’ preferences is essential for moving forward and staying profitable.

Level-up your digital marketing strategy with these five tips

, a HIPAA-compliant business texting solution. If your practice wants to start texting customers, Text Request can give you all the tools and resources you need to create a safe and successful text messaging strategy.

Some of the highest-quality healthcare strategies nowadays include remote components and patients are increasingly wanting to communicate with their providers 

. Texting is a great way to keep up with matters such as payments, appointment scheduling, patient conversations, and earning valuable feedback for your practice.

Texting needs to be part of your patient communications, and you need to ensure that your healthcare organization meets the standards of the 

Health Insurance Portability and Accountability Act (HIPAA)

. While texting can make things a lot easier (and more profitable), it can also be easy to unknowingly violate HIPAA regulations.

So how do you stay compliant while texting with patients? Be sure to not make these five common mistakes. 

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Patients and providers want to be able to text each other, but it can be unsafe to exchange sensitive information from just any old device. You will always want to avoid communicating with patients on a personal smartphone, or on a system where their information isn’t encrypted and can be accessed or intercepted.

Additionally, patients don’t want to download a separate app or log into a specific portal to ask questions or get updates—they just want to text you.

To text patients securely, you can implement a HIPAA-compliant text messaging platform that maintains government privacy and security standards.

A secure channel ensures that information is encrypted at every level, from physician to patient. Without a secure platform, you leave valuable patient information at risk.

Apart from encryption, it’s important that your texting solution will track the statuses of all messages, clearly identifying the sender and receiver, and safely integrating with your current practice management software.

Before texting a patient, you need to make sure that they’ve given their consent to being texted by you. Texting patients who haven’t consented to text message communication can be a major violation of HIPAA standards, not to mention other regulations set by the Federal Communications Commission (FCC).

It’s easier than most people think. You can start by encouraging inbound traffic. Prompt patients to text you first, which you can do from your website. For example, use an SMS Chat on your homepage, or say “text us at [phone number]”.

Another way to get patients to opt-in is just to simply ask them.

On your web form, include a disclaimer that providing contact info gives you the right to communicate with them through those channels for an appointment and care-related communications. Add the same checkbox to any patient paperwork, and you’ll be surprised how quickly your opt-in list grows.

Patients also need to be able to opt-out of communications at any time. This holds true for text, but also for any other kind of communication. Most text systems include some sort of opt-out message or function.

Patients want to be able to ask you questions and hold conversations through text, but you need to always make sure that they are confirmed and opted into sharing PHI via text.

Some patients will want to text with you just for scheduling and reminders, while others will want to text with you throughout their care (and after). PHI is sacred, so be sure to ask patients if they’re okay with texting you about their care.

How do you make sure this happens? You can start by adding it as a question on patient paperwork. For example: “Would you like us to text you about your care?”

As long as patients have opted in to receiving texts about care related to PHI, you're good to go.

Without a secure platform, valuable PHI can be intercepted by anyone. An unattended mobile device can grant unauthorized employees access to your patient’s data, which can lead to consequences such as insurance fraud or identity theft.

Even a secure system can grant access to the wrong people. Make sure you are only granting access to authorized employees!

The “wrong employees” in this situation could be someone working in a different department or under a different provider.

For example, Employee X may be working in collections and doesn’t need to see the conversations Patient A had with the Provider about their patient care. Employee X just needs to text about collections.

Part of having a secure system is making sure users have the right permissions and access. It’s important to make sure that the appropriate personnel in your practice have access to those patient conversations.

Ensure that only authorized employees are communicating with patients. By assigning different phone numbers and different dashboards to each authorized employee, you can more confidently assume that patient communication will be secure.

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It can be easy to accidentally send messages to the wrong person when you are using a personal mobile device or even a secure platform, especially when you are in a rush.

Secure system or not, this is never acceptable. By the same token, you wouldn’t want to send an email to the wrong person or leave a voicemail on the wrong line.

This can result in unauthorized disclosure of PHI to the wrong people, violating HIPAA compliance.

To avoid these mishaps, it boils down to ensuring that your staff knows what they’re doing, and that you also have appropriate checks and balances in place. It’s imperative for them to exchange information with the correct person. Otherwise, you may be putting your patients and your practice at risk.

Confirm patient contact info every time they come into your office so that you always have their updated information. This way, you aren’t sending private information to the wrong person.

While texting can make things a lot easier (and more profitable), it can also be easy to unknowingly violate HIPAA regulations.

Avoid these HIPAA mistakes when texting patients

There are many different models and action steps for strategic planning. Attempting to "jump right in," however, is ill-advised. Undertaking some basic pre-work will help to ensure better success for the strategic planning process. Here are three perquisites for strategic planning:

Prerequisites for Strategic Planning

There are many different models for strategic planning. Attempting to "jump right in," however, is ill-advised. Here are three steps to consider.

If you’re like most healthcare practitioners, you have probably realized the importance of online reputation and how it can make or break your practice.

When patients find a practice with overwhelmingly positive reviews, there’s a good chance that it will end up in a phone call or visit.

When it comes to healthcare, many people value the quality of care more than the affordability of the service. According to a 

 by Software Advice, more than 40% of consumers are willing to go out of their insurance network for a practitioner with positive reviews.

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4 Tips on How to Manage Your Practice’s Online Reputation

You can’t fix something if you don’t know what you’re working with. Take a step back and assess your current reputation by checking what people have been saying about you.

Doing so is as simple as searching for your practice and checking relevant review platforms such as Yelp, RateMDs, Healthgrades, Vitals, or Angie’s List. By visiting these websites, you’ll gain a lot of valuable information that will shape your online reputation management strategy.

A website is one of the most effective marketing tools for healthcare practitioners to manage their online reputation.

First, you have control over the information that goes into your website, which means that you can highlight the positives of your practice. Second, a website is usually the first point of contact for many of your potential patients. If you’re managing your site properly, you can make an excellent first impression on your visitors and appear more professional and trustworthy.

Social media isn’t just a powerful tool for managing your online reputation but also for proactively engaging potential and current patients. Physicians all over the U.S. have used social media platforms such as Facebook and Twitter to combat misinformation—not just about their practices but healthcare information in general.

Thus, you should take the time to create social media accounts that are relevant to your practice - Doximity, LinkedIn, Twitter, and Facebook, just to name a few. Creating robust social media accounts has been proven effective in managing online reputation.

For physicians who are doing well, online reviews are excellent for attracting new patients. On the other hand, dealing with negative reviews is a public relations nightmare.

This is a difficult issue to navigate but can be solved by simply allowing yourself to take a step back and designate someone to respond to online reviews. After all, it’s hard not to be emotional when dealing with negative comments.

Make sure you’re not responding to the review with any information that would compromise patient privacy protection. This includes not mentioning any details about the patient’s case.

Whether it’s positive or negative reviews, designate someone to respond to all of them. This approach won’t only help you manage negative reviews and not make the situation worse, but will also show that you’re listening to patients’ concerns and addressing them professionally.

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Options to dispute negative or incorrect reviews?

Many search engines have a process for disputing a review and requesting it be removed. In most cases if you can prove that the review was left in error, the review site will take the review down. For instance, if someone reference their experience getting a mammogram, and you don’t offer that, then explain in your dispute report that it isn’t a service you offer. Or, if the reviewer references someone who’s not on your staff, be sure to provide those details in your dispute with the review site.

In addition, if a patient makes erroneous claims, such a malpractice without proof, there is a good chance you can get the review taken down for libel. Be sure to follow the process with the third party review site to report the review and request removal.

Online reputation management is critical for all healthcare practitioners. 

Tips for improving your practice's online reputation

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How COVID-19 ignited a rapid adoption of telehealth services and how these might influence care delivery after the pandemic has subsided. 