Seamlessly integrating telehealth into care delivery

November 16, 2020
Thomas Schwieterman, MD, MBA

Dr. Tom Schwieterman practiced family medicine for 12 years before joining the team at Midmark. As vice president of clinical affairs and chief medical officer, he leads the company’s focus on innovative technology and new approaches that enrich experiences between caregivers and their patients at the point of care.

Perhaps the most evident care site that needs some transforming is the exam room.

The COVID-19 pandemic has already reshaped ambulatory healthcare and continues to challenge the patient-caregiver experience. It has been an accelerator, as well as a catalyst, for positive change, forcing healthcare organizations to fast-track existing programs that promote improved access to care and expand value-based metrics. The global pandemic has also forced providers and systems to urgently seek new technological solutions to accommodate rapidly changing needs.

Nowhere is the impact of COVID-19 more evident than with the rise of virtual care and telehealth. In many ways, the pandemic has been a breakthrough event for telehealth. With access to care impeded by valid concerns of infection spread among caregiver teams and at-risk patients, virtual access to care quickly became widely adopted. Nearly all healthcare organizations urgently took steps to maintain the delivery of care while keeping patients and staff safe from viral contagion exposure risk. The Centers for Medicare & Medicaid Services (CMS) has since proposed changes that would expand telehealth permanently as a means to further broaden access to care for everyone, including those living in rural areas

While telehealth is a powerful technological tool that markedly expands the definition of “point of care,” many healthcare organizations were ill-equipped to accommodate the dramatic shift within their traditional clinic ecosystems. Numerous caregivers, despite months of ‘practice,’ continue to struggle with integrating the technology into pre-pandemic workflows. Critical attributes of excellent care, such as maintaining effective patient-caregiver interaction and gaining access to objective data like vital signs, remain as real challenges.

What many healthcare organizations are now discovering is that telehealth does not simply offer an “apples to apples” replacement of the traditional in-person visit. Rather, it is increasingly understood that telehealth is a means for augmenting disease management and traditional care protocols, which continue to require intermittent onsite care experiences. As such, the clinic is forced to change as disease care adapts to a new norm.

Perhaps the most evident care site that needs some transforming is the exam room. Today and into the future, physician workflows and related clinical spaces must accommodate both in-person and virtual visits. The face-to-face visit and virtual visit must be considered to be seamless partners in cohesive patient care, with each acting synergistically to facilitate the other. Following are two suggestions that could help healthcare organizations ensure a seamless integration of telehealth at the point of care.

1.) Employ Mobile Workstations

The first suggestion can be a quick and easy solution. Employ mobile workstations to deliver care anywhere and foster a more accessible, patient-centered experience. Workstations have been a central fixture in most exam rooms for years and their value has been fully established. With a mobile workstation in play, workflows are streamlined and interactions at the point of care are unobstructed. The platform has proven to be easily adjustable to support all forms of interactions occurring within that space.

Likewise, mobile workstations offer an optimal platform for supporting virtual care, as well. Many mobile workstations currently on the market provide the opportunity for customization to the unique needs of the provider, thus allowing health systems to optimize the platform for their specific telehealth program. Mobile workstations can also easily incorporate advanced technology such as cameras, digital instruments, and expanded monitors. Some of the better carts on the market provide a wide range of optimization, allowing providers to maintain an ergonomically correct working position, whether seated or standing.

2.) Define a Dedicated Zone Workflow

This suggestion may require a reconfiguration or redesign of the space. Define a dedicated zone workflow for the exam rooms where virtual visits can be effectively conducted. This workflow design establishes two distinct patient care zones within the exam room, providing clear separation between the care zone for in-person caregiver interaction and the private zone where telehealth visits can be conducted.

This virtual visit zone should be designed to enhance the experience for the patient. The quality of the audio, video lighting and background can greatly impact of someone participating in a virtual call. If there’s one thing the pandemic has shown us about video meetings is how frustrating and distracting these factors can be if they become an issue. The separation of virtual and in-person allows physicians to incorporate telehealth into their practice without infringing on the efficiency and effectiveness of either one. 

Most healthcare experts agree that the ‘coming of age’ of telehealth will continue to transform the point of care ecosystem for years to come. With telehealth technology now widely established during the COVID-19 pandemic, the marriage between physical and virtual patient care needs to be expertly balanced and integrated. Many virtual visits will prompt the need for subsequent face to face encounters. Likewise, many onsite visits will drive follow-up exchanges through a virtual channel. The expanded access to care provides powerful opportunities to improve outcomes and lower costs. As we settle into a ‘new normal’, health systems need to consider how their point of care ecosystems should be properly adapted to fully embrace the change to achieve new levels of performance.

Giving deliberate thought to exactly how telehealth will be supported and integrated into the exam room point of care will help ensure the valuable time shared between the caregiver and patient (whether in-person or virtually) remains at the highest priority during the patient journey. Employing mobile workstations and a dedicated zone workflow can have a meaningful impact on telehealth integration, ensuring the provider-patient encounter remains intimate, unobstructed, and effective.

About the Author

Dr. Tom Schwieterman practiced family medicine for 12 years before joining the team at Midmark. As vice president of clinical affairs and chief medical officer, he leads the company’s focus on innovative technology and new approaches that enrich experiences between caregivers and their patients at the point of care.