Top 6 Best Practices For Staying Human While Keeping Your Distance

One of the major developments of the COVID-19 pandemic has been the phenomenal growth of telehealth use, especially in behavioral health care. Telehealth became ubiquitous during the pandemic, and it is predicted that a large percentage of health care will continue via telehealth even after the public health emergency eases. A recent survey by Qualifacts and the National Council for Behavioral Health found that:

  • Before the pandemic, telehealth utilization in behavioral health care was relatively low, with only 2% of organizations providing 80% or more of their care virtually (See COVID-19 and Value-Based Reimbursement: What Do We Know? Where Will it Go?).
  • At the height of the pandemic, 60% of behavioral health organizations were providing 80% or more of their care virtually – due to policy changes reducing barriers to telehealth.
  • A majority of behavioral health care executives expect the increased utilization of virtual services to continue, with an estimated 40% to 60% of their overall services being provided via virtual platforms (See The New Role of Virtual Care in Behavioral Health).

Before 2020, health care was poised to start using more technology to allow consumers to make appointments, share records, and connect with their clinical professionals electronically. However, COVID-19 forced the rapid adoption of many of these services, particularly telehealth (See 21st Century Cures Act Paves The Way For Telehealth To Bloom During Pandemic). It turns out, consumers appreciate the ease of telehealth, especially because it allows them to avoid traffic and waiting rooms. Clinical professionals have also benefited from telehealth, finding that it allows them to see how their consumers are living day-to-day. Another advantage of telehealth is the ability to reduce barriers to care, such as time away from work and the stigma associated with seeking care (See What You Should Be Thinking About Now).

Mental health services were among the quickest health care specialty to switch to online treatment. With data collected between November 2020 through February 2021, 33% of all mental health appointments were conducted virtually. Primary care followed behind, holding 17% of its visits virtually. Pediatrics held 9% of its visits virtually, cardiology 7%, and OB/GYN visits were at 4%.

But despite the popularity and advantages of telehealth, clinical professionals must recognize that telehealth does not work for all consumers and all conditions. Regardless of age, many individuals are uncomfortable using technology, especially for sharing private health information. Also, not all consumers have access to high-speed internet, and therefore must resort to telephone appointments when an in-person visit is not an option. Above all, clinical professionals need to deliver the same personal, human interaction over the internet or the phone as they do in person. To ensure your clinical staff are maintaining a high quality of care without losing the personal touch while virtual, be sure to follow these key best practices:

  1. Establish a baseline for in-person versus virtual visits. Take a hard look at your service lines and consumer populations, as well as any payer requirements, when considering how often to require in-person versus virtual visits once the current pandemic ends. Even if your consumers love telehealth, make sure requirements are clear on how frequently they should be seeing consumers in-person — such as once every four telehealth visits — or whatever is determined to be best for your organization, clinical professionals, and payers. Advise your staff to be up front with consumers about the in-person/telehealth requirements from the office. Many people have anxiety as the world re-opens, and it is best to give people advanced notice of plans and expectations for future meetings.
  2. Acknowledge previous statements. Just like in an in-person visit, encourage your clinical professionals to spend a moment to chat with their consumers, perhaps following up and checking in on what you discussed in your last visit to make sure you both understand where you left off. This also works for clinical professionals as they move from topic to topic during consultations – spending a moment to reiterate an earlier conversation confirms you’re both on the same page. This helps the conversation stay on topic and helps your consumers build a connection with their clinical professionals, even if they have only ever met virtually.
  3. Listen to your consumers. As the world starts to re-open, advise your clinical professionals to check in with their consumers to see whether they would like to continue virtually, start meeting in-person again, or some combination of the two. Staff should realize it is also important to acknowledge any frustrations consumers may have regarding the platform or anything else in their lives. Even during a virtual appointment, it is obvious if someone is upset by the tone of their voice. Acknowledging these frustrations will demonstrate to consumers that their clinical professionals are present, even if they are not physically in the same room. This person-centered care approach will help your consumers feel more connected to their clinical professionals and actively involved in their treatment, which can positively impact health outcomes.
  4. Different policies for different diagnoses. As an office policy, it is also important to think about the consumer diagnoses your organization handles to see what works well digitally. Some treatment plans focusing on talk therapy may lend themselves naturally to telehealth, while others requiring injections or blood samples must be conducted in person. Think through the consumer population your organization treats and set some guidelines for your clinical professionals about how they should plan to handle future visits. For example, children being treated for attention deficit hyperactivity disorder (ADHD) are typically weighed to make sure they are not losing weight due to appetite loss from medication. Set a policy for parents to weigh children at home or develop a schedule for in-person visits.
  5. Explain the technology. All these tech tools are great, so long as everyone can use them. As an organization, be prepared to offer some training to your staff on how to effectively use technologies. If consumers are intimidated by a patient portal, they may be too shy to continue with treatments. It is important for your staff to be respectful of consumer’s tech knowledge and offer guidance without being condescending. Depending on your practice, you could even designate someone in the office to handle tech support for all consumers. Whatever you decide–just make sure you have someone available and willing to reach the consumers where they are.
  6. Do not be afraid to ask questions. Even on a virtual visit, your staff must be able to talk with consumers and engage with them as they would in person. Encourage your staff to make simple small talk to start a conversation, such as commenting about the weather or compliment a new hair style. Even in a virtual world, consumers need to feel connected to clinical professionals, so it is important to show attention to the consumer’s person. Teach your staff basic techniques to recenter and engage again with the conversation should their focus wane briefly.

As the world and industry change and we approach the next normal, provider organizations must embrace the fact that virtual care is here to stay. Incorporating a person-centered approach to care is incredibly important during these times when most of our care is being delivered virtually. To learn more about person-centered care and how to keep your consumers actively engaged in their own health care, view this recent archived webinar, A Stable Connection Should Mean More Than Just a Strong Wi-Fi Signal: How to Keep Care Connections Personal in a Virtual World.

The full text of “athenahealth Creates Online Telehealth Insights Dashboard to Help Practices Benchmark Their Performance and Find Opportunities to Better Meet Provider and Patient Needs” was published March 9, 2021, by athenahealth, Inc. A free copy of this and access to the Telehealth Insights Dashboard are available online at https://www.businesswire.com/news/home/20210309005235/en/athenahealth-Creates-Online-Telehealth-Insights-Dashboard-to-Help-Practices-Benchmark-Their-Performance-and-Find-Opportunities-to-Better-Meet-Provider-and-Patient-Needs (accessed July 23, 2021).
The full text of “Help patients adjust to telehealth by remembering the human touch” was published June 23, 2020, by the American Medical Association. A free copy is available online at https://www.ama-assn.org/practice-management/digital/help-patients-adjust-telehealth-remembering-human-touch (accessed July 12, 2021).

Four ‘Must Have’ Competencies For Post-Pandemic Competitive Advantage

By Monica E. Oss

We’ve covered the “triple whammy” of the pandemic on next normal health care—shifting competition based on changing consumer expectations, payer expectations, and price points (see Post-Pandemic, Strategy Needs Technology). I got a better sense of the market factors driving these changes—and the new competencies required for success—in a recent article, How Digital Is Changing The Pharma & Healthcare Industry, by Nikki Gilliland at Econsultancy. My takeaway is that there are four new competencies that executive teams should be thinking about to stay in the game as the effects of the pandemic digital shift become standard market factors.

To start with, the “must have” hybrid service model requires digital first consumer intake processes. For care coordination programs to be successful—and cost-effective—remote monitoring capabilities will likely be a “must have.” Another takeaway—to improve consumer engagement, social communities need to be built on and integrated into existing commercial internet platforms. And finally, without a robust web presence and expertise in search engine optimization, competing for referrals will be increasingly difficult. These are the next frontiers in organizational infrastructure for competitive advantage—and I’m adding them to my specialty provider organization competency map (see From Crisis To Growth: A New Leadership Mindset).

Digital first consumer intake/interface is critical to success with hybrid models. The pandemic has moved much of care delivery to virtual. But as we move to the post-pandemic landscape, the preferred service delivery modality is a combination of virtual and in-person care in clinics and in consumers’ homes. Recent research confirms this preference—in a national survey, more than 40% of consumers said that when it comes to mental health and routine care, they’d rather access services virtually or through a combination of virtual and in-person visits (see Post-Pandemic, Majority Of Patients Say They Prefer In-Person Care, Survey Finds). And a Healthgrades study found that when given a choice between health care providers with similar experience, proximity, availability, and patient satisfaction ratings, the vast majority of consumers—81% for primary care and 77% for specialists—choose the provider who offers online scheduling (see Specialty Care Strategy For A Tech-Enabled Future).

To make hybrid services an operational reality at scale, provider organization executive teams should develop a digital first consumer intake process with a well-designed “digital front door.” This intake process should include real-time appointment scheduling that is linked to both benefits eligibility information and the schedules of clinical team members. Many components of the digital front door, including online scheduling, can likely be built into existing EHR systems but standalone technology platforms are also available and can be integrated with current technology platforms.

Best practice care coordination will require leveraging personalized remote monitoring. Care coordination and case management services are slowly moving to risk-based and value-based reimbursement models—with reimbursement tied to outcomes. To be competitive in this market space, provider organization managers will likely need to deploy a coordinated suite of tech-enabled functionality. What does that look like? Decision support tools for care coordinators, driven by consumer data. Smartphone-based outreach to consumers for active monitoring, self-care supports, and engagement. Passive remote monitoring tools for staying on top of consumer health status over time. Market advantage will go to the organizations that can reduce costs by leveraging their clinical workforce with technology, while managing and optimizing performance and consumer outcomes.

Consumer engagement success will depend on strategies to build specialized social communities on existing platforms. Consumer engagement and participation in managing their health is key to making value-based reimbursement work. The question for clinical management teams is how to connect with those consumers. There are many standalone consumer web portals, discussion boards, blogs, and more. But getting traction with those standalone initiatives is difficult. Rather, consumers are likely to discuss issues and seek health care information, opinions, and suggestions from channels they are already active on. Provider organizations should consider facilitating social networks on existing platforms for their consumers and encouraging staff to weigh in on these online communities to share expertise when appropriate.

Social media platforms like Facebook, Twitter, Instagram, and YouTube (and to a lesser extent, LinkedIn), as well as messaging apps like What’s App and WeChat (in China) host consumer and caregiver groups with interest in specific conditions and treatments. Some of the newer apps for behavior-based chronic disease management also include a social component to let consumers engage with peers. But most consumer and professional engagement communities are web-based—they can be found through simple online searches and accessed with a web browser, while they also maintain a presence on all the major social media platforms. A Pew Research survey indicated that 26% of adult internet users had read or watched someone else’s health experience about health or medical issues in the past 12 months. And 16% of adult internet users in the U.S. go online to find others who share the same health concerns (see The Social Life Of Health Information).

There are a number of existing online communities. For example, MedHelp has communities for mental health, general health, diabetes, heart disease, pregnancy, and coronavirus. PsychU offers information, resources, and collaboration and discussion platforms on challenges and treatment approaches for mental health professionals. Verywell Mind offers consumer-friendly information, generated by clinical professionals, on a range of mental health topics. And, HealthUnlocked offers technology to build health communities and is available free to nonprofits, health advocates, and consumer organizations to start new communities.

Web presence and SEO expertise are needed to compete for customer eyeballs. As care becomes increasingly virtual, referrals will become increasingly virtual. Today, 13% to 17% of visits across all of health care are conducted via telehealth—which is 38 times higher than pre-pandemic use of virtual care (see Telehealth: A Quarter-Trillion-Dollar Post-COVID-19 Reality?). Prior to the pandemic, 67% of consumers searched for health care information online and 60% searched for provider reviews online (see Digital Health Consumer Adoption Report 2020). The pandemic has likely increased this consumer behavior and will also likely change the nature of professional referrals.

As executive teams consider whether their current website and web presence is an impediment to success or an asset, there are some basic questions to ask. Is the website content, user experience, search engine performance, and online reputation strategy meeting current consumer and referral source expectations? (For more, see our on-demand OPEN MINDS Circle Executive Roundtable Session, Designing Best In Class Websites: The OPEN MINDS Website Evaluation & Improvement Process.) The answers will drive strategies for enhancing the online brand presence, upgrading web site design and content, evaluating paid web advertising options to be “found” in web searches, and linking content to social platforms in order to increase reach to consumers and health plan partners.

The bottom line? To meet the preferences of consumers  and health plans—and succeed with new reimbursement rates and models—executive teams need to make a few additions to their “core competencies.” This will involve broader planning of infrastructure, both technology and human. The key question is not “What technology should we invest in?” but rather to define how technology can help to drive strategic objectives.

For more on the organizational competencies needed for strategic success, check out these resources: