While exciting stories of telehealth have garnered a lot of attention among professionals and the media, telemedicine has yet to prove itself fully to some experts in the field.
“In the broader sense, [telemedicine] has not” yet shown value, said an independent consultant who spoke at the in Washington, D.C. “My basic theme is technology is great but if you can’t show real value to it and you can’t prove that it demonstrates an improvement in health rates” it will have limited adoption and impact, he said.
“I am an advocate of telehealth,” Kohn clarified. “I think it has a real role and real potential. But we need to do more than just [produce] a litany of single success stories.”
To harness telehealth’s true potential, Kohn advocates taking a more holistic approach. “We need to understand the basis” of a specific telehealth program’s success, he said. Kohn boiled it down to four basic questions: How much of it was the technology? How much of it was the people? What was the program that took advantage of that telehealth technology application to make it successful? Was that success sustained?
Healthcare literature is “rife with reports of success of programs that lasted three or six months and a dearth of reports of programs that have been successful after the second or third year,” he said. “We can’t [always] tell if the program is actually doing something effective, is it the novelty of the program that’s attracting attention?”
Kohn challenged industry analysts and advocates to “look at these programs that are claiming success and compare them to programs that have failed.” Specifically, he advised examining what policies were developed internally to make a telehealth program successful. “Can that be generalizable [in terms of wider telehealth applications] or do we just have a litany of individual successes that have no broader value?” Kohn asked.
For Tamara Perry, senior director of operations, virtual health and innovation, Children’s Health System of Texas, telehealth success and sustainability begin with defining value. “How are you defining success, and what does that look like for a patient?”
Perry, who also spoke at the Telemed Leadership 2019, has been part of a tremendously successful at her organization.
“Within our programs, before we started telemedicine [initiatives], we looked at the drivers, where are the outcomes, what are we looking for with the metrics,” Perry said. For example, “within our kidney transplant or solid organ transplant pediatric patients we’ve seen patients released two days earlier because they are able to go home with a kit and be monitored remotely,” she said.
“You have to define success,” Kohn agreed. However, he counseled against overpromising. “The danger is claiming more than you can deliver.” It’s not a problem unique to telehealth, he said, and in fact this industry may have learned the lesson from technologists of the past. “Over the last 40 years health information technology has shot itself in the foot by consistently overpromising and underdelivering,” Kohn said.
“The first thing you need to do is identify the problem, identify the scope of the problem, and then create a vision for the future,” Kohn said. “You can’t induce change if you don’t have a vision of what that change will accomplish,” he added.