Robust measurement and accreditation programs are key components of a successful telehealth program, leading experts say.
“There shouldn’t be any difference between a quality telehealth visit” and a traditional in-office doctor visit, says Marybeth Farquhar, vice president, quality, research and measurement, URAC. “The accreditation piece sets the standard at the threshold level. The measure itself [demonstrates] whether you are providing quality care or not,” she adds. Farquhar is responsible for conceptualizing and implementing URAC’s strategy for measurement and research.
Yet while most experts agree that telehealth has the potential to be equal to more traditional visits, several challenges remain, says Jason Goldwater, Senior Director, National Quality Forum (NQF).
The U.S. Department of Health and Human Services (HHS) asked NQF to convene a multi-stakeholder Telehealth Committee to recommend various methods to measure the use of telehealth as a means of providing care. The Committee was charged with developing a measurement framework that identifies measures and measure concepts and serves as a conceptual foundation for new measures, where needed, to assess the quality of care provided using telehealth modalities.
Goldwater, part of a panel at URAC’s Telemed Leadership Forum 2018 next March, hopes to address three common questions he’s hearing out in the field:
- Why did NQF take the project on? “This is our first foray into developing a measurement framework around telehealth,” he says.
- How can practitioners effectively use the report’s findings?
- How does industry use the framework to move to the development and acceptance of measures and accreditation? “That’s going to be the key point I’ll talk about,” Goldwater says.
In August 2017, NQF issued the report, Creating a Framework to Support Measure Development for Telehealth. The report asserts that there’s a “general consensus” that telehealth supports a range of clinical activities, including:
- Enhancing interactions among providers to improve patient care (for example, consultation with distant specialists by the direct care provider);
- Supporting provider-to-provider training;
- Enhancing service capacity and quality (for example, small rural hospital emergency departments and pharmacy services);
- Enabling direct patient-provider interaction (such as follow-up for diabetes or hypertension; or urgent care services);
- Managing patients with multiple chronic conditions from a distance; and
- Monitoring patient health and activities (for example, home monitoring equipment linked to a distant provider).
In fact, increased telehealth usage will only put more pressure on industry to identify quality measures and embrace accreditation, says Farquhar. Policymakers and others who control the financial purse will demand that the provider community “show that they, indeed, can provide quality of care through the services of telehealth.”
“But accreditation is not a silver bullet,” Farquhar cautions. “It only provides a snapshot of the organization’s performance, and the accrediting body’s enforcement authority is limited.”
Accreditation will help set the baseline standards to “ensure that the services they are receiving are of high quality or have the potential to be of high quality,” she adds.