Blog | Telemedicine

How Telehealth Can Keep Care In-Network

Blog | Telemedicine

How Telehealth Can Keep Care In-Network

Lee Horner explains how provider-to-provider communication using telehealth tools can help patients stay in-network.

Emerging applications of telehealth that enhance existing provider-to-provider workflows (rather than facilitate patient-to-provider communications) are presenting health systems with new ways to ensure patient care remains in-network while maintaining and clearly projecting the organization’s brand identity. The importance of having this capability is growing as the rate of hospital merger and acquisition activity accelerates and organizations strive to glean the most value from their investments into resources and workflows. 

Health systems are moving away from the concept of reaching out to out-of-network specialists, and telehealth plays a large part in that shift. Telehealth can help an organization accomplish the following objectives as it strives to keep care in-network:

  • Make the in-network choice easy and convenient for providers
  • Increase care coordination and satisfaction for patients
  • Help reduce costs by automating provider workflow to facilitate better staff utilization

Creating In-Network Efficiencies

When seeking specialized expertise, providers can use telehealth to facilitate provider-to-provider interactions that accomplish the critical objective of doing what is right for the patient, including delivering timely care. By focusing on patient outcomes while factoring in provider convenience, a health system can ensure that it delivers enduring value while enhancing its overall reputation. In assessing how and when to use telehealth to enable provider-to-provider interactions, health systems should ask five critical questions:  

  • Have we identified the specialists in-network?
  • Have we made these contacts readily available and accessible to our providers?
  • Are we properly managing the communication channels between providers and in-network specialists?
  • Do we staff these specialists around when providers may need to access them for virtual consultations?
  • Do we have standard processes and expectations as to when and how in-network specialists will be available for virtual consults?

Increasing Care Coordination and Improving Patient Satisfaction

It is extremely important that patients experience seamless continuity as they move between providers (such as physicians, nurses, specialists, care coordinators, and case managers) and  between care institutions (such as hospitals and skilled nursing facilities). Enhancing the continuum of care is important because the providers can collectively benefit from ensuring that the standard of care supports their mission/vision in serving patients and strengthens their respective reputations in the community. In assessing how and when to use telehealth to better coordinate care and improve the patient experience, healthcare organizations should ask themselves the following four questions:  

  • Have we established accountability and responsibilities for all members of the care team and outlined potential changes throughout the care continuum?
  • Have we made these contacts readily available and accessible to all care team members as well as the patient and his/her caregiver?
  • Have we assessed patient needs and goals in remaining in touch with their providers, their care team, and their treatment plans?
  • Do we have standard processes and the expectations for the transition of care?

Achieving Better Staff Utilization

Organizations that embrace telehealth as an efficient method of healthcare delivery will increasingly drive greater staff productivity and utilization while reducing the need to rely on an external or supplemental workforce. In assessing how and when to incorporate or substitute telehealth with existing workflows, healthcare organizations should ask these questions:  

  • Have we assessed how readily we are able to respond to patients during their hospital stay, round the clock?
  • Do we have standard patient engagement strategies for following up with patients after discharge?
  • Have we assessed how readily we are available to address patients’ questions after discharge?
  • Can we staff our medical resources around our patients’ needs and timing both during their hospital stay and after discharge?

Moving Forward

Innovative healthcare organizations are at the cusp of realizing the benefits of leveraging telehealth to optimize existing resources and processes. By incorporating telehealth into its strategy, a health system can ensure its providers are fully aligned in the organization’s objectives to deliver more timely, cost-effective, and impactful care.


Lee Horner is the president of telehealth, Stratus Video, Clearwater, Fla.

About the Author

Lee Horner

Advertisements

Related Articles | Telemedicine

Executive Roundtable | Revenue Cycle Technology

Reimagining the revenue cycle today to benefit us tomorrow

In this executive roundtable, eight revenue cycle leaders share their insight on what new innovations the healthcare revenue cycle will see following COVID-19 and how the pandemic changed the ways in which revenue cycle leaders think about technology investment.

News | Health Plan Payment and Reimbursement

Employers again are planning to expand their use of narrow networks, survey finds

Large employers again say they plan a big increase in the use of narrow networks, a scenario made more likely by the pandemic.

Blog | Telemedicine

Major insurers roll back no-cost sharing telehealth services

HFMA's Chad Mulvany says patients who received a surprise bill for a telehealth visit will likely blame the provider.

White Paper | Artificial Intelligence

How investment in AI for healthcare organizations has changed due to the pandemic

A business focused on artificial intelligence (AI) in healthcare explains how COVID-19 has raised the bar in the utilization of AI and dives into the value of its use to be successful in a post-COVID future.