Much has been written about the rise of consumerism and demand for retail medicine, but any health system that has tried to launch telehealth knows that these programs can be challenging to get off the ground. Provider buy-in is often difficult to achieve. Integrating a new technology platform with an existing EHR presents technical challenges. Patient adoption can be challenging as well; even the patients who demand more-convenient care options need to adjust to receiving care remotely.
Cone Health overcame all of these barriers with a phased approach to implementing telehealth. The health system’s Phase I telehealth launch was purposefully simple, offering patients the opportunity for an asynchronous, questionnaire-based interaction with a provider around a common condition such as sinus pain. Within 6 months, Cone providers had more than 700 such eVisits under their belts. Their positive outcomes – high patient satisfaction, reduced wait time for care, and decreased cost of care – prompted leadership to green-light a second phase with expanded real-time phone and video visits, which are live today. Looking ahead, Cone has plans for a third, even more sophisticated evolution of the program in which it uses telehealth to tackle advanced use cases.
Achieving Early and Significant Results
During Phase I, Cone surveyed all patients who utilized the telehealth questionnaires for care. The results speak for themselves:
- 96% received care within 1 hour.
- 95% received the expected level of service.
- 61% would have visited a higher-cost setting such as urgent care, ER, or a walk-in clinic if not seen via telehealth.
The total net promoter score – a measure of a patient’s likeliness to recommend the telehealth service to a friend or family member – reached 92%, well above average by any standard.
A Strategic Approach
A phased, provider-friendly approach was central to the health system’s success in deploying telehealth.
1. A Simple Point of Entry
Since Cone was already using Epic’s EHR for health records and documentation and MyChart for its patient portal, ECG suggested using Epic’s asynchronous eVisit module as the first entry into telehealth. The familiar Epic platform ensured ease of use for providers and patients and alleviated integration concerns. Cone added some customization, including email notifications for providers.
2. Feedback From Affected Stakeholders
Cone established project work groups for each function affected by telehealth, including operations/revenue cycle, IT, marketing and change management, and clinical standards. A number of the providers who were actually treating patients via eVisits were members of the clinical standards group, closing the loop on the development of telehealth-specific clinical protocols.
3. Emphasis on Clinical Support
Having a clinically focused work group helped Cone develop the tools participating providers needed to easily deliver care through telehealth. Cone also appointed provider champions to advocate for the program and cement support. Finally, the health system ensured that providers felt supported at the point of care by addressing work flow issues promptly.
4. Piloting With the Employee Population
Cone didn’t want its providers to be discouraged by the limited reimbursement opportunities in the state, especially during this important introductory period, so Phase I asynchronous telehealth visits were only offered to Cone Health employees who belonged to a Cone Health insurance plan. Cone was able to closely monitor the pace of adoption, as well as solicit honest feedback from a representative sample of the area population.
5. Effective Marketing and Communications
The marketing and communications plan included both internal and external promotional activities. Provider champions were put on the agenda for medical staff meetings and committee meetings across the organization. Marketing efforts also targeted employees via benefits sessions and email blasts. Later, efforts expanded to include flyers at clinic sites, social media, web marketing, and eventually even radio spots.
Through careful planning and implementation of this process, Cone was able to achieve both tangible and intangible returns on its investment. Learn more about Phase I by reading our full case study.