Searching for the Best Telehealth Solution: Five Practical Steps to Success

If we asked clinicians and patients if they knew anything about telehealth today, most would say they do. However, when asked for the definition of telehealth, the answers would likely vary.  

The market illustrates this in the sheer number of telehealth vendors operating worldwide. A quick web search will reveal plenty of articles not only about the top 10 telehealth vendors, but even the top 200.    

Telehealth is broadly defined by the U.S. Health Resources and Services Administration as “the use of electronic information and telecommunication technologies to support long-distance clinical healthcare,” as well as patient and professional health-related education, public health and health administration.   

Telehealth solutions can be synchronous or asynchronous and may involve remote monitoring. These solutions cover a wide spectrum of clinical specialties from general medicine, pediatrics, psychiatry and endocrinology to rheumatology, gastroenterology, among others.   

The core functionality of telehealth tends to remain the same. However, some solutions feature additional functions that healthcare organizations might find to be perfect for their needs.   

With so many possibilities, it begs the question – where to start? Although telehealth has become a necessity due to the COVID-19 pandemic, the true telehealth needs of an organization moving forward should be established as a strategic goal as part of implementation.  

Here are five practical steps for those searching for the right long-term telehealth solution for their organization.  

Form a Project Team and Identify Needs 

A project team should be formed, and a foundational layer of your search should be identifying critical organizational needs and biggest obstacles. This will not only help guide your implementation strategy, but also will help define metrics to measure success.  

These critical needs could include:  

• Continuity of care 
• Clinician shortages 
• Barriers to in-person visits 
• Improving access to healthcare in rural or underserved areas 
• Reducing the risk of spreading illnesses like COVID-19 
• Targeting specific groups of patients for certain types of care  

During this phase, it’s important to involve and receive support from not only key stakeholders, but key users as well. Telehealth is a good example of a type of healthcare technology which requires a level of digital literacy from both clinicians and patients, and they should be considered key users. 

Set Up Requirements  

The second step on your search for the best telehealth solution should be establishing an organization’s requirements. Requirements are either conditions or capabilities needed by a user to solve a problem or achieve an objective. A system may have requirements to ensure a formally imposed document, standard or contract is satisfied. Organizations should document a list of requirements under implementation needs and expectations.  

In order to establish requirements, collect information from relevant stakeholders and provide explanations to all participants to ensure everyone has the same baseline knowledge.   

During this stage, the longer the list, the better.  

A few requirements to start the list:  

• Audio and videoconferencing, secure messaging and chat  
• Electronic scheduling with a reminder system 
• Dashboards, analytics and reports 
• Billing, reimbursement and online payment  
• Image and file uploads  
• E-prescribing 
• Geolocation, verification of patient and clinician location and eligibility 
• Digital medicine coding 
• Personalized intake and visit summary forms 
• Datacentre (cloud-hosted, private-cloud or on-premises) 
• Existing data migration and scalability requirements 
• Interoperability and security  
• Digital medicine device, PACS and EHR integration  
• Health data regulation, information system security requirements and third-party audit compliance 
• HIPAA compliance for the U.S.; GDPR compliance for the EU 
• User authentication and authorization processes 
• Branding and customization 
• Language localization 
• Branded mobile application  
• User interfaces (clinician, patient and administrator) 
• Customer service during and after implementation, training for users, 24/7 hotline and technical support 

The project team can group requirements into categories, such as business, stakeholder, clinical, technological, and financial.  

Priorities  

An organization must now answer several questions to ensure the telehealth solution is right for their organization. 

These questions can include:  

• How do we identify the right priorities?  
• How do we make a matrix of requirements with priorities based on current needs and current regulations? 
• How do we ensure the core of this matrix aligns with our needs for a long-term telehealth solution for our organization?  

One of the easiest ways to determine a healthcare organization’s priorities is ranking requirements from one to 10 and applying priority weightage. This step will identify the most important requirements as “the highest priority – 10,” or “must haves” and the less important requirements as “the lowest priority – 1.” or “nice to have.”  

A prioritization matrix is useful when the requirement list can include upwards of 50 items. It also shows the Minimum Viable Product (MVP), or the least amount of functionality that would be acceptable at launch.  

The prioritization matrix will be a key tool for communicating your organization’s needs during the demo and pilot phase.  

Some requirements that may be considered must haves or 10 priority weightages include:  Audio and video conferencing, user authentication and authorization process, and compliance with local regulations.  

Government authorities in many countries share a list of telehealth vendors that are compliant with the local regulations like HIPAA in the U.S., as well as policies about types of telehealth visits and document flow necessary for reimbursement.  

Demo and Pilot Phase 

The main goal of the demo and pilot phase is to see telehealth solutions in action and confirm it works in the healthcare organization’s ecosystem based on the requirement matrix. 

While a demo session is a brief one-to-two hour overview, a pilot requires more time and effort (potentially several days) from both the customer and vendor. So, it’s important to narrow down your list to the top one or two solutions before entering the pilot phase. The pilot provides significantly more information, which can be used during implementation. 

Before a pilot, organizations should take some extra steps to prepare. The schedule, participants, customizations as well as the requirements for systems, devices and internet connections should be agreed to in advance. The implementation team should receive requirement lists written to the level of the user’s digital literacy (administrators, clinicians and/or patients).  

Telehealth workflows for all types of users, their roles, responsibilities, and different permission levels, as well as document flow can be tested within the pilot phase. This is the perfect time to re-engage patient advocates in the process of user interface testing. They will determine if the solution is non-device specific and if improvements are needed for different types of patients, including groups like adolescents, older adults and underrepresented groups.  

Supplying the project team with presentations, videos of telehealth workflow and checklists will help when evaluating possible telehealth solutions and collect feedback from key users. Checklists should contain high-priority requirements with exact actions to test and criteria of success.  

One example would be the requirement for an electronic scheduling function, which is an opportunity for patients to check availability of clinicians and to make, change and cancel reservations for virtual consultations. The objective is to create, change, delete timeslots of consultations and to receive email and/or SMS notifications about these actions. Success is achieved when all users complete these steps.   

There are also secondary tasks that can be fulfilled during the pilot. One of which is defining the preliminary list of customization and additional software development needed based on the pilot analysis and project team feedbacks.  

Assess the Results   

A demo and pilot provide a practical way of evaluating how close the telehealth solutions are to the outlined requirement matrix. Ratings can be added to every solution to make more effective comparisons when assessing future suppliers.  

For example, based on the pilot results, each solution would receive a rating for every requirement (from the minimum “doesn’t meet requirement - 0” to the maximum “fully meets requirement - 5”).  

Then each rating should be multiplied by its priority weightage (from “the lowest priority - 1” to “the highest priority - 10”) to obtain the score for every requirement. Thus, for all HIPAA-complaint solutions the score would be 50 for the U.S implementations.  

The sum of all scores for all requirements gives us the total final score for each vendor. As a result, the matrix with requirements and their priority weightages will be complemented with ratings and final total scores for all vendors making it easier to compare. 

Many vendors provide a detailed budget calculation, which can include:  

• Software 
• Hardware 
• Services 
• Integration and customization costs 
• ROI (Return on investment) 
• Staffing 
• Patient and clinician training  

The vendor should also provide an overview of business and financial information, references from notable customers, and related experience with existing projects. This information paired with final presentations from vendors will help leadership within your healthcare organization make an informed decision on the right telehealth solution and partner for implementation. 

Conclusion  

While the pandemic drove many to implement new telehealth options to serve their patients, it’s important for organizations to take the time to find what works best long term for their organization. Utilizing these five practical steps will help organizations narrow down a vast number of telehealth solution vendors to the ones that best meet their specific needs and requirements for the long haul.