Let’s Not Lose Sight of Patient Experience with Virtual Care
Strategies are needed that take most, if not, all of the burden away from the patient so that RPM enhances their experience with their care. Both telehealth and RPM have those elements needed to improve the patient experience, including good communication between doctors and patients and improved patient engagement.
That old adage, “There is no place like home” is increasingly becoming applicable and true of healthcare today. The COVID-19 pandemic has taught us a lot and one of those learnings is that care can, and probably should, be delivered more efficiently and more conveniently. For years, large health systems have made substantial efforts to bring the point-of-care closer to the community. Those efforts have largely included expanding footprints, establishing accountable care organizations, and partnering with community-based groups to deliver prevention and treatment services.
The pandemic has changed this dynamic completely and required us to deliver medical care remotely to patients in their actual home. Thanks in large part to Medicare establishing clearer guidelines around the reimbursement of telehealth and remote patient monitoring (RPM), adoption of these new care methods is steadily growing. That’s in part because physicians can bill for them and generate revenue, but there is also mounting evidence that telehealth and RPM save money and improve outcomes.
Saving costs while improving outcomes is important and should be a centerpiece of clinical decision making. However, patient experience needs to be considered. This is especially relevant to Medicare patients, who often make up the sickest and most expensive population for any hospital or physician office. In short, along with cost, quality of care and outcomes, which are all interrelated, the Centers for Medicaid and Medicare Services (CMS) has made patient experience a fundamental tenant of value-based purchasing. Now HCAHPS (Hospital Consumer Assessment of Healthcare Providers & Systems) and CAHPS (Consumer Assessment of Healthcare Providers and Systems) scores are tied to reimbursement levels.
The good news is there is compelling evidence that telehealth and RPM can help improve both patient satisfaction and patient experience, which are two different, but related measures as assessed by the HCAHPS and CAHPS surveys, respectively. A recent research report from KLAS Research showed that along with improved health and quantifiably reduced costs, RPM resulted in greater patient satisfaction. The same holds true for telehealth, which research shows improves patient satisfaction.
Remember, these are new concepts to a lot of people. In fact, nearly three-quarters of patients accessed their first-ever telehealth visit during the first wave of the COVID-19 pandemic. We saw a nine million patient surge in telehealth visits in Medicare alone during the early days and telehealth visits jumped from 0.1 percent of all primary care visits in February 2020 to 43% of total visits in April of the same year. As such, and given the circumstances, it’s not surprising that satisfaction today with these services is good.
Let’s face it, telehealth was forced on us by a public health crisis beyond our control. It is by no means a novel or new approach to care. Nevertheless, it’s an important tool and by all accounts it is here to stay. The key moving forward is to ensure that telehealth does not inhibit the patient experience, but instead enhances it. Proper training by physicians, nurses, and allied health professionals will be a critical part to this, as well as ensuring we have the proper systems in place that are compliant and not frustrating for patients to use. Many organizations and physicians are focused on getting this right and the future for virtual healthcare visits looks promising.
RPM is a different approach altogether. Telehealth augments a care approach that has existed since the dawn of healthcare – physician-patient interaction. RPM, on the other hand, is a relatively new approach to care that has been enabled by significant advancements in technology. It provides physicians with real-time data and a profound ability to intervene earlier and avoid expensive emergency care or help to change the course of care to achieve better outcomes.
But, just like telehealth, there are pitfalls that could jeopardize the patient experience. These include cumbersome devices, having to manage the setup of remote monitoring technology, and actually asking patients to take steps – sometimes daily – to check biological measurements, including A1c levels, blood pressure, heart rate, weight, and so on. We need to deploy solutions that are focused on the patient experience just as much as they are on improving the quality of care. Making these devices easy and convenient to use will enhance the patient’s experience and move adoption.
Let’s consider several factors: does the patient need to set up the device? If the answer is yes, then there are risks for failure. Many patients that need RPM are older and sicker than a typical patient. Requiring them to set up a device is a recipe for disaster and would almost certainly decrease their satisfaction. Secondly, is there an engagement plan with the patient? Giving a patient a device and expecting them to adhere to monitoring isn’t a realistic expectation. Rolling out RPM with a patient engagement plan is a critical success factor and the two must go hand in hand. Higher engagement improves the patient experience.
The bottom line is that we need strategies that take most, if not, all of the burden away from the patient so that RPM enhances their experience with their care. Both telehealth and RPM have all of the elements needed to improve the patient experience, including good communication between doctors and patients and improved patient engagement. While patient satisfaction and experience are important in their own right, there is substantial evidence linking those aspects of patient care to better outcomes and lower utilization of unnecessary healthcare services.
The pandemic has shown us the importance of value-based care and introduced new approaches to care that have the ability to help us better achieve value. Telemedicine and RPM are among the most promising and most experts agree they are very much part of a post-COVID world. And, most agree that patient experience is central to their success.