Editor’s Note: In a new report, the Association of American Medical Colleges (AAMC) and Manatt Health describe telehealth integration imperatives and best practices for academic medical centers (AMCs) to sustain and grow telehealth programs in the future. The report serves as a practical guide for health system leaders and telehealth managers as they critically assess, design, implement and integrate their telehealth programs across clinical, education, research and community mission areas. To download a free copy of the report’s executive summary, click here. For more information on accessing the full report, visit the AAMC web site here.
The COVID-19 pandemic has dramatically and permanently altered the telehealth landscape for AMCs. While many AMCs had begun to offer telehealth services before the pandemic, uptake was negligible, with telehealth visits representing less than 1% of total AMC ambulatory volume. At the height of the pandemic in April 2020, telehealth visits surged to over 50% of all faculty practice plan evaluation and management visits. Recognizing an opportunity to sustain adoption, many AMCs are setting future telehealth volume targets at 20%–30% of overall ambulatory visits.
Now that telehealth has become a widely accepted mode of delivering care, AMCs are examining the role of telehealth in advancing their overarching strategic goals. Prior to the pandemic, AMC telehealth programs often operated as pilot projects or small stand-alone programs. AMCs must learn how to integrate telehealth capabilities into the fabric of their organizations, so they become part of everyday clinical care and operations. This will require prioritizing telehealth capabilities based on overall strategic priorities, organizing telehealth appropriately within the organization, and successfully integrating telehealth throughout the entire organization and across all mission areas—clinical, research, teaching and community engagement.
Multiple Clinical Strategies to Meet Goals and Serve Communities
Most, if not all, AMCs will concurrently pursue multiple clinical strategies to meet their organizational goals and effectively serve their communities. These clinical strategies include optimizing hospital-level care, distributing access to specialty and primary care, managing population health, and improving community and public health status. Telehealth can support each strategy for meeting organizational goals.
Once AMCs determine the balance among priority clinical strategies, they should develop several telehealth programs that advance each clinical strategy and together form a portfolio of telehealth solutions. Investments in telehealth programs will be made based on high-priority and high-potential clinical-use cases and will span the full range of telehealth modalities (e.g., virtual visits, e-consults, virtual consults, remote patient monitoring (RPM)). As they consider the investments needed, leaders will need to critically evaluate telehealth’s ability to drive operational efficiencies, improve clinical quality and patient outcomes, and enhance the patient experience, each of which can drive financial results.
Six Integration Imperatives
Our research with 15 national AMC leaders revealed six integration imperatives for building successful telehealth programs:
- Cultivating a culture that fosters telehealth innovation,
- Recognizing that driving telehealth adoption requires new skills and new roles,
- Aligning financial incentives,
- Using human-centered design approaches in program design,
- Integrating telehealth tools and data with existing IT infrastructure, and
- Systematically incorporating telehealth into medical education and community engagement programs.
Acting on these imperatives will advance AMCs along the telehealth-adoption curve and mitigate barriers to successful implementation and program expansion. AMCs can also play a critical and unique role in advancing the field of telehealth by effectively linking clinical, education, research and community missions. Clinical innovations in telehealth should be studied to build the evidence base for virtual care and the roles it can play in advancing high-value care. Expertise in training will help ensure the necessary skills for telehealth care are incorporated into future best-practice care models.
By focusing on the successful practices that Manatt Health and the AAMC share in their new report, AMC leaders will be able to take a well-informed approach to developing telehealth opportunities that are aligned with system goals and priorities and integrating telehealth capabilities within their organizations.