The most accurate way to describe the meteoric rise of telehealth visits that occurred last spring? “Trial by fire.” Not just because it was a novel idea for many organizations, but also because of the enormous implications it had in keeping healthcare afloat during a crisis.
And although there were certainly bumps in the road — particularly for those who hadn’t yet ventured onto it — at the end of the day, “we were able to pivot as an industry with incredible speed,” said Rich Temple, CIO at Deborah Heart and Lung Center.
In addition to enabling care to continue while clinics were closed, the “trial” also highlighted the strategic benefits of telehealth, Temple noted during a recent webinar, which also featured John Henderson (CIO, CHOC Children’s) and Eric Gray (Chief Solutions Architect, Netscout). It also underscored the need to ensure telehealth tools are integrated with core clinical applications to provide a “seamless and frictionless experience,” said Henderson. “When a patient clicks on the text message link to launch the visit, we want them to go right into the waiting room.” That means the EHR, telehealth and patient engagement platforms must “all work in harmony.”
It’s a goal that most — if not all — healthcare organizations share, but in reality, integration isn’t always a given. In fact, both CHOC Children’s and Deborah have had their struggles when it comes to tying it all together. During the discussion, the panelists talked about where the biggest challenges exist, how they’re looking to close those gaps, and the importance of setting realistic expectations in terms of service delivery.
The Big Three
When it comes to something as complex as integration, it’s helpful to get down to the bare bones and identify the core components, according to Gray, which are: availability, performance and security.
First and foremost is availability. Although it may not be as fragile as it was in the past because of the redundancy that’s in place with most infrastructures, as well as in the cloud, availability is “still critical,” and should be accounted for.
The same goes for performance. Even if applications are readily available, it doesn’t necessarily mean they’re performing at an acceptable level, Gray noted. “If you want to make sure the patient and provider both have a great experience, the performance has to be excellent.”
Where it can get dicey, however, is measuring that — particularly in a cloud environment. “It’s one thing to monitor equipment on premise and be able to capture data and analyze the performance of your devices,” Gray said. However, when EHRs are hosted in the cloud, as is the case with both Deborah and CHOC Children’s, CIOs need to “trust someone else,” he noted. “I want to be able to trust, but verify. And so you need some flexibility to monitor performance and availability,” especially for those who are working remotely.
Temple agreed, adding that the expectations when it comes to uptimes are extremely high, despite the fact that outages can happen that are beyond IT’s control. “That’s not the magic ticket in terms of knowing you’re going to have dependable service across the board,” he said. “It’s about performance and knowing you’ve got a good signal and have cybersecurity baked in.”
And of course, the application piece can’t be neglected, Henderson noted. “That’s what lets us know if we’re going to deliver the right type of experience and the right responsiveness with the solutions our providers are using.”
The final component is security, which has posed enormous challenges for healthcare systems during the pandemic, as cyberattacks spiked across the industry, according to Gray. “The hackers realized this was a prime time for them to take advantage of the chaos that has gone on, and wreak even more havoc.”
As a result, IT and security leaders face even more pressure to safeguard information, noted Henderson. “Things don’t change yearly with cybersecurity; they change daily. And so having that level of insight and visibility to what’s happening on the perimeter, as well as inside your network, is important.”
And while most organizations are well aware of the risks when it comes to data leaks, it’s vital to remember that even if you’re successful 100 percent of the time, “hackers only have to be successful once,” Temple added.
Service delivery: “Front and center”
At the same time, user experience cannot take a backseat, even to something as critical as security. Being able to deliver high-quality service to those providing care is a must, said Henderson. “When it comes to the application solution delivery side, the approach I take is, ‘Is it mission-critical? Does it fit into the top tier of critical solutions needed to run the inpatient and outpatient care delivery?’ And if it fits into that category, we want to provide that at the highest levels.”
When cloud solutions are part of the mix, there’s a lot of integration that needs to happen, and happen flawlessly, he noted. “It has to be on, all the time.” And while his team is willing to commit to top tier service levels, the hard truth is that ensuring applications are always available “isn’t always achievable, but that’s what we want to provide.”
Recognizing that limitations exist, and being willing to be transparent about them, is absolutely essential, he said. “We bake that into the conversation upfront with the key business sponsors. We let them know the likelihood of something happening, and where we may not be able to deliver, because what we’re trying to offer is really unique.”
And if something does happen, his team’s focus is not just on resolving it, but digging deeper to understand how the user experience has been affected, and how similar issues can be prevented going forward.
It’s precisely what Temple hopes to achieve with his team — and is a core part of what IT departments offer. “Our unique value add is that we help lift all the boats around us at the hospital by providing an excellent level of service and supporting their technology,” he noted. “That’s always front and center in everything we do.”
To view the archive of this webinar — Safeguarding Physician & Patient Satisfaction While Integrating EMR Solutions with Other Clinical Applications (Sponsored by Netscout) — please click here.