How to launch an effective telemedicine practice

Launching an effective telemedicine program is the result of an effective strategy, business model, operations and technology, according to Sarah Sossong, MPH, director of telehealth for Massachusetts General Hospital.

In her presentation entitled “Health Tech – Technology in Practice” delivered during the American Heart Association (AHA) Scientific Sessions in New Orleans, Sossong discussed reasons for creating a telemedicine program, how to launch an effective one and specific uses for cardiologists.

Reasons for clinicians to create a telemedicine program, she said, include increasing access to care, reducing cost, attracting consumers and expanding reach.  The impact of these strategies can be measured through both return on investment (ROI) and value metrics. When looking at ROI metrics, these may include any combination of direct revenue from payers or contracts, indirect revenue from new patients or cost avoidance through avoided visits or hospitalizations. Value metrics may vary greatly depending upon the telemedicine intervention and clinical specialty, but could include improvements in access for new patients or clinical quality metrics like medication adherence. 

Sossong emphasized that telemedicine provides an avenue to participate in the shift to value-based care by offering patients new ways to access healthcare, improving the quality of care for patients through sustained connections between clinician and patient and improving patient outcomes and experience. Flipping the traditional paradigm of having a patient come to the clinician’s office, telemedicine allows for clinicians to meet patients in their location-whether in the patient’s home, office, an outpatient clinic closer to the patient’s home or even inpatient or post-acute settings. In many ways, she said, telemedicine has allowed the return of the “virtual house call.”

Launching a successful program, she said, depends on a number of considerations.

First, make sure you have a clinical champion, a respected, influential clinician who can inspire enthusiasm and adoption of your telemedicine initiative and act as a role model for other clinicians. Next, ensure that the program is rolled out and scaled up in a systematic way addressing business, technology, and legal and regulatory infrastructure. Only a comprehensive and holistic approach can lead to sustained adoption of telemedicine, she said.  

Next: Why can't go it alone

Sharing insights from her own experience in launching telemedicine programs, Sossong highlighted several additional factors that are critical for a successful launch: knowing your target patient population, identifying your goal and providing incentives for physicians, administrators and patients to participate. For example, she said that when identifying the goal of a program, it may be useful to consider what is needed at specific levels of care. In the primary care setting, the goal may be management of chronic disease (e.g., management of high blood pressure for a heart failure patient via e-visits). For outpatient care, the goal could be to extend clinical coverage from cardiologists to patients in the home via virtual visits. In the emergency department setting, a consulting cardiologist might provide remote consults to a remote emergency department clinician to triage cases to ensure appropriate transfers and reduce inappropriate admissions.  

Sossong emphasized that when launching a program, it is important to partner with aligned individuals or groups within one’s organization to succeed.

“Don’t go it alone,” she emphasized.

Sossong also talked briefly on specific uses of telemedicine in cardiology, highlighting its use with both patients and remote clinician colleagues for pre-visit consultations, post-hospital discharge visits, post-imaging follow-up visits or online second opinions.

In closing, Sossong reminded people that launching a telemedicine program is a marathon, not a sprint.

“In the end, the success of your telemedicine program will be measured not only in the achievement of your goals, but in the nature of the journey you take to reach your destination,” she said.