How to Implement Telehealth in a Hospital

Modern tools such as high-quality imaging and low latency communication devices allow today’s doctors to provide health services from a distance. In this article, you will learn how to implement telehealth in a hospital. 

Like any system implementation, telemedicine needs a carefully laid out plan. There must be a list of what is required, and how to overcome any challenges. 

As most hospitals that need telehealth services are in rural areas, many of the challenges will pertain to rural telehealth challenges. 

The article will cover: 

• What goes into a telehealth implementation checklist? 
• How to conduct a site resource assessment 
• Three key factors for project success 
• What are the wins for local communities? 

What goes into a Telehealth Implementation Checklist? 

Before starting the work, teams must formulate a robust plan that captures how to approach the implementation.

Here is what a telemedicine implementation checklist could look like: 

1. Form a Clear Strategy

Organizations should have clear reasons and a compelling need for establishing the telemedicine program. Goals should be informed by data and research. It’s vitally important to clearly identify the key metrics that will define the success of the program. 

It’s not simply about installing the instruments. Other key metrics can involve the adoption levels of the new system. 

2. Create a Powerful Team with Cross-functions

A typical program will involve staff and service providers from different segments. Think of IT, legal, construction, and medical professionals. Having clear processes to cut across these functional concerns is important.  

If a delay arises, or if a decision must be made, there needs to be a clear line of command.

3. Check Legislation

This is something that cannot be left until last or it could be an expensive mistake. Legal due diligence, especially in an emerging but sensitive field like telemedicine is vitally important.  

Already there are rules like HIPAA that need to be taken into account. Teams should be aware of federal and city-specific telehealth network, connectivity, and equipment rules. 

4. Verify Your Vendor Partners 

Technology will make or break a program like telehealth. There is no getting around this. Important factors like cyber security, ease of use, and integration are critical to the success of your program. 

It’s not the sophisticated equipment vendors that need to be managed. Even simple equipment vendors like furniture and lighting need to be reliable. 

5. Implement a Change Management Checklist

Embracing integration means that you need to have a change management program. Medical professionals are often stressed with little time to learn new things, no matter the importance.  

A change management plan is a good idea. If there are blockages in implementation or adoption, a change management plan will help you. 

6. Learn from Feedback

Put in place mechanisms to learn how your program is going. Insert feedback loops so you can find out about the usability of the system.  

Even a well-designed system can sometimes require tweaks after the project is complete. 

7. Measure Performance Against Goals

As part of your working plan, set periodic measurements of how you are tracking against goals. If you are falling short in any area, you can course-correct before it is too late.  

Conduct a Site Resource Assessment  

After laying out the plan, it’s time to get into action. Finding out about the site is a crucial part of the process. Failure to ensure that sites have appropriate technology may lead to suboptimal patient care.  

A thorough site resource assessment will alert you to any potential problems before you implement telehealth in rural areas.

Remember, conducting an equipment assessment is not simply about establishing if a particular machine is actually in the hospital. You also need to establish if it is working and if it has the necessary safety specifications in place.  

Trained and knowledgeable information technology and network staff should be involved in conducting assessments to ensure equipment and network readiness and address security and version concerns.

A telehealth site resource assessment will generally involve finding out about the following items:

• Is the internet connection good enough?  
• Do computers have the right performance specifications?  
• Are computers equipped with a camera, speakers, and a microphone? 
• Does the equipment adhere to local medical board security requirements?  
• Does credentialing and privilege access take into account medical licensing? 
• Is the equipment the right specification to handle Electronic Medical Records?  
• Are reimbursement and payment models catered for?  
• Are data management services for handling, storing, printing, and transmitting medical information up to the required standard? 
• Is the level of physical access security acceptable? 
• What are the failsafe mechanisms for loss of power or other hazards? 

Three Key Factors for Project Success 

The following factors will have a large bearing on the overall success of the project, both during installation and once the project is in steady-state: 

1. Training

Doctors and other medical professionals must be trained on the software. Training is not simply to teach users how to use the system, but it also ensures that adoption levels stay high. 

When users do not know how to use a system, they tend to shy away from using it. Reduced medical staff adoption is usually the start of reduced patient use. 

Your telemedicine program won't get off the ground if nobody takes part. Educate your staff and patients about its benefits and they will become champions of the system. 

2. Implementation

This key part of the process must be the main idea of the strategic plan. Successfully implemented programs usually have a multi-level approach, with all stakeholders well known. 

As mentioned, documented processes and even a change management checklist will increase the chances of a successful implementation. Be sure to take stock of the following in your plans:   

• People 
• Resources 
• Structure 
• Systems 
• Culture 

3. Support 

Some of the most advanced technological programs fall down because of a lack of adequate support. Part of your implementation plan should include installing a support mechanism for when it is needed. 

With telemedicine, support is time-critical. Patients cannot wait for a support person to fix a problem. This could create backlogs in standard treatment. It could also create an unwanted medical emergency because the telemedicine system is not working. 

Support mechanisms should also take into account that the medical field has no true downtime. People get sick at any time and multi-level support needs to be always on. 

How Does the Use of Telehealth Impact Rural Healthcare Providers? 

Besides frontline medical reasons, there are other benefits to telehealth systems. Telemedicine use in rural areas can reduce a provider's feelings of isolation and fatigue.  

This can lead to better staffing retention at rural hospitals. These are some of the benefits of telehealth systems that are not often spoken about. 

As such, implementing a telehealth system well is so vital when the following benefits can be realized:

• Improved patient outcomes   
• Decreased transportation costs for patients 
• Reduced hospital staffing costs 
• Increased patient access to specialists 
• Providing timely care 
• Ensuring patient comfort 

How Much Does It Cost to Implement Telehealth?

This is a natural question to ask. Telehealth costs are variable. It depends on where your practice is and the level of competition among the telehealth vendors who can help you. 

Rest assured, the following items will have to go into your budget:

• Hardware and networking costs
• Contractor costs
• Consultancy and customization costs from the EHR vendor
• Software and licensing fees
• Training fees
• Data conversion, backups, and storage costs

It is common for some practices to adopt telehealth for under $80,000. Of course, if you go for a state of the art system, it could cost as much as $150,000.

Find Out About the Cost of Setting Up a Telemedicine System

Implementing Telehealth: Navigating Legal and Regulatory Considerations

Each telemedicine provider should consider the legal aspect first while implementing telehealth. The United States government's official Telehealth website declares the two primary branching in legal and regulatory considerations upon telemedicine implementation:

1. Protecting patient health data.
2. Protecting your telehealth startup from penalty and malpractice.

These two paragraphs include: 

• Liability and Malpractice. Telehealth services should contact the insurance provider and confirm that the offered insurance will cover all services in the required state.

• Written or verbal Consent.  For telemedicine implementation in some states, you can be asked to convey informed consent to patients before providing services. It shall cover technology, privacy, and security topics. Check the CCHP policy map for consent rules in each state. You can also use the California Telehealth Resource Center's written consent template.

• Privacy and HIPAA. Patient’s personal health information can only be collected under HIPAA laws. Challenges to telehealth include privacy, where programs should check how data is handled from smartphone apps, use multi-factor authentication on mobile gadgets, manage images and videos, encrypt and create private workspaces, and others. 
• Additional Cybersecurity. Additional precautions are needed when working with health monitoring technologies and patient data that might not uphold HIPAA standards. Healthcare providers must also protect the patient and the devices since the FDA does not check medical devices for cybersecurity before releasing them.

Find your state's complete information on telehealth implementation regulations at the National Telehealth Policy Resource Center and check for telehealth privacy tips here. 

Conclusion

Telehealth has quickly become integrated into nearly every aspect of current trends in patient care in distant communities.  

Medical professionals who provide telehealth maintain the same professional best practices as they would in face-to-face treatment, with all the added benefits of technology.  

It all starts with a robust implementation plan. If teams work together, telemedicine can create all the intended wins for all stakeholders in healthcare.