Koninklijke Philips N : What does the future hold for telehealth? Q&A with medical experts

In the face of COVID-19, communities across the globe quickly adopted telehealth as a safe, convenient care delivery model. Clinician acceptance grew exponentially as the home became a new base for care. As we approach the end of a tumultuous year, healthcare leaders look toward finding stable ground and cementing telehealth for years to come. To help guide this process, three Philips medical leaders weighed in on both the opportunities and challenges ahead for telehealth's long-term sustainability - Huiling Zhang, Chief Medical Officer of Connected Care, Cindy Gaines, Clinical Transformation Leader of Connected Care, and Adam Seiver, Medical Leader for Therapeutic Care and Hospital Respiratory Care. The resounding sentiment? For telehealth to last, it will take a clinical transformation - workflows need to be reconfigured, the industry will collaborate in new ways, and providers must continuously adapt to shifting dynamics and ways of working.

Q1: Telehealth use skyrocketed during the pandemic. In your eyes, what is the main obstacle to its long-term adoption?

Huiling Zhang (HZ): First of all, we need to stop thinking of telehealth as one-off video chats or phone calls with one's provider. As the location where care takes place becomes more flexible, and our dependence on technology grows to support these various settings, telehealth can serve an important role as a more operationalized form of care delivery. Just like in-person visits, telehealth should be fully integrated with the day-to-day operations of a healthcare organization - from scheduling appointments, to billing and payments, to where to deploy staff according to need. All parties, including providers, payers and patients, need to have confidence that telehealth, when deployed and used properly, can be as effective as an in-person visit, and put into practice to fully integrate it into clinical and operational workflows to optimize location-independent care delivery..

Cindy Gaines (CG): Any digital transformation that happens this quickly has a risk of becoming a 'fad,' so there's work to do to ensure that is not the case. There is a real threat that telehealth could become the next EHR adoption of the early 2000s. While the 'Meaningful Use' push promised to advance health information management, over time these solutions evolved to be disparate sources of administrative burden, largely because organizations did not invest the time to modify workflows to incorporate the technology and gain the efficiencies and advantages. The same risk exists for telehealth - while its promise lies in its convenience and improved access, if workflows don't change, it will not stick. To avoid history repeating itself, we need to get comfortable blending the old with the new and hire workflow experts and technology navigators devoted to the transition and workflow design.

Adam Seiver (AS): If we've learned anything from healthcare's digitization over the years, it's that it is not just about the technology - it is about the people, processes, and incentives in place to support it. There is a risk that telehealth's adoption is more of a technology 'push' than an underlying problem 'pull.' Telehealth is not just the icing you put on top; it needs to be mixed into the batter. If we look at tele-critical care as an example, for the eICU to be an effective and collaborative model for monitoring our sickest patients, it requires a redesign of critical care workflows, not just a technology installation.

Q2: What is the most critical piece of hardwiring telehealth long-term?

HZ: While telehealth has made a name for itself this year, we now need to ensure our informatics backbones mature with these solutions, activating a secure flow of data where and when it's needed. Telehealth's stake in the future of patient care depends on interoperable solutions that inform data-driven decisions. Supporting patients in a variety of care settings requires robust data-sharing infrastructures, establishing a standard for disparate systems to more easily talk to one another, and reevaluating restrictive privacy policies that fit a brick-and-mortar, transactional care model. The right financial incentive and payment reforms will also be critical for the long-term hardwiring of telehealth.

CG: For me, telehealth's success lies in transforming how we talk about healthcare. We need to eliminate the word 'discharge' from our vocabularies. That word is meant for episodic, sick care, not a continuum of care. Remote patient monitoring via wearables or connected devices isn't just for after discharge to prevent a readmission - it's for giving the provider eyes into a patient's lived environment for proactive health management, and for giving patients a passive, convenient way to stay tethered to their providers.

AS: Collaboration and connectivity from bedside to webside - and the role technology plays in enhancing it - is a big part of securing telehealth's longevity. For tele-critical care, this means the virtual and bedside staff need to feel they are a part of the same team, supporting each other and enhancing care for the patient. With this mentality, determining which tasks are best managed remotely and which are best done at the bedside to maximize the team's time, energy and resources is cooperative instead of competitive. Beyond this, 5G and the enhanced connectivity and mobility it enables holds a lot of promise in ensuring telehealth remains a convenient, go-to tool for both providers and patients.