Many providers implemented telehealth programs for the first time in response to the COVID-19 pandemic. As with any new program, it’s important to measure outcomes for telehealth visits.
Let’s look at the basics of measuring outcomes for telehealth, including guidelines developed by the National Quality Forum.
Start with clear goals
As with any effective initiative, it’s important to start with achievable goals. Are you measuring outcomes to improve clinical efficiency or reduce readmission? Is your aim to lower the cost of care delivery or improve access to specialists?
Unfortunately, there is no set template for organizations to follow when it comes to setting goals around telehealth. It’s therefore vital to ask, “Why is our practice adopting telehealth?” Use your answer to decide on the cost, care, and quality outcomes that are most important at this time.
Types of outcomes for telehealth
Once your team has decided on initial goals, it’s useful to look at your telehealth program holistically. Consider the following four evaluation measurement areas, developed by the National Quality Forum.
Access to Care
Is telehealth improving your ability to effectively provide clinical services to patients who experience access barriers? Typically this refers to remote patients, but during the COVID-19 pandemic, many more patients will face challenges to visiting in-person.
This domain has five components: affordability, availability, accessibility, accommodation, and acceptability. You might ask questions like:
- How many encounters and claims are submitted and reimbursed?
- What services are available to patients remotely?
- How many patients continue treatment at 30, 60, and 90 days and at one year?
- How many people are using new services?
Financial Impact & Cost
What is your telehealth program’s financial impact on patients, caregivers, the care team, insurance providers, and the wider community?
Measuring outcomes in this area could mean looking at: cost per visit, patient travel miles saved, or return on investment.
Is telehealth meeting patients’ and providers’ needs? This domain asks how user-friendly and effective telehealth is for patients, providers, and other care team members.
To measure experience outcomes for telehealth you will need input from providers and patients. Ask providers: “Are you satisfied with the telemedicine experience?” Another valuable measure is whether patients comply with their care plan.
A simple 10-item Likert-type survey is a simple and effective way to ask patients if they are satisfied with their care.
This domain looks at your telehealth programs’ clinical, operational, and technical aspects. How much time passes between a provider’s request for consult and delivery of that consult? Are technologies that providers use at work user-friendly? How well is telehealth integrated within the care setting?
Non-standard evaluation measures may be necessary to measure telehealth outcomes in this area. Patient experience and staff satisfaction surveys are common methods you might use to collect this information.
Focus on patient outcomes
If measuring outcomes for your entire telehealth program seems out of reach, consider keeping it simple.
In an article on performance measurement in the Harvard Business Review, the authors emphasize that the simplest way to measure outcomes is to ask the patient. There is still no widely-used system for patient-reports outcome measures, but that shouldn’t stop you from collecting some information. As the authors summarize:
“For many types of care — especially care that is routine, highly standardized, and completed over a short duration — one may thus get significant mileage out of asking patients very simple questions such as, “At this point, how satisfied are you with the outcome of your care?” Consider, for example, a knee replacement or appendectomy. Given that a return to normal function is a key outcome for these treatments and an expectation for many patients, asking patients at predetermined intervals post-treatment to rate the quality of their outcomes may prove highly valuable.”
Of course, it’s not always so straightforward to measure outcomes, whether care is delivered via telehealth or otherwise. Measurement is more complicated for outcomes that may be subtle, technical, and reveal themselves over extended periods of time (e.g. cancer treatment).
However, collecting some information is better than nothing. By putting a few simple outcome measures in place now, you’ll make it easier to gauge the effectiveness of your telehealth program and make improvements down the line.