Michael Barbella, Managing Editor11.26.21
Out of the darkness, comes light.
Telehealth has been the saving grace of the COVID-19 pandemic, enabling patients and physicians to safely access and deliver healthcare amid strict lockdowns and rampant waves of infection. Though its growth slowed considerably this year, telehealth is nevertheless a permanent fixture in the medical field.
Telehealth utilization is 38 times higher now than it was before the pandemic, McKinsey & Company data indicates, and both consumer and provider attitudes toward remote care have improved as well. After initially spiking to more than 32 percent of office and outpatient visits in April 2020, telehealth utilization currently ranges between 13 percent and 17 percent across all specialties, the management consulting firm reported in July.
“Telehealth appears poised to stay a robust option for care,” McKinsey’s article stated. “Strong continued uptake, favorable consumer perception, the regulatory environment, and strong investment into this space are all contributing to this rate of adoption.”
Yet challenges threaten to prevent telehealth from realizing its full potential. The difficulties include the need for better data integration and improved data flows, equity concerns, large-scale access (high-speed broadband internet is not available in many rural areas), patient privacy, reimbursement, and professional licensing, among others.
MPO’s feature “Face to (Virtual) Face” explores the barriers telehealth must overcome to ensure its long-term growth, and spotlights some of the virtual tools available to doctors and patients. Jeff Donnell, president of Enterprise Health, provides insight into this growing field in the following Q&A.
Michael Barbella: What specific aspects of employee/occupational health can telehealth capabilities help most with?
Jeff Donnell: While an increasing percentage of employers have deployed on-site clinics to provide occupational and employee health services, multi-site employers with a geographically dispersed workforce rarely have on-site clinics at every location. In addition, organizations often have field service, sales and other employees who are not tied to an office location. For employees in one of these situations, telehealth is an excellent way for an organization to provide health services without having to rely as much on external providers (which adds expense and challenges in terms of managing employee health records). This situation existed pre-COVID and will, of course, continue. Now that COVID has struck, remote and hybrid workers can also receive services using telehealth. While certain encounters require on-site testing and exams (e.g. audiograms, pulmonary function tests, etc.), other services can be provided remotely—including initial consultations, health and wellness visits, chronic disease counseling, and follow-up consultations.
Barbella: Telehealth services saw robust growth during the pandemic. How will they remain an important part of employee/occupational health management for companies in a post-COVID world?
Donnell: COVID-19 has demonstrated to organizations that many jobs can be performed remotely. As a result, employers are looking at shifting once on-premise jobs to permanent remote status or moving to a hybrid approach where workers split time between working on site and at home. As more employees continue to work remotely, telehealth will enable organizations to continue providing health services for individuals without regular access to an on-site health clinic. This will be especially helpful in the provision of health and wellness services and follow-up consultations, as well as in assessing at-home issues that may arise, such as ergonomic problems.
Barbella: Many regulatory barriers were eased during COVID-19 to allow for more use of and access to telehealth services. What needs to be done from a regulatory and policy standpoint to ensure that employee and occupational health technologies can use telehealth to its full potential?
Donnell: As befits an emergency situation, the relaxing of telehealth regulatory requirements made sense to support the rapid shift of employees to remote work. This was not only the appropriate response, but it also put a fine point on the benefits of telemedicine when an in-person medical visit is difficult or impossible. Now that the benefits of telemedicine are more widely understood, and we are more than a year into COVID-19 response, it is time to find a happy medium in terms of regulations and policies. Many of the barriers that stood in the way of wide telehealth adoption should not be erected again, as providers and patients (employees in an occupational health setting) realize the significant convenience of telehealth visits. With the benefit of widespread use, policies around which kinds of visits can be accomplished via telehealth versus those that require an in-person visit can be reviewed and updated. Perhaps most importantly, rules around security and the protection of data privacy were relaxed, and as a result, telehealth visits were often conducted using technology and infrastructure that was not fully secure or HIPAA compliant. Again, this made sense early on, but long-term, these requirements should be reviewed, updated and reinstated to protect against security vulnerabilities.
Barbella: What should hospitals and health systems know before they invest in employee and occupational health management software? How big a consideration should telehealth features be?
Donnell: It is important for hospitals and health systems to realize that occupational and employee health software is different from traditional patient care software. Over the past decade, most hospitals and health systems have invested heavily in enterprise-wide electronic health record systems as well as other health IT applications, and it is understandably tempting to leverage that investment across the organization. However, EHR platforms built for patient care lack the depth of occupational and employee health functionality required to support compliance requirements and healthy workforce initiatives. Occupational and employee health is a unique niche, and too often hospitals are using a combination of their patient care EHR, spreadsheets, home grown databases and even paper to manage employee health. In addition, hospital privacy officers and staff alike typically have concerns about commingling employee health data and patient data in the same application. Telehealth should certainly be a factor when evaluating occupational and employee health software. It’s important to recognize that, post-pandemic, there is still a need to support remote workers or those who are unable to visit an on-site employee health clinic.
Barbella: What specific aspects of employee and occupational health management software must be improved after the pandemic? How will telehealth features factor into this?
Donnell: In terms of functionality, occupational and employee health software must be fine-tuned to support pandemic response. At Enterprise Health, we worked with one of our health system clients several years ago to build out pandemic response functionality as they were involved in managing the last Ebola outbreak. When COVID-19 struck, we were able to rapidly modify that functionality to support COVID-specific requirements. In addition, we moved quickly to leverage existing modules including employee engagement, case management, vaccine management, encounter documentation, and reporting to aid our clients with their COVID workflows. In addition to functionality, it is important for software vendors to adopt and maintain an agile footing. We were able to refine and launch telehealth, contract tracing, and new mass immunization capabilities in days, as client needs all but dictated a higher level of urgency. While we have seen the pace slow down gradually, we recognize that agility is a new imperative going forward. It is also important that occupational and employee health software deliver both compliance and clinical capability. Recognizing that regulatory compliance will remain essential while ensuring that an organization has a present, productive and healthy workforce has taken on a much higher degree of importance. COVID underscores the critical nature of having healthy healthcare workers available to provide services to patients.
Barbella: With more than 80 percent of hospital IT systems running on outdated software when the pandemic hit, cybersecurity will clearly play a key role in maintaining the adoption of employee/occupational health management software. What do hospitals and health systems need in order to optimize their IT systems so that they can best support the health and safety needs of their own employees?
Donnell: The pandemic shined a bright spotlight on the importance of occupational and employee health in a hospital setting, as the need to take care of the healthcare professionals who are responsible for taking care of patients was put into sharp focus. Health systems have invested heavily over the last decade in patient care information technology, often assisted by government incentives to adopt healthcare IT. COVID demonstrates that investments (albeit on a much smaller scale) need to be made in health IT solutions focused on the unique occupational and employee health needs of hospital staff. From a privacy protection and security practices standpoint, employee health records should be maintained on a separate platform from the hospital patient care electronic health record to ensure that records are not commingled and to prevent unauthorized access to sensitive employee health information.
Barbella: Are telehealth services that address employee/occupational health and safety going to become the norm for companies moving forward, even if they maintain the option for their employees to use on-site care facilities? Please explain.
Donnell: As a result of COVID, the telehealth genie is fully out of the bottle. Now that more employers have deployed and realized the benefits of telehealth, we expect the use of these services to continue. While there will be a shift back to in-person healthcare provision at on-site clinics, we anticipate that some visits and consultations that do not require in-person physical interaction will remain on telehealth platforms given the ease and convenience of this approach. Telehealth will also remain important for workers who continue to work remotely or in hybrid mode, as well as for employees who do not work at a location with an on-site clinic.
Telehealth has been the saving grace of the COVID-19 pandemic, enabling patients and physicians to safely access and deliver healthcare amid strict lockdowns and rampant waves of infection. Though its growth slowed considerably this year, telehealth is nevertheless a permanent fixture in the medical field.
Telehealth utilization is 38 times higher now than it was before the pandemic, McKinsey & Company data indicates, and both consumer and provider attitudes toward remote care have improved as well. After initially spiking to more than 32 percent of office and outpatient visits in April 2020, telehealth utilization currently ranges between 13 percent and 17 percent across all specialties, the management consulting firm reported in July.
“Telehealth appears poised to stay a robust option for care,” McKinsey’s article stated. “Strong continued uptake, favorable consumer perception, the regulatory environment, and strong investment into this space are all contributing to this rate of adoption.”
Yet challenges threaten to prevent telehealth from realizing its full potential. The difficulties include the need for better data integration and improved data flows, equity concerns, large-scale access (high-speed broadband internet is not available in many rural areas), patient privacy, reimbursement, and professional licensing, among others.
MPO’s feature “Face to (Virtual) Face” explores the barriers telehealth must overcome to ensure its long-term growth, and spotlights some of the virtual tools available to doctors and patients. Jeff Donnell, president of Enterprise Health, provides insight into this growing field in the following Q&A.
Michael Barbella: What specific aspects of employee/occupational health can telehealth capabilities help most with?
Jeff Donnell: While an increasing percentage of employers have deployed on-site clinics to provide occupational and employee health services, multi-site employers with a geographically dispersed workforce rarely have on-site clinics at every location. In addition, organizations often have field service, sales and other employees who are not tied to an office location. For employees in one of these situations, telehealth is an excellent way for an organization to provide health services without having to rely as much on external providers (which adds expense and challenges in terms of managing employee health records). This situation existed pre-COVID and will, of course, continue. Now that COVID has struck, remote and hybrid workers can also receive services using telehealth. While certain encounters require on-site testing and exams (e.g. audiograms, pulmonary function tests, etc.), other services can be provided remotely—including initial consultations, health and wellness visits, chronic disease counseling, and follow-up consultations.
Barbella: Telehealth services saw robust growth during the pandemic. How will they remain an important part of employee/occupational health management for companies in a post-COVID world?
Donnell: COVID-19 has demonstrated to organizations that many jobs can be performed remotely. As a result, employers are looking at shifting once on-premise jobs to permanent remote status or moving to a hybrid approach where workers split time between working on site and at home. As more employees continue to work remotely, telehealth will enable organizations to continue providing health services for individuals without regular access to an on-site health clinic. This will be especially helpful in the provision of health and wellness services and follow-up consultations, as well as in assessing at-home issues that may arise, such as ergonomic problems.
Barbella: Many regulatory barriers were eased during COVID-19 to allow for more use of and access to telehealth services. What needs to be done from a regulatory and policy standpoint to ensure that employee and occupational health technologies can use telehealth to its full potential?
Donnell: As befits an emergency situation, the relaxing of telehealth regulatory requirements made sense to support the rapid shift of employees to remote work. This was not only the appropriate response, but it also put a fine point on the benefits of telemedicine when an in-person medical visit is difficult or impossible. Now that the benefits of telemedicine are more widely understood, and we are more than a year into COVID-19 response, it is time to find a happy medium in terms of regulations and policies. Many of the barriers that stood in the way of wide telehealth adoption should not be erected again, as providers and patients (employees in an occupational health setting) realize the significant convenience of telehealth visits. With the benefit of widespread use, policies around which kinds of visits can be accomplished via telehealth versus those that require an in-person visit can be reviewed and updated. Perhaps most importantly, rules around security and the protection of data privacy were relaxed, and as a result, telehealth visits were often conducted using technology and infrastructure that was not fully secure or HIPAA compliant. Again, this made sense early on, but long-term, these requirements should be reviewed, updated and reinstated to protect against security vulnerabilities.
Barbella: What should hospitals and health systems know before they invest in employee and occupational health management software? How big a consideration should telehealth features be?
Donnell: It is important for hospitals and health systems to realize that occupational and employee health software is different from traditional patient care software. Over the past decade, most hospitals and health systems have invested heavily in enterprise-wide electronic health record systems as well as other health IT applications, and it is understandably tempting to leverage that investment across the organization. However, EHR platforms built for patient care lack the depth of occupational and employee health functionality required to support compliance requirements and healthy workforce initiatives. Occupational and employee health is a unique niche, and too often hospitals are using a combination of their patient care EHR, spreadsheets, home grown databases and even paper to manage employee health. In addition, hospital privacy officers and staff alike typically have concerns about commingling employee health data and patient data in the same application. Telehealth should certainly be a factor when evaluating occupational and employee health software. It’s important to recognize that, post-pandemic, there is still a need to support remote workers or those who are unable to visit an on-site employee health clinic.
Barbella: What specific aspects of employee and occupational health management software must be improved after the pandemic? How will telehealth features factor into this?
Donnell: In terms of functionality, occupational and employee health software must be fine-tuned to support pandemic response. At Enterprise Health, we worked with one of our health system clients several years ago to build out pandemic response functionality as they were involved in managing the last Ebola outbreak. When COVID-19 struck, we were able to rapidly modify that functionality to support COVID-specific requirements. In addition, we moved quickly to leverage existing modules including employee engagement, case management, vaccine management, encounter documentation, and reporting to aid our clients with their COVID workflows. In addition to functionality, it is important for software vendors to adopt and maintain an agile footing. We were able to refine and launch telehealth, contract tracing, and new mass immunization capabilities in days, as client needs all but dictated a higher level of urgency. While we have seen the pace slow down gradually, we recognize that agility is a new imperative going forward. It is also important that occupational and employee health software deliver both compliance and clinical capability. Recognizing that regulatory compliance will remain essential while ensuring that an organization has a present, productive and healthy workforce has taken on a much higher degree of importance. COVID underscores the critical nature of having healthy healthcare workers available to provide services to patients.
Barbella: With more than 80 percent of hospital IT systems running on outdated software when the pandemic hit, cybersecurity will clearly play a key role in maintaining the adoption of employee/occupational health management software. What do hospitals and health systems need in order to optimize their IT systems so that they can best support the health and safety needs of their own employees?
Donnell: The pandemic shined a bright spotlight on the importance of occupational and employee health in a hospital setting, as the need to take care of the healthcare professionals who are responsible for taking care of patients was put into sharp focus. Health systems have invested heavily over the last decade in patient care information technology, often assisted by government incentives to adopt healthcare IT. COVID demonstrates that investments (albeit on a much smaller scale) need to be made in health IT solutions focused on the unique occupational and employee health needs of hospital staff. From a privacy protection and security practices standpoint, employee health records should be maintained on a separate platform from the hospital patient care electronic health record to ensure that records are not commingled and to prevent unauthorized access to sensitive employee health information.
Barbella: Are telehealth services that address employee/occupational health and safety going to become the norm for companies moving forward, even if they maintain the option for their employees to use on-site care facilities? Please explain.
Donnell: As a result of COVID, the telehealth genie is fully out of the bottle. Now that more employers have deployed and realized the benefits of telehealth, we expect the use of these services to continue. While there will be a shift back to in-person healthcare provision at on-site clinics, we anticipate that some visits and consultations that do not require in-person physical interaction will remain on telehealth platforms given the ease and convenience of this approach. Telehealth will also remain important for workers who continue to work remotely or in hybrid mode, as well as for employees who do not work at a location with an on-site clinic.
