Engaging Physicians in a Telemedicine Roll Out

A crucial part of any technology rollout in healthcare is not the software or hardware. Instead, it’s stakeholder buy-in of the technology. Without acceptance of the tools, the chances of rolling out telehealth or any other technology are likely doomed.

Let’s dig into the issue of why so many technologies fail on the ground. How can hospitals and medical practices roll out a telehealth service line while ensuring the engagement of clinicians? Why does doctor acceptance matter and how can healthcare providers guarantee they’ll reap the benefits of their investment?

Ask any EMR vendor and they’ll tell you the technology is only as effective as the clinical buy-in on the ground. Information technology is rife with horror stories about technology failures linked to end-user buy-in. These stories cross industries, job descriptions, and technology applications. Simply put, if the person using the software or hardware application has a conscious or unconscious bias against it, the deployment has a high probability of failure.

The Project Management Institute studies these failures and each year releases a report chronicling why strategic technology initiatives fail. In the last report, 3,000 project managers were surveyed to find out what went wrong. The study noted:

• 37% said it was a lack of clearly defined benchmarks with clear milestones stymied their projects.
• 19% said poor communication was the primary cause.
• 18% tied the failure to a lack of communication by senior management.
• 14% said employee resistance.
• 9% reported insufficient funding.

It’s clear that technology is playing an increasing role in business workflows. In healthcare, technology continues to innovate, streamlining how doctors deliver care and how patients interact with caregivers. Yet physicians are sometimes reluctant to adopt these tools – and sometimes their skepticism is warranted. Becker’s Health IT & CIO Report suggests:

Some technology systems that were intended to improve organization and user efficiency, like EHRs, have inadvertently complicated provider workflows and contributed to physician burnout largely due to design and workflow issues.

But when technology has proven to help clinical practice, a study from the American Medical Association says 82% of physicians are supportive of the rollout. These attitudes matter greatly; one survey showed that securing physician support is imperative for any successful technology rollout, but it is critical for telehealth. The problem, of course, is that telemedicine technology changes the very nature of the clinical visit from a hands-on face-to-face meeting to a virtual house call. That’s exactly why physician adoption is the biggest hurdle facing telehealth today. Too, older doctors may be less likely to consider embracing this new trend. Ultimately, Deloitte reports that although 90% of doctors say they see the benefits of telehealth, only 14% are using these tools today.

Here are some ways we can help bridge this gap.

Becker’s health IT & CIO Report has a few suggestions for improving any technology roll-out, including telehealth. They include:

• Involve clinical teams from the beginning of the process. This means including all technology users in the due diligence process to map out the goals of the service line, select the vendor, and establish clinical and non-clinical goals for successfully marketing and leveraging telehealth. Becker’s suggests these early adopters should then be positioned at the front of the rollout process as “evangelists” for the service.
• Know the difference between adoption and implementation. While the go-live may force clinicians to use the tool it does not take into account the end-users acceptance. Becker’s points out “Implementation is a technology-centric milestone that has little to do with achieving the specific patient-centric outcomes that inspired the project in the first place.” This requires not only measuring that the tool has been launched, but also tracking if it’s being utilized – and if that use is increasing.
• Select the right clinical leadership to support the project. Medicine is built upon standardized workflows intended to reduce medical mistakes. Telehealth forces doctors to change some of these workflows, which, for the reluctant physician, could feel risky. Developing a key team made up of doctors and administrators to create new workflows that decrease the perception of risk while standardizing best practices is a crucial part of the telehealth roll out.
• Find the right technology partner. How many times have you heard of health systems adopting an EHR only to discard it for another vendor later on? Part of the problem, Becker’s argues, is that vendors are selected that do not fully understand clinical workflows. Telehealth is a much simpler tool to use, but it is just as important to find a vendor that approaches the technology from the perspective of the physician first. Becker’s suggests, “Before selecting a technology, ask prospective vendors to conduct a clinical workflow assessment showing the impact of their solutions or platforms.”

But Health Care Law Today has a few different suggestions for encouraging physician support of a telehealth initiative. They include:

• Providing in-depth training on the technology. They suggest that a one-hour training over lunch will not be enough to overcome physician reluctance. Instead, working with practices to discuss how they will successfully launch the new service line to patients is a crucial part of telehealth adoption.
• Create quantifiable goals and best practices for the telehealth practice. While telehealth has proven to cut overhead costs, it can also be a revenue generator for a practice. However, there are other ways to measure a telemedicine launch beyond bottom-line metrics, including patient satisfaction and quality of care. Establishing these goals and then revisiting the data regularly improves the efficacy of the overall program. That data can also aid in overcoming physician reluctance.
• Establish quality standards for the service line. This is imperative for any change in established clinical protocols, of course. Establishing frameworks for uniform, repeatable quality patient care and safety will ultimately increase clinical adoption. Health Care Law Today concludes, “Having strong standards in place helps set the stage for physicians to understand what these services mean for their practice, and that what is being implemented meets regulatory requirements.”

The team at OrthoLive understands physician reluctance toward technology adoption. Our telemedicine application was designed by an orthopedic surgeon who realized the tremendous benefits of the technology for improving access to care for his patients. Contact us.