Reaching Through the Screen: Telehealth and Patient Engagement

By: | February 26, 2021

Michael Combs is the President and Chief Executive Officer for CorVel. He has been with CorVel for 30 years — he joined the company as a software engineer in 1991 and rose through the ranks as Vice President of Information Systems, deputy chief and Chief Information Officer, and President in 2017 before assuming the additional role of CEO in 2019. Prior to joining CorVel, Michael was a software engineer with Science Applications International Corp., where he developed software for the Naval Oceans System Center. Michael holds a bachelor’s degree in computer science from San Diego State University

A friend of mine was always reluctant to see a doctor, but recently he went in for a minor problem.

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He rearranged his schedule and left work, driving 45 minutes in traffic, and then he was kept waiting for half an hour because the doctor’s office was backed up. He was finally ushered into an exam room and had to wait another 10 minutes sitting in a paper gown. Then the doctor seemed to spend more time on her computer than she did looking and listening to him, so he felt reluctant to bring up another small concern he had.

She was courteous and competent, but as he left, he wished he’d had more “quality time” with her.

This common scenario illustrates that what really matters to patients is the interaction and connection with their health care provider, not the mode of delivery.

The pandemic has caused an enormous uptick in the use of telehealth and the virtual delivery of care and information, but some providers are worried that digital care delivery may be off-putting to patients and that important human connection is lost. There are concerns that:

  • Telehealth lacks the “bedside manner” that patients expect when they visit a doctor’s office
  • Technology will create a barrier between the patient and the doctor
  • Discussing health issues through a screen will feel impersonal and cold
  • The platform will be difficult or confusing to use

I would counter that good telehealth is not only just as personable and compassionate as in-person care — it actually improves patient satisfaction by offering face-to-face “quality time” and eliminating the hurdles that often lead to frustration, such as complicated commutes, long wait times, missed work and difficulties finding childcare.

In fact, data shows that patient satisfaction rates for telehealth visits have increased to 4.8 on a scale of 1 to 5, compared to just 3.65 for in-office appointments.

As telehealth becomes a more standard option in care delivery, it only makes sense that we look carefully at the patient experience and how injured workers are engaged — a critical factor in the success of the treatment and the return-to-work plan.

From In-Person to Online

Although telehealth has been around for years, clinicians and patients were slow to adopt the technology.

Patients were concerned about privacy, quality of care and the new, unfamiliar technology, while clinicians could not visualize how to connect with the patient through a screen or over the phone.

Before the pandemic, only 8% of Americans had ever used telehealth. However, as COVID-19 spread, some medical providers reported that up to 95% of patient visits had shifted from in-person to virtual appointments.

It’s important to implement training and protocols to ensure that telehealth providers are as effective — or perhaps even more effective — as when they are treating patients in an office.

Implementing virtual care is not simply switching from office to screen. The traditional in-person routine doesn’t translate directly to an online appointment.

Bridging the perceived gap between in-person treatment and virtual care requires high-touch interaction and increased engagement to address patient and provider concerns. It’s important to implement training and protocols to ensure that telehealth providers are as effective — or perhaps even more effective — as when they are treating patients in an office.

As providers and patients continue to engage virtually, they’re becoming more comfortable with the process and learning to navigate the virtual interactions.

For example, in the early days of telehealth visits during the pandemic, clinicians initially tended to dominate the conversation in a virtual setting while patients were more reticent to speak because they were unaccustomed to the format. However, providers are learning that by pausing to allow patients to speak, the patients are more likely to open up and disclose sensitive information in a remote setting, especially when they’re in the safety of a familiar place instead of a sterile doctor’s office.

Virtual Care Continues

Telehealth allows patients to reduce the risk of exposure to COVID-19, but it also saves frustration and costs stemming from transportation, childcare and getting time off work.

As a result, we’re now seeing virtual services expand to address end-to-end care — from initial intake via phone or video, to online clinician appointments and home delivery of pharmaceuticals, to virtual ongoing care such as rehabilitation, physical therapy and even mental health services.

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Nurse case managers are handling virtual triage with a focus on the patient; physicians are using video to visualize an injury and assess facial expressions for subtle cues; and interactive platforms are allowing for ongoing monitoring, check-ins and follow-ups, which are often overlooked when they require in-person appointments. Technological issues (or fear of them) are being addressed with concierge IT services during visits.

For businesses, telehealth can be incredibly efficient.

Let’s consider a job site injury. If an employee cuts their finger at work and is trying to determine if stitches are needed, the ability to be seen quickly by a nurse or a physician via smartphone or video saves time and allows for rapid assessment of the injury. If there’s no need for stitches, the employee can be bandaged up and back on the job in a short amount of time.

Telehealth provides injured workers with prompt, appropriate care, and helps employers maintain a healthy, productive workforce while reducing unnecessary claims and costs.

Over a five-year period, we have seen considerable data measuring the positive impact of the telehealth, including:

  • Treatment wait times have been cut from an average of two hours to 10 minutes
  • Treatment costs have been significantly reduced anywhere from $100 to $850 per visit, depending on the specialty, with improved quality of care
  • The number of unnecessary medication prescriptions have been reduced by nearly 50%

When we ask consumers about the most important factors for choosing health care, they state three things — convenience, transparency and personal service, including a professional “web-side manner” even when providers are working from home.

When properly delivered, virtual care consistently provides all three of these benefits.

Staying Connected

As more people become familiar and comfortable with virtual care, its adoption will continue to grow. Providers are embracing it, patients are embracing it and employers are embracing it.

With private insurers and public health programs now providing reimbursement for remote office visits, at-home patient monitoring, and physician-to-physician consults, it’s clear that telehealth is here to stay.

However, what will really make this trend continue to gain acceptance and grow is the convenient access to care regardless of how far you live from your physician or a specialist, the reduced time spent commuting and sitting in a waiting room hoping for your name to be called, and the extra time and attention that caregivers are able to provide to patients to keep them engaged.

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With telehealth, we have the opportunity to find the right balance of service and convenience and to leverage technology in a manner that preserves the essential components of care.

With the increased use of telemedicine, surveys are now showing that nine out of 10 patients who have experienced telehealth would use it again.

As for my friend, his next doctor’s visit was via telehealth. His appointment was prompt, and he liked being able to see his provider’s face up close on his screen and knowing she was hearing what he had to say. Now he’s sold on telehealth and plans to continue — even after the pandemic is over. &

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