February 19, 2021
Inpatient telehealth is the use of telehealth technologies in a hospital setting for admitted patients. Telehealth uses electronic data and telecommunication technologies to enable providers to care for patients in certain circumstances without having to enter the patient’s hospital room.
Among the necessary equipment are a television (and depending on the telemedicine vendor, hospitals may be able to utilize existing televisions in patient rooms), a high-definition web camera that clinicians can operate remotely, and a microphone and speaker. There is also the option to add mobile telemedicine carts to rooms without televisions, such as an emergency department or remote facilities. These carts include a touchscreen interface with the audio/visual capabilities as the hardwired components.
Providers only need a phone, laptop, tablet, or computer connected to the Internet and a vendor’s application to provide face-to-face video conferences and evaluations. Clinicians can talk with patients, family members, and nurses in the room, as well as operate the camera to zoom in to see the patient close up and view in-room vitals monitors.
While many hospitals across the U.S. were already implementing inpatient telehealth prior to COVID-19, the virus sparked a greater interest. Hospitals enjoyed the benefits of telehealth to increase access to physicians, but the pandemic revealed another benefit of telehealth technology: safety.
In the report, “Quick Safety Issue 55: The optimal use of telehealth to deliver safe patient care,” The Joint Commission lists the primary benefits of telehealth:
More specific to inpatient telehealth, the report says, “Inpatient settings can use telehealth at the patient’s bedside to conduct remote monitoring as well as remote consultation, either among doctors within the organization or from different regions, to diagnose and treat patients.”
Cleveland Clinic lists a few additional benefits of deploying inpatient telemedicine pre- or post-COVID-19:
One of Cleveland Clinic’s Vice Chairs summarizes the impact of inpatient telemedicine in light of COVID-19, saying, “Although the pandemic has been an undeniably tragic crisis, it may have one silver lining. It is likely to push us, as a community, to further adopt and refine this technology that can serve us well for decades to come. This pandemic may well make this a mainstream technology from which patients all over the world can benefit.”
Whether dealing with the COVID-19 virus or any other transmissible disease, using mobile carts or in-room telehealth systems enables hospitals to reduce virus transmission between patients and providers without sacrificing the quality of care. They are also able to expand their capacity as they experience staffing shortages due to increased admissions and quarantined or ill frontline providers.
Another benefit of the inpatient telehealth technology is that it allows providers from multiple disciplines and locations to collaborate more easily on a patient’s care. Without geographical limitations, providers can work more collaboratively as an integrated care team using the virtual technology as the connection point. Patients receive a more comprehensive and responsive continuum of care, even when providers are not physically in their room.
These capabilities are driving more hospitals to invest in inpatient telehealth systems even more than before COVID-19. The telehealth market is expected to grow at a CAGR of nearly 38% to reach $191 billion by 2025 from an estimated $39 billion in 2020.
But even as beneficial as inpatient telehealth has been to healthcare so far, there are some concerns with the surge in use. The Joint Commission says patient populations are not all at the same technological maturity, unable to understand or be comfortable with the shift in healthcare practices. There is also the challenge with access to the technology or connectivity issues. Not all facilities have the budget for telehealth equipment and/or lack stable Internet/WiFi.
One of the biggest issues is that the rapid adoption of these technologies leaves little time to evaluate which medical conditions are appropriate to manage with telehealth. Hospitals can’t afford to learn as they go, yet there is no standard as to which conditions lend themselves to telehealth or which specific exam protocols can leverage it.
Inconsistent reimbursement models, legal and regulatory issues, and questions about security, privacy, and confidentiality are also among The Joint Commission’s list of telehealth barriers and challenges. The rapid escalation of telehealth usage hasn’t given insurance carriers, regulators, or privacy and security experts time to develop standardized policies or protocols.
As such, hospitals must be proactive in developing their own success metrics, usage standards and protocols, and workflows to successfully and safely deliver virtual care. It is essential for hospital systems to keep track of any existing, new, or changing regulations around telehealth, both nationally and at the state level.
Not all staff members will need the technology, but those who do become valuable in refining its usage. For instance, by getting regular feedback from users, hospitals can continue to improve their telehealth services and explore opportunities to expand usage.
Hospitals will also need to train users and educate patients to maximize results. Staff must understand the telehealth workflow and their role and responsibilities. Producing educational support in the form of live and online training modules, providing access to online manuals, and developing focused intranet sites with community forums will help engage staff and give them familiarity and comfort with the new technology.
Finding the right telehealth provider is also crucial. With so much demand and a positive market forecast, expect an increase in telehealth vendors. The technology needs to leverage the latest innovations, support comprehensive mobility, include modern security tools, and make the transmission and sharing of data seamless.
Other qualities to look for are vendor support and scalability. The vendor should offer pre- and post-implementation support, including a readiness assessment, consultation, training and tech support, workflow design collaboration, and data analysis. Measure scalability by how easily the technology is to implement in various locations and adapt to new and changing requirements, as well as the breadth of products available to meet specific needs. The vendor should also be committed to the continual development of state-of-the-art technology and upgrades.
The more facilities and specialties that can use the system, the higher rate of return on the investment. Being able to purchase everything needed now, with the assurance that it will scale for future requirements, from one vendor will simplify the network and its management while also reducing costs. A turnkey telehealth solution from one provider, therefore, is ideal.
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