The Dangers of a “Good Enough” Telehealth Solution

When the COVID-19 pandemic hit, many employers without telemedicine offerings were caught off guard. Maybe your organization was one of them. 

In the mad scramble to lock down offices and transition employees to a remote work environment, there may not have been enough time to thoroughly vet telehealth providers. A “good enough” telehealth solution would need to suffice.  

One year into the pandemic, however, with more time for reflection, it may be time to reconsider your telemedicine provider. 

What may have been a stopgap solution is now the status quo. But with the pandemic still playing out and a shift in the workplace underway, simply having an adequate telemedicine option for your employees actually poses dangers

CirrusMD's proven platform enables faster and easier access to care, supporting safe and secure conversations between Veterans and their healthcare team, with guidance throughout the care experience.

DANGER #1

A zombie telehealth offering.
You may have a telemedicine offering that passes for a functioning employee option, but is really a “zombie benefit.”

It’s not vital. It’s not embraced by employees. It goes largely unused. Or it gets used once, and is then forgotten.

Many telehealth solutions are underutilized by employees because they do little more than replicate the traditional doctor visit, plagued with the same hassles and barriers to access:

The need to schedule appointments, some of which are backlogged for weeks.

Virtual waiting rooms and a lengthy intake process. A JD Power survey indicated that only 18 minutes of an average 44-minute telehealth appointment involved the actual clinical consultation; 17 minutes were required to complete the enrollment process, and 9 minutes were spent in the virtual waiting room.

The need to find a private space to discreetly confer with a clinician. Not an easy task if you work in a field like retail, transportation, education, construction, manufacturing or energy production.

• THE NEAR MISS - Picture a retail employee waiting in a telehealth queue for a physician. To get some privacy, she takes the call from her car. She scheduled the appointment to coincide with one of her 15 minute breaks, but the doctor is running late and the clock is ticking. Just as the doctor is ready to see her, she needs to leave in order to check back into work.
• NO ACCESS - For remote employees who live in rural areas without reliable broadband service, scheduling a video appointment is often impossible. The same is true for employees who are part of the mobile workforce — field service technicians, delivery workers, home health providers — and can’t depend on having broadband access. Requiring them to use a traditional video telehealth service is actually perceived as a detriment.
• THE BOT DOC - The surest path to creating a zombie benefit is to provide your employees with a zombie telehealth solution: a bot masquerading as a live doctor. Your employees are led to believe they’re engaging with a physician when in fact, they’re communicating with a glorified medical intake form. Worse still, the algorithm may just recommend that they visit the ER, or pass them to a physician who asks them the same questions they just answered during the intake process.

DANGER #2

Employees still select higher-cost healthcare options.

If your employees don’t like or trust your current telemedicine option, they will gravitate to the path of least resistance. That usually means dropping in at an urgent care center or scheduling an in-person appointment with their primary care physician. All of which leads to higher healthcare costs. 

In fact, an in-person doctor appointment typically requires a 2 hour commitment:

• 37 minutes of travel time
• 64 minutes spent at the clinic
• 20 minutes actually spent with the doctor

If your current telehealth benefit doesn’t offer something significantly better or different than the traditional office visit, then your employees will default to the “devil they know” and your virtual care investment will be wasted.

DANGER #3

The quality of the physician network is inadequate.

The assumption when considering telehealth solutions may be that they are all staffed with experienced, top-performing clinicians, solely motivated to generate better patient outcomes. That isn’t necessarily the case, however.

Some telemedicine services are disproportionately represented by inexperienced doctors who have recently completed their residency or, conversely, by retired physicians. Others are staffed by clinicians who drop in to provide service when they have a few minutes of downtime, and then toggle back to their primary practice. 

Many of them are compensated based on the volume of patients they treat, much like the fee-for-service model that has contributed to soaring healthcare costs that don’t generate correspondingly better outcomes. 

If the right combination of clinical experience, medical specializations, financial model and proficiency in delivering virtual care are not in place, it can lead to inadequate medical care for your employees.

CHECKLIST TO EVALUATE YOUR CURRENT TELEHEALTH PROVIDER’S NETWORK:

• Is it staffed exclusively with physicians?
• Are its physicians board certified? 
• Has its network received NCQA accreditation?
• Do its physicians specialize in telehealth?
• Are physicians paid according to the patient volume they serve or paid an hourly wage that is more conducive to longer patient consultations?
• Is it composed of clinicians that span across many specialties or constrained to just one?
• Does it integrate behavioral health and medical health in a single platform?
• Can it provide longitudinal care for the “whole person?”
• Are its physicians licensed in all 50 states?

If the answer is “no” to any of the above questions, the quality of your telehealth solution may be one of the dangers of your “good enough” solution.

DANGER #4

Employees don’t receive the behavioral health treatment they need.

The stresses imposed by COVID-19 have triggered a behavioral health epidemic.

Even before the pandemic, a third of employees reported they were not productive for half the workweek because of their mental health issues. Employee anxiety levels have only spiked higher since furloughs and workplace changes have been implemented in the wake of the coronavirus outbreak. 

Requiring an employee to wait for a scheduled therapist appointment or find a quiet, broadband-enabled location for a session may introduce more friction and worry. And that’s assuming an employee is able to self-diagnose their underlying condition as having a mental health component. 

Not only are employees who use substandard telehealth at risk of not getting the help they need or the proper diagnosis, there are significant stigmas and fears associated with chatting with a stranger over video or phone. 

A danger of a “good enough” telehealth benefit is that the barriers to access mental health services actually discourage some employees from seeking care.

DANGER #5

The administrative burden is too great.

Sometimes a “good enough” telehealth solution will deliver an acceptable patient experience but will be an administrative nightmare for your human resources team.

• It can require too much manual intervention from an already overburdened employee benefits department. 
• The addition of more manual work often introduces more errors, and time spent cleaning up those errors. 
• The increased errors can trigger more calls and messages from exasperated employees.

There is little value to an employee benefit designed to make things easier and reduce costs, when instead it creates an administrative burden that frazzles your HR team.

“Good Enough” Means Your Results May Not Be

Nobody can be faulted for rushing the selection of a telehealth vendor to address the COVID-19 pandemic. The situation demanded a swift response. 

But now that you have a telemedicine solution in place, it's important to assess whether it’s achieving your intended objectives.

Is it being used widely across your organization? Is it diverting costly trips to the ER? Is it addressing both the health and mental wellness of your employees?