How Technology Supports Virtual Care
A variety of solutions come together to connect patients and care providers.
The use of virtual care saw a massive expansion in 2020 as healthcare organizations sought a way to deliver care to patients while maintaining social distancing efforts required by the coronavirus pandemic.
As these organizations emerge from the pandemic, they are now faced with a new challenge: to sustain the success they achieved in delivering care remotely while addressing some of the issues that may not have received their full attention in the rush to build out virtual care practices, such as compliance and security.
When the pandemic made it necessary to scale virtual care at a breakneck pace, healthcare organizations rose to the challenge. The goal now is to build foundations for virtual care that are streamlined, secure and sustainable. Healthcare organizations are deploying a variety of solutions to achieve this objective, including software, endpoint devices and security tools.
For many organizations that escalated virtual care rapidly in 2020, the most valuable investment to support the refinement and expansion of these services is an end-to-end platform. Typically provided via Software as a Service, these platforms house virtual care applications and facilitate workflow. Currently, only a small percentage of physicians use a dedicated telehealth solution, and a smaller percentage use an EHR telehealth module, according to the COVID-19 Telehealth Impact Study Work Group.
These platforms also facilitate ancillary activities that support virtual care, such as making appointments, ordering labs and other tests, sharing test results, ordering and following up on medication, and logging patient information. This makes workflows more efficient, which can help increase adoption by clinicians.
Integration, particularly with EHRs, is a best practice for successful virtual care delivery. The majority of physicians cannot access telehealth solutions directly from the EHR, which they cite as a barrier to maintaining telehealth after the pandemic, according to research by the COVID-19 Telehealth Impact Study Work Group. EHR integration means the videoconferencing and collaboration platform primarily serves to provide the virtual meeting space, while the clinician conducts the visit and manages patient information within the EHR.
Remote patient monitoring benefits from a similar end-to-end software solution. A solution in this category may have the additional capability of allowing patients to transmit biomedical data to the provider, who can then ensure progress matches the care plan or modify the care plan if needed.
Providers should also have access to web-based applications that interface with mobile phone apps and Bluetooth-enabled biomedical devices to verbally set reminders for patients. This type of support can increase the likelihood that patients will follow their discharge plans and adhere to their plan of care. For clinicians, apps can also record the length of the session and send that information to the EHR, reducing the amount of administrative work that they must perform.
Collaboration platforms also support virtual rounding. This proved to be a critical strategy during the pandemic, when personal protective equipment was in short supply. It will continue to be a valuable option for clinician efficiency and for patients who require isolation. Initially, many providers assembled their own virtual rounding systems, but they now have access to a larger selection of enterprise-class solutions that offer a more tailored experience for users and easier IT management.
Clinicians and patients can join virtual sessions with simple setups, such as mobile phones, tablets and laptops. Many providers, however, prefer more robust arrangements, such as multiple monitors that make it easier to simultaneously use the videoconferencing platform, enter notes into the EHR and consult images or other materials.
Audiovisual technologies can enhance the quality of the experience significantly through stand-alone cameras and microphones that allow physicians to create a mini-studio from which to provide care. For other virtual care services, such as eICUs and telesitting, digital cameras are essential, allowing clinicians and sitters, respectively, to remotely observe several patients at once.
In eICU rooms, caregivers in a command center can observe patients on multiple monitors via high-definition, pan-tilt-zoom cameras in patients’ rooms. Locating clinicians within the command center not only extends the reach of critical-care staff, but also allows them to make more data-driven decisions about care — for example, using platforms that analyze data from several sources to identify trends and alert clinicians when patients need attention.
PTZ cameras expand clinicians’ ability to monitor patients closely for longer than they could if they physically had to visit each room. The quality of PTZ cameras allows for extremely close observation, enabling clinicians in the command center to observe a patient’s pupils or read a prescription bottle. Cameras may be augmented with monitors to facilitate two-way video communication.
Remote patient monitoring is increasingly reliant on connected biomedical devices to facilitate oversight and report health markers to clinicians. These devices may transmit data directly to the provider or to the cloud, or the patient may share data with the provider directly.
Despite the development of medical-specific technologies, a survey by the COVID-19 Telehealth Impact Study Work Group found that the primary remote sensor technology that physicians use to support patients in virtual care is simply a smartphone camera. Other primary devices include blood pressure cuffs, body weight scales, pulse oximeters, smartphone microphones, thermometers and heart rate monitors.
The pandemic intensified cybersecurity concerns throughout the healthcare industry. Organizations faced multiple challenges: new threats, an expanded attack surface and new vulnerabilities, including remote employees, rapid expansion of virtual care and suspension of certain HIPAA requirements for telehealth.
For cybercriminals seeking to sell data on the dark web, medical records are among the most lucrative targets. Hackers quickly adapted their attacks to the operating environment of the pandemic. In addition to increased phishing attacks, they seek to exploit vulnerabilities in the devices, networks and software used for telehealth services.
The risks are especially high when employees are using disparate tools and inconsistent procedures in nascent programs that have not yet established strong security controls — exactly the type of environment in which many telehealth programs expanded during the crisis. In addition to deploying the appropriate security solutions, organizations must ensure every employee is well trained in security best practices, particularly how to identify and avoid phishing attacks.
Virtual care should be subject to data encryption at rest and in transit. Remote monitoring devices, together with devices used for telehealth, virtual rounding and eICUs, should have regular software updates to ensure that patches are installed appropriately. Networking controls and best practices, such as multifactor authentication, should be in place for all virtual care solutions.
Providers should expect the suspension of HIPAA enforcement in connection with services deployed during the pandemic to be temporary. In the future, these will be subject to the same HIPAA compliance as the rest of the organization.
Finally, it is important to remember that patients are also cognizant of privacy and cybersecurity when it comes to their medical records. Hospitals enjoy a relatively high level of trust among consumers, 84 percent of whom trust hospitals “some” or “very much” to keep their digital information safe, Accenture found. But that percentage drops for other areas of healthcare, such as nonmedical staff at doctor’s and provider’s offices (63 percent). These perceptions matter as consumers begin to seek out providers offering more comprehensive digital services.
To learn more about how healthcare organizations can achieve telehealth success, read the white paper “Realizing the Power of Virtual Care” from CDW.