Telehealth Promises Greatest ROI on Hospice Technology Investment

Leveraging technology during the coronavirus pandemic has kept providers connected with patients and their families from a distance. Despite unknowns regarding the future of telehealth regulations, hospice providers expect those systems to yield the highest return on investment when it comes to technology.

Nearly half of respondents (47%) of the 2021 Hospice Industry Outlook Report indicated that telemedicine and telehealth would yield the highest return on investment this year compared to 2020. Telehealth outpaced other solutions such as predictive analytics (20%)and electronic health and medical record systems (29%).

“Telehealth is quietly revolutionizing hospice and palliative care. Strategic partnerships are key to helping more people across the entire lifespan, and technology is a must for everyone. The future belongs to leaders who can effectively bring technology and quality service together to create cost savings.,” said Brian Mistler, president of ResolutionCare Network, a telepalliative care public benefit corporation. “Telehealth is all about choice and efficiency.”

While respondents of the industry outlook report indicated that a range of business or environmental factors were driving their technology investments in 2021, 17% said that the COVID-19 outbreak was influencing those decisions.

Temporary suspension of some regulations due to the pandemic helped fuel the boom in telehealth during 2020 and into this year. The U.S. Centers for Medicare & Medicaid Services (CMS) extended a number of flexibilities for telehealth on a temporary basis during the COVID-19 national emergency. While CMS is reviewing those rules to determine which can be made permanent, providers can expect that telehealth will not be going away when the pandemic fades.

Patients have been receptive to the implementation of telehealth, though gaps in the infrastructure still need to be filled. About 80% of family caregivers stated they would give a hospice higher ratings if the provider had real-time communication capabilities via computer, tablet and smartphone, but fewer than half (44%) do not use a digital platform, according to a Net Health study from February.

Starting in 2018, Alive Hospice began a telehospice program, Henry Hooker Connect. Patients cared for in the home and in long-term care facilities receive an iPad with the Alive Connect application installed to provide them with 24/7 access to the hospice’s staff and the ability to connect face-to-face over video calls. Adoption by patients and families quickly grew during the last year in large part due to COVID-19, according to Kimberly Goessele, president and CEO of Alive Hospice

“Over the course of time, we were seeing adoption by our patients and their families. When the pandemic started, we saw a rapid change in that timeline,” Goessele told Hospice News. “We rapidly expanded our program by deploying more iPads into the community. Today, every patient that is admitted to our care is offered this technology platform.”

Based in Nashville, Tenn., Alive Hospice serves more than 3,600 patients and their families each year throughout the states. Hospice utilization among Medicare decedents in Tennessee was at 44.9% in 2018, according to the National Hospice & Palliative Care Organization, slightly under the national average rate of 50.7% that year.

The hospice financed many of these technology investments through philanthropic dollars, according to Goessele. This enabled Alive Hospice to expand the telehospice program’s reach and improve staffing efficiencies.

“One of the greatest steps is streamlining the activities that are captured within the telehealth platform and integrating this into an EMR,” said Goessele. “We were able to increase the number of iPads that we have deployed, improve and simplify the training that we give to our staff and patients, and we have digitized many of our education and informational materials.”

EMR integration represents one of the largest outstanding needs to fill when it comes to building telehealth platforms. Integration helped simplify the process of updating clinical documentation, according to Goeselle.

Staff training will be essential in order to thrive in the telehealth realm, according to Mistler. Ensuring that staff are educated on best practices for using these systems will be necessary to remain competitive with other hospices that are implementing telehealth programs.

“Quality telehealth requires an investment in training at all levels — management, care coordinators, nurses, social workers, and providers,” Mistler said. “Anyone can pick up a chessboard and even learn the basic moves, but it takes training to become a master. That’s what we’re seeing in telehealth as well; organizations that try to provide bargain-based care using telehealth casually just can’t compete on quality and customized care with telehealth experts.”

A number of factors contribute to return on investment from telehealth. A big one is cost savings from reducing unnecessary home visits or cutting down on employees’ travel time to different patient locations. This can translate into savings for payers as well, which hospices can leverage during negotiations.

“The return on investment on telehealth is outrageously a win-win,” said Mistler. “The secret to success in any health care business is pretty simple — help as many people as possible in a sustainable way. The efficiencies created by telehealth increase access, reduce cost and maintain quality. Technology will be the biggest seismic shift in independence in aging we’ve seen since the invention of the wheel. Telehealth is here to stay.”