by Heidi Bullman

There’s a growing interest in telehealth and telemedicine programs from payers and providers across the United States. While telehealth programs were once the province of those with ‘Cadillac’ health plans, the recent uptick in adoption has demonstrated broad-based interest in the benefits that these programs can bring to patients and providers. From the opportunity to expand coverage to underserved populations, improve patient to physician engagement and control the costs of care, there are many reasons for healthcare systems to adopt telehealth programs.

Still, implementation challenges persist. Future Healthcare Today caught up with Debbie Voyles, Corporate Director of Virtual Health at Ballad Health in Johnson City, TN, who shared her insights on the types of challenges commonly encountered when healthcare systems seek to augment in-person care with telehealth solutions.

One of the first challenges Ballad Health’s program faced stemmed from a lack of connectivity. “There are areas when you get into the mountain regions where they don’t have good cell phone coverage or broadband coverage into their communities,” Voyles shared. “It’s a real barrier when you’re trying to do things virtually and get healthcare into those communities and populations. It’s one of the biggest challenges that I have to manage until we can work with the government on broadband expansion.”

One solution stems from an innovative way Ballad Health is making services possible by identifying spoke sites within the community to build telehealth access points. The organization has implemented a web-based application for its telehealth program to allow the use of different modalities to reach patients, which has also proven helpful in addressing aging technology issues.

“When we used the older, codec-based technology, you really had to worry. Since we have chosen to go with a web-based application, we’re using computers, tablets, and cell phones in addition to more mobile devices that get changed out on a pretty regular basis anyway, so it’s a lot less costly,” said Voyles. “To manage security concerns we work closely with our IT department. They conduct an intensive review of any technology application from both a security and HIPAA compliance standpoint.”

With its focus on solutions, Ballad Health has experienced myriad benefits by implementing telehealth services including, “timely access to needed services for telestroke and teleneonatology, [especially] getting the specialists to patients in a very timely matter to gate any issues they may be facing,” shared Voyles. “As our services expand, we can get a growing number of patients seen faster with reduced time away from work and families.”

While organizations like Ballad Health are paving the way and setting a standard of excellence for telehealth programs across the country, there’s still work to be done. “I was surprised when I came into this area at the lack of understanding of what telehealth/virtual health really is,” shared Voyles. “I still hear lot of people that say, ‘oh, is that just a phone call with a provider?’ But really, we have stethoscopes, otoscopes, and cameras that can zoom in and see moles and the dilation of somebody’s eye – people don’t fully understand the extent of what we’re capable of with technology,” she concluded.

Being able to deliver a full suite of medical services with connected devices from remote sites requires a sophisticated support infrastructure. “Behind the scenes of a telehealth instance there’s an impressive array of sophisticated technology,” shared Lisa Hines, MBA, former director of telehealth services for Greenville Healthcare System and now Strategic Advisor for Healthcare at NetApp.

“Debbie Voyles noted the challenges presented by poor connectivity when it comes to running telehealth system. To be really effective and enable providers to augment care, issues of latency must be addressed before launching a telehealth program,” Hines explained. “A doctor can’t accurately diagnose a condition if the image feed freezes or if lab data can’t be shared or retrieved. At the heart of a reliable, robust, and relevant telehealth program is an equally robust and reliable data management infrastructure.”

As organizations like Ballad Health continue to improve the quality of care they are able to provide through their telehealth services, it will be vital that they maintain the infrastructure that enables their doctors and nurses to treat patients remotely. With a resilient and adaptable data management infrastructure in place, doctors will be able to care for patients in virtually the same way whether they are in the office or in their home.

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