In late 2020, we learned from several Zebra healthcare customer advisory board (CAB) members that the trend toward telehealth wasn’t going to be short lived. Though COVID-19 may have accelerated the adoption of virtual care models in primary, specialized and emergent settings to support patients at home, it is the growing distance between clinicians driving the healthcare community to embrace telehealth solutions on a greater scale.
So, we recently reconnected with Chris Sullivan, Zebra’s global healthcare practice lead, and Rikki Jennings, Zebra’s Chief Nursing Informatics Officer (CNIO), to learn about the increasing investment healthcare providers are making in telehealth technologies – as well as the new virtual programs they’re piloting – to improve the quality of patient care both inside and outside the four walls.
Your Edge Blog Team: There have been a lot of realizations in the healthcare world over the past year or so, including the value of and potential for telehealth. In our last discussion, you both shared how the quick shift to virtual patient consults allowed providers to maintain continuity of care and even provide emergency interventions when it was the only option. But do you expect the use of telehealth to be sustained as hospitals and doctors’ offices return to normal operations?
Chris: We’ve already observed a partial decline in patients’ at-home use of telehealth, but not to pre-COVID-19 levels. There is still a great convenience factor in not having to go into a facility every time you need to talk to a practitioner. Many people were having to drive an hour or two to see their doctors and others were having to wait weeks or months to get appointments before the pandemic started. The unplanned acceleration of telehealth innovation, though chaotic and disjointed at first, has turned out to be quite beneficial to both the healthcare community and our global communities – often in unexpected ways.
Your Edge Blog Team: How so?
Chris: As telehealth technology systems are maturing and the rules of engagement are being better defined, hospitals, clinics, and private practices are successfully eliminating some of the barriers that would have deterred patients from getting timely care before, such as geographic distance and provider availability. In doing so, though, they are also eliminating some of the silos that have long existed between internal departments and others across the healthcare community.
Your Edge Blog Team: In other words, as technology systems mature and the availability of telehealth services becomes more widespread, it’s no longer about just connecting physically distanced doctors and nurses with their patients but connecting them to one another.
Chris: That’s right. Virtual appointments aren’t going away. The application of telehealth solutions is simply expanding as many realize the real opportunity to improve outcomes lies in virtual clinician collaboration.
Your Edge Blog Team: Rikki, as a nurse, have you seen the need to enable greater collaboration between clinicians who are dispersed across campus buildings or even global borders?
Rikki: Absolutely. Throughout the pandemic there has been a need for clinicians and even hospital administrators to collaborate in unprecedented ways as we work through best practices and aim to share learnings regarding COVID-19 patient care and treatment.
And as demand for quality care rises overall, not just specific to this virus, giving care team members access to telehealth tools could serve as a gateway for specialized assistance from well-seasoned health professionals across cities, countries, even continents. We’ve already started to see how much it can enhance connectivity between different healthcare workers who are caring for the same patient within hospitals across the U.S. and abroad. Those working a case, regardless of whether they are in the building or remote, can audibly and visually communicate with each other using clinical smartphones, healthcare-grade tablets, and other similar collaboration devices to support even more patients simultaneously.
In fact, that’s why many of our customers are focused right now on creating digital systems that link healthcare professionals to each other during every step of the patient care process, whether it be via voice, video, or data-based applications. The goal is to knock down a lot of information silos that have previously caused miscommunication, errors and frustrations within clinical settings.
They want to ensure the right information is being passed on to care teams during patient handoffs, whether the person is being transferred from ambulatory care to the emergency room (ER) or a telehealth consult referred the patient to the hospital. So, we’re doing all we can to break down any digital and physical boundaries that remain today across the healthcare community. If we give the right care team members a way to fully sync with one another at the right time, it could change a lot about the way we approach new healthcare situations.
Your Edge Blog Team: Understanding it’s continuing to mature, what is the current “state of telehealth” from a clinical perspective? How are technologies being used right now to facilitate virtual collaboration between care team members?
Chris: Primary care practitioners are the ones who most often utilize telehealth applications today, and this is for general or first level patient diagnosis. Specialty doctors such as dermatologists, surgeons, mental health providers and others are also increasingly leveraging telehealth. However, EMS is a good example of where we’re seeing more breakthrough innovation and unique applications, but this is a niche area.
Your Edge Blog Team: Can you elaborate a bit more on the EMS use case?
Chris: Historically, there have been digital disconnects between emergency medical technicians (EMT) in ambulances and the ER staff waiting for patients to arrive. Sometimes, they’re communicating through a dispatcher. But in many cases, the ER team has very little insight into the incident or a patient’s status until the EMTs debrief them during handoff, which can be very chaotic and even lead to treatment delays.
So, if you equip EMTs with rugged tablets that let them plug into hospital systems – or even just video chat with ER staff – they can provide real-time status updates from the field and start the handoff while the ambulance is in route to the hospital. EMTs can record and share the patient’s vitals, images of injuries and even early intervention updates in real time, so ER staff can somewhat triage ahead of arrival. If an operating room needs to be prepped or a specialist called in, the proper people can be alerted before the patient arrives. That way, the hospital team is better prepared to proceed with the right course of treatment the moment the patient is transferred to its care.
At the same time, EMTs can use their tablets to pull up patient histories to check for any known medical conditions, implants, allergies, contraindications, or other pertinent information before administering treatments to patients in the field or during transport. In fact, EMTs could consult with remote clinicians from the field if needed to help improve outcomes. Perhaps the emergency department team or even doctors and nurses assigned to helpline-type programs could be “called in” via telehealth tools to advise EMTs on how to triage or stabilize a patient experiencing symptoms or trauma beyond their expertise. And with the right software on the tablet, they can unlock medical vaults quickly to administer recommended medications and update patient records on the spot, notifying the ER team of drug administration to inform future treatment decisions. Again, just another opportunity to influence – and improve – ambulatory strategies for each case and hopefully improve outcomes for all patients.
Your Edge Blog Team: Are similar telehealth use cases emerging elsewhere in the healthcare community?
Chris: Actually, collaborative telehealth tools can make a big difference within emergency departments themselves. Not every hospital or emergency department is going to have the right specialists on hand around the clock – or ever. Telehealth tech gives the option to video chat or talk to remote specialists to pull in their insight when needed, even if they can’t be there in person. The ED team can ask the specialist to help walk them through how to treat a patient for their specific condition, and the patient does not have to experience long delays or fragmented communication to get the right care immediately.
Your Edge Blog Team: Very much like the EMT field triage and treatment example, then – just in a different setting.
Your Edge Blog Team: Rikki, have you come across any other unique telehealth applications either in your work as a nurse or in your consults with customers as Zebra’s CNIO?
Rikki: It’s really significant to see the kind of ongoing problems telehealth can solve, including the timeliest one which is the need to connect clinicians who are treating high-risk patients. If a medical crisis is occurring that involves a highly contagious disease, you want as few clinicians coming in contact with patients as possible. With the help of Internet of Things (IoT) devices, a tablet, clinical smartphone and/or workstation on wheels, you can leverage telehealth to minimize physical clinician exposure without sacrificing the quality of patient care. Two nurses can gear up to engage with the patient directly while getting assistance from doctors safely distanced outside the room.
More broadly, I’m seeing telehealth solutions being used to facilitate clinician-to-clinician collaboration across routine care actions. The average inpatient nurse may be assigned to monitor six different cases per shift, and they can’t be in all rooms at once. So, if an alarm goes off, someone else could respond and then loop in a doctor as needed. Both primary team members and specialists can be called in virtually as needed, and everyone can get up-to-speed on patient status and collaborate on procedural steps for case-by-case medical situations regardless of physical distance.
Your Edge Blog Team: So, by leveraging the mobile devices widely available today, healthcare systems can fill in those information gaps to smooth patient handoffs and ensure a more optimized caregiving experience for all persons involved.
Rikki: That’s right. The emerging telehealth use cases we’re seeing prove physical distance does not have to sacrifice the quality of care. In fact, this type of connectivity ultimately better serves patients because telehealth doesn’t require clinicians to be at a particular physical place at a certain time to provide effective care – and patient access isn’t restricted to physicians within a certain proximity of them.
Your Edge Blog Team: Given the clear-cut benefits of virtual collaboration tools, one would imagine the adoption rate to be quite significant. The healthcare community seems eager to embrace new technologies or systems that can improve the speed and quality of patient care, and anything that reduces the burden of higher patient volumes is appreciated. So, we’re curious if there’s any reason why a clinician would say, “No, I’m not using this” and what could slow telehealth uptake in hospitals?
Rikki: If you’re a tech-savvy individual, it’s easy to perceive the mobile devices and software used for telehealth as being straightforward and intuitive. However, not all clinicians may see it this way. If a clinician is more accustomed to an iOS user interface due to everyday personal use, having an Android™ clinical smartphone put in their hands could take an adjustment period. Equipping clinicians with the proper software applications upon being introduced to new mobility solutions is also essential to making this adjustment period as stress-free as possible, and it is something we’ve been more focused on lately at Zebra in collaboration with our customers. We want clinicians to feel confident knowing the technology will be aligned with their existing workflow and it’s here to solve many of the communication, coordination and collaboration challenges they have faced in the past.
It’s the job of us technologists and innovators to solicit end users’ feedback. If the tools aren’t easy to navigate at first, we need to know so we can either adjust the user experience or train them more thoroughly. Plus, it has become so important to have technology developers shadow clinicians to understand themselves exactly what functionality and connectivity these professionals need to execute their job properly. They need to see exactly how their processes can be improved before they get to work engineering or refining solutions. Getting that direct exposure is more meaningful than ever as we develop tools that are truly designed for clinicians’ duties. We want to ensure the work we’re doing will make a real difference in care optimization. Of course, then educating these professionals on how to use this technology effectively to harness its value is key to everyone’s success.
Chris: Rikki’s right. Though the COVID-19 pandemic forced technology adoption to skyrocket and paved new avenues for care administration, we still have a way to go before the telehealth experience will become completely frictionless. In addition to the concerns Rikki mentioned, we know we must streamline data access. Having to shift between five or six or more different information systems to piecemeal together different bits of information about the patient’s history is a frustrating experience for physicians. They will not be interested in using scaling telehealth applications – or offering virtual care services at all – unless they can access accurate and timely patient data in a matter of seconds. Telehealth can’t become a hindrance to current workflows or complicate day-to-day tasks. It must simplify them – especially if clinicians are expected to bounce back and forth between in-person patients and virtual patient consults. We need to ensure these tools are easy to use and accessible to everyone who may be connecting this way: EMT teams who need to coordinate with emergency department staff, inpatient nurses who need a doctor to weigh in on a case change identified during rounds, primary care managers (PCM) who will refer patients to specialists or admit patients to the hospital, and even the patients themselves.
Your Edge Blog Team: Beyond more collaborative care decisions, what other benefits can we expect from telehealth as it becomes more widely utilized in hospitals and other acute environments?
Chris: Some of our CAB members believe focused telehealth services will increase the quality of care for patients due to the time clinicians save in-between tasks. Plus, the technology can provide more accessible, practical and beneficial wellness solutions for professionals and patients alike, whether the patient is physically sitting at home or in a hospital.
Rikki: From the healthcare workers’ perspective, these virtual tools maximize their ability to prepare for patients properly, make the right decisions under pressure, and minimize the risk of miscommunication.
They also give clinicians the flexibility to complete their duties and stay updated from anywhere at any time which can really boost morale. Subsequently, telehealth contributes to an improved patient experience, ensuring clinicians can give them the timely, accurate, effective and safe care they deserve.