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2 Key Concerns for Telehealth in Skilled Nursing Facilities

Posted by Lawrence Kerr on Tue, Aug 01, 2017 @ 06:01 AM

damian-zaleski-843.jpgRecently, I’ve been coming across more data that solutions like iClickCare in an SNF or Long Term Care setting can be transformative. We know it from our colleagues that use iClickCare in these settings, but the studies are helpful in providing context and ROI.

For instance, this author at the University of Arizona says, "Telemedicine offers great promise as a strategy to reduce the skilled nursing/emergency department loop." And this study looks at the dramatic impact telemedicine can have on hospitalizations from SNFs and the cost savings that accompany this shift.

But we identify two key blind spots that these programs have -- which can have unintended negative consequences for the well-intended telemedicine programs.

In both articles, the author is assuming that telemedicine in the SNF context looks like a doctor virtually "seeing" a patient in an SNF, after hours. 

No doubt about it, these initiatives are being shown to have strong positive consequences for hospitalizations and costs. For instance, this study finds that "after the introduction of the telemedicine service, hospitalization rates declined 9.7 percent among the intervention facilities" and there resulted $120,000 in net cost savings.

On one hand, we applaud these SNFs for their use of telemedicine and for trying something new. But we see two big blind spots in this program -- so if you're considering a telehealth solution in your program, we encourage you to keep two considerations front-of-mind:

  • Does it depend on busy providers always being available?
    One key problem with the telemedicine program described above is that it depends on the consulting provider being available at the time of the consult. During after-hour periods, this becomes increasingly difficult. We all know how challenging playing "phone tag" with other providers can be. Playing "video conference tag" is even worse. If you're implementing a telemedicine program at an SNF, we encourage you to look for a solution that is asynchronous, which allows providers to consult on their schedule.

  • Does it improve or worsen care coordination?
    If a provider is giving a video-based consult after-hours, it's likely that the content of the consult will be difficult to integrate into the rest of the patient's care. Certainly, an additional provider can be available to document the findings in an EMR/EHR, but this requires yet more providers available at the time of the consult. That's why we believe that a telemedicine solution must facilitate the medical collaboration that needs to occur -- with one provider asking another for a consult, not a patient wrangling a doctor via FaceTime -- and that that consult must be saved and available for every other member of the medical team. In a context where the patient's issues are simple and not chronic, a one-off video consult could work well. But for the complex, often chronic issues found in most SNFs, we think that a hybrid store-and-forward telemedicine solution is the only adequate approach.

There is a really wide range of telehealth solutions becoming available. The use of them, especially in Long Term Care or Skilled Nursing Facilities can be transformative. But don't be afraid to demand a solution that will work for the patient in a more holistic way.

If you're investigating telehealth for your facility, download our free guide to hybrid store-and-forward telemedicine:


ClickCare Quick Guide to Hybrid Store-and-Forward



Photo by Damian Zaleski on Unsplash

Tags: telemedicine, healthcare collaboration, telehealth in skilled nursing facilities

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