The need for quality 24/7 telehealth services has exploded in the wake of the COVID-19 pandemic. Over a recent two-week period, Carenet Health has experienced another 200% increase in telehealth coronavirus-related triage cases. Other top telehealth providers for COVID-19, such as MDLIVE, are facing similar situations.
With that kind of surge, the patient experience can slip in priority as telehealth companies try to manage the immediate need. But it’s important for us as an industry—health plans, health systems, telehealth services providers and others—to pause for a moment and listen to those healthcare consumers who are using virtual care right now—and learn as much as possible about the patient experience.
At Carenet, we’re fortunate to have the industry’s best registered nurses (RNs) offering nurse advice line support for COVID-19, plus excellent care coordinators and clinical operations teams. Together, they serve thousands of patients on the clinical support and telehealth frontlines every day, providing everything from telehealth mental health care to professional advice to ease coronavirus fears. They also provide us with key insights and near-real-time engagement intelligence. It’s information that the Carenet Health Pandemic Response Taskforce is using to rapidly optimize our telehealth operations and scripting. It’s also information that can help us all better plan, understand, empathize and act as the pandemic continues to unfold and telehealth remains a critical part of the nation’s healthcare response.
Here’s what we’re hearing:
This is most people’s first experience with telehealth. Virtual care utilization, while increasing gradually in the past year, has been lower than expected in the U.S. until the COVID-19 outbreak required a major shift in just the past several weeks. Now telehealth services are being highly recommended to help keep patients with mild to moderate symptoms at home and out of hospitals and physician offices, so the sickest patients can receive the care they need when resources are stretched. It’s also a key strategy for social distancing and stopping the spread of the virus.
As more and more people take advantage of telehealth visits and telehealth nursing care for the first time—whether that’s a nurse advice line or virtual telehealth consults by physicians—we’re finding that they’re often nervous and unsure of the process. For instance, they’re uncertain of the qualifications of the healthcare professional with whom they’re speaking because, unlike an office visit, they can’t see evidence like degrees hanging on the office walls. They’re not sure if they’ll be talking by video or telephone, or how they will pay for their telehealth visit, if payment is needed.
Health organizations can help by sharing information about what to expect when accessing telehealth services; what’s needed from the consumer in terms of video, photos and patient identification; satisfied patient testimonials; clinician qualifications; and other details that could help alleviate uneasiness about how the service works.
They’re willing to wait. Many patients say they’re feeling isolated and detached from the healthcare providers they normally rely on, such as primary care offices that are overloaded with patients during the pandemic. Just-in-time, on-demand guidance is harder to find right now, yet confusion over testing, treatment and next steps is widespread. Plus, most patients want to avoid going to the emergency department (ED) or urgent care right now unless their symptoms are very serious.
That’s why patients are telling us how thankful they are to be able to reach a licensed healthcare professional through telehealth services—and they’re willing to wait for a call back, even if those wait times are far longer than usual due to demand. They’re just appreciative of a reassuring, knowledgeable voice who’s there to help when it feels like no one else is.
They’re confused about COVID-19 symptoms. Conflicting information about the virus’s symptoms is being distributed from a variety of sources. Social media isn’t helping, certainly, but authoritative sources have had to change some details about the virus as the crisis evolves. Even the official coronavirus triage guidelines, based on CDC information, have changed multiple times in the past four weeks. Patients are also concerned about things they have heard from friends and neighbors or read online from first- and second-hand accounts. For instance, they have questions like: Is the virus always associated with a fever? Is sneezing a true symptom if there aren’t any others? Many also want reassurance that a chronic condition they’ve had for months or years is not related to COVID-19 now. Others need help navigating mild symptoms, whether they have the virus or not. All of these questions may not be urgent needs, which means guidance may not always be available any time soon from overly busy primary care practices. Telehealth can be their only source for professional, from-a-live-person answers to symptom questions.
They’re not sure how their symptoms will be assessed. Individuals who have not used telehealth services previously are not sure how the nurse or doctor will assess their symptoms remotely. The uncertainty can be especially troubling for older patients with limited computer or online experience. It is up to the healthcare providers, telehealth companies and other partners to help these patients and explain how the triage process works. Patients will respond well to an overview of what to expect at the beginning of every consult. It is also helpful to provide information about the types of triage protocols used in telehealth on your website. For example, Carenet Health’s telehealth nursing team follows the evidence-based Schmitt-Thompson guidelines, a structured decision support tool that ensures consistent health information is provided to patients and consumers on every call.
You can also point callers to these types of resource examples in messages they receive about response times for return calls.
They’re uncertain about what a virtual nurse or physician consult can actually do for them. Many patients are not clear on what telehealth RNs and doctors are able to do, especially if they have symptoms of the novel coronavirus. For instance: Can they order a telehealth coronavirus test? Can they prescribe medications? Can they call an ambulance if I need it? Will they help me figure out next steps? Can they help me determine when I can stop a self-quarantine?
In general, telehealth physicians can write prescriptions, but may not be able to order tests. Telehealth nursing staff can refer patients to physicians with the right level of urgency based on their assessments as well as advise on appropriate self-care and self-quarantine.
As a healthcare industry, this is an opportunity to proactively educate consumers about the capabilities of telehealth services in a time of intense need.
They want to do the right thing. Patients are expressing time and again that they want assurance that they’re doing the right things to stay safe and healthy, to treat their symptoms the right way at home and to keep their loved ones safe. Many callers are more concerned about spreading the virus to others in the community than worrying about themselves. Others need clarification on the Centers for Disease Control (CDC) guidelines about social distancing or what to do if they need to self-quarantine if they’ve been exposed.
Fortunately, this is the kind of information and confidence that can be easily delivered via telehealth nursing advice lines and virtual telehealth visits, in easy-to-understand language, by compassionate professionals who are trained to not only care, but educate.
Anxiety levels are high for everyone. The pandemic, including the necessary social distancing measures, has all telehealth patients on edge, no matter their age, profession or reason for initiating a consult. The numbers of cases that Carenet’s nurse advice line is handling that mention anxiety-related chest pains has increased significantly.
So, beyond the medical advice provided by telehealth RNs and physicians, some patients will need access to behavioral health-focused services to help manage stress, anxiety, depression and other mental health telehealth concerns, and learn about coping strategies for mental wellness.
It’s time to keep the patient experience top of mind
As the nation struggles to handle the COVID-19 crisis, telehealth professionals are supporting the healthcare system in a way that has never been required before. A careful focus on the patience experience will help ensure telehealth continues to serve essential needs now and in the future.