In case you missed the first episode of this series, we are currently looking at and discussing the weaknesses and gaps exposed in healthcare organizations due to the volatility and changes that have come with the COVID-19 pandemic and subsequent events. Since March of 2020, the world has been on a roller coaster of up’s and down’s, zigs and zags, attempting to deal with the effects of this historical situation. Healthcare provider organizations have experienced these effects in a very acute and direct way.In the first article of this series, we addressed potential gaps in financial planning and management exposed by the volatility of 2020. There is no spoiler alert necessary when I say the gaps are numerous. In this installment, we will look at the weaknesses that have come to the surface related to technology within healthcare organizations. Once again, there are many--far too many--for us to go through all of them or dive into extensive detail on each one. Below are a few such gaps that the Coker team has identified in working with our clients.
Perhaps the biggest weakness and most obvious shortfall exposed in healthcare entities’ technology came immediately after the pandemic’s rise. The lack of telehealth adoption and capabilities hit healthcare organizations hard. Around mid-2020, studies estimated the adoption of telehealth was less than 20% before COVID-19’s outbreak; however, as of April 2020, the rate of adoption for telehealth exceeded 50%. Further, the broader consensus is that the actual adoption and utilization of some form of telehealth is significantly higher today.
As of fall 2020, the feedback from our clients (and the market) suggests re-opening all healthcare entities has decreased the utilization of virtual visits. Even if the rate of telehealth use has subsided, it is not necessarily back to pre-COVID levels. However, one thing is clear: the adoption and, more importantly, the capability around telehealth is still at very high levels because whether it is another wave of coronavirus or some other chaotic situation, no hospital or medical group wants to find themselves without any way of seeing and treating patients ever again.
Another critical gap COVID-19 exposed in many healthcare organizations is the technological capability to continue functioning at quality levels amid crisis. Earlier in the summer, Coker conducted a study among healthcare organizations regarding telehealth. Our survey found that while many entities had some form of telehealth, they were not equipped to utilize it at an optimized level. Meaning, they had the capabilities, but it did not work how they needed. Many hospitals and practices were faced with this challenge, and they have experienced it across all of their technology platforms, not only with telehealth. Often, organizations will buy a technology solution, thinking they are optimized to use it effectively or as intended; however, the reality is that optimization is more than merely purchasing a piece of technology and implementing it.
Optimization requires planning, among many other things, which brings us to another distinct gap exposed during the pandemic. In this case, we are not just talking about general planning that goes with any strategic or tactical initiative within an organization. We are talking specifically about crisis planning. The term “crisis” does not necessarily have to tie to a global pandemic. There are all kinds of crises that healthcare organizations have endured for years. But despite this fact, it is so easy for organizations to find themselves unprepared when it comes to planning and building protocols for managing crises. We find this has become so common that Coker is releasing a book on crisis planning and management later in 2020, published by the American Association of Physician Leaders.
When it comes to technology, crisis planning is essential for healthcare organizations. No one can predict what the next crisis will be or when it will hit. But one thing is for sure: healthcare providers cannot have their technology fall short when that crisis arrives. The good news is that there are many steps leaders can take to prepare for a potential crisis and ideally lessen the negative impact that results.
The next area of weakness ties together two closely related technological risk factors: the lack of technology infrastructure and poor connectivity. 2020 has illuminated many shortfalls in technology tied to the lack of infrastructure. The challenges of inadequate support, hardware resources, access to new technology, and similar issues make the burden of operating in a remote environment very challenging. It is not just the lack of telehealth; we have seen many of our clients struggle with back-office functionality as well.
For instance, a provider may easily have a virtual visit with a patient via a telehealth platform; however, we have seen office functions such as appointment scheduling, patient check-in, insurance verification, among others, become very difficult. When an employee is working from home with their personal computer and a home internet connection, often trying to monitor children or even facilitate online learning, it interferes with in-office scheduling and check-in procedures. Many practice management systems do not allow these procedures to occur smoothly (or in some cases at all) in a remote environment. Billing has also proven difficult in this environment. Many entities found themselves thrust into the telehealth and remote-work dynamic. If you cannot bill effectively and correctly for those services, the organization will suffer from a financial standpoint, and the arrangement will not be sustainable.
These examples also highlight the last technology-related vulnerability that we will discuss: security and compliance. Cybersecurity has always been a challenging battle for healthcare organizations to fight since introducing technology to medical practices. However, this battle has escalated significantly in recent years, and the introduction of a global crisis has only compounded the difficulty for hospitals and medical groups.
As previously mentioned, having the technology is only one piece of the puzzle. If you do not fully optimize it, there is no option for whether its use falls within the bounds of compliance. The compliance issues do not change in the middle of a crisis; however, the presence of a volatile and uncertain market dynamic makes compliance an even more significant burden that is often missed or overlooked. Usually, the oversight occurs simply because of mistakes or the natural consequence of trying to navigate uncertain territory, but in healthcare, there is no exception for an honest mistake.
When it comes to security, one does not have to wonder how challenging it might be for healthcare organizations to operate with so much sensitive information in a remote environment using technology. Again, it is not just the risk of Zoom visits being hacked. There has to be a full range of security protocols in place regarding patient health information, financial details, and other personal information while practicing remote care and using remote-operating environments. A crisis will quickly highlight the vulnerabilities of improperly or hastily implemented technology platforms.