Business Continuity Series: Telehealth


Healthcare organizations are moving quickly to find solutions that can support new healthcare delivery models. WWT Chief Healthcare Advisors Dr. Justin Collier and Dr. Sanaz Cordes, and Kait Miller, a business development manager specializing in Meraki Smart Cameras and video analytics, talk about specific technologies that enable telehealth and their collective ability to produce better patient outcomes.

Read the transcript below:

- Hi there, my name is Brian Feld with World Wide Technology and today I am happy to be joined by Dr. Justin Collier and Dr. Sanaz Cordes, two of our chief healthcare advisors and Kate Miller, a WWT Business Development Manager who specializes in Meraki smart cameras and video analytics. Before we get into the bulk of the conversation today, I want to remind everybody that all of the information and all of the resources that we mention throughout this conversation are available on WWT.com, our platform. We're talking articles, case studies, briefings and assessment, anything that can get healthcare organizations further along their journey toward the digital transformation, but also maintaining business continuity as we go through the COVID-19 pandemic. So today we're talking about business continuity in the healthcare industry specifically in light of the disruption that's been experienced by the COVID-19 pandemic and the technology or technology solutions that are most vital to those areas and delivering treatment to patients whether it's in isolation rooms, enabling real-time collaboration, or just making for a more seamless experience. We'll start with Telehealth, and Telehealth isn't necessarily anything new and healthcare organizations have been playing around with this technology for some time now, but I have to imagine that it took a massive leap forward when all of this remote working and need for more solutions in hospitals has occurred. So high level, how were some of these healthcare organizations prepared in position for such an environment? Were they prepared or caught off-guard or probably somewhere in between?


- Yeah, I mean I can sort of start with touching on both sides of the spectrum. Many health systems were far advanced; they had some virtual care programs set up that involved televisits, telemonitoring, telehealth in the in-patient and out-patient setting, but definitely to your point I think COVID put that all on accelerated mode, and I mean just to look at some statistics, last year about 25% of visits were telemedicine and just in March alone there was a 50% surge in the number of telemedicine visits, so we were on track for 2020, the experts estimates were about 36 million visits and now the prediction is 200 million visits, so it has definitely boosted telemedicine and I think that we're going to continue to see even post-COVID, a long-term solution there as well.


- So, we're talking about patient care from a medical perspective but really the heart of this this is a technology play without the technology there's no way to provide any of this virtual care, so Dr. Collier, maybe walk us through what kind of what type of technologies are proving critical to enable these healthcare organizations to maintain this continuity and level of service for patients.


- Sure, so there's actually a wide variety. One of the excellent things that happened as we were preparing and moving into really I would say the heart of this crisis was that the regulatory environment was relaxed significantly, so what we have seen is a huge variety in terms of the technologies being used to deliver that care and to deliver it in an effective way. We've seen everything from commercial applications that organizations already had being ramped up in a quick and nimble manner, we've seen other cases where consumer-grade products and collaboration tools are being used pretty heavily, so it's a pretty broad mix. Even the places that were prepared found that they had to scramble a little bit in order to ramp up to meet demand and really to provide those needed services.


- There's a security issue here, too as providers are broadening their network and enabling remote working and these types of solutions they're opening themselves up to a broader range of an attack surface. Dr. Collier, what type of security issues might arise when these organizations are considering such solutions?


- Yeah, so any time you've got more endpoints it is, as you mentioned, it's a much broader attack surface, so there are more places, more opportunities where the bad guys can get in. Another thing that comes in concert with that is the fact that you're interacting with patients on the other end, so you have to consider their endpoint as another potential route of attack ensuring that privacy for that pretty intimate patient encounter is vastly important. Some of the consumer software that was out there didn't really have the right protections regardless of the fact that HIPAA regulations were relaxed, there is still that importance of protecting that sensitive information, that identifiable patient information that intimate conversation between patient and clinician.


- Kate, we'll flip it over to you here, so this technology is dramatically changing how patients and hospital staff or teams interact with each other. One of the interesting things that we've seen happening with organizations is smart cameras not only to help with patient care but also the safety and well-being of clinician nurses and staff, maybe walk us through a little bit about how these cameras work and what the value is.


- Absolutely, so these cameras allow us to physically monitor a patient remotely, so we're helping to reduce the number of true physical interactions or exposures while we're still ensuring that there's an extremely high level of care. The cameras are also helping to reduce PPE usage and promote hospital staff safety by reducing the number of true physical exposures, but this is really not a typical one-size-fits-all model. These solutions really need to be tailored to each customer and in fact one of the things that we've seen with this type of a solution is actually a remote operation center of sorts where a handful of hospital staff are monitoring multiple patients simultaneously in a remote capacity and as a physical interaction is needed, they can then contact clinical staff that is onsite, but it's really just keeping those physical interactions at bay and ensuring the health and safety of that clinical staff as well and, Dr. Collier, Dr. Cordes, maybe you can talk a little bit more about what we're seeing from the best practices perspective.


- Absolutely. Again, sort of coming back to where does the health system or even we think outside the health system the public health organizations, other facilities that provide care to patients, they all have sort of a different need and a different use case and yet the tools that we're providing them whether it's cameras, whether it's video surveillance, telecommunication via video chat still remain the same and if we sort of take two use cases there's scenarios where there's a lot of inbound query to the facility with people, the public being concerned and wanting to inquire about whether or not they should escalate care. Some of the things that we're seeing are patient engagement tools that free up staff to actually take care of patients and automate a lot of that initial, what we call triage process and whether it's a chatbot or some branching logic or whatnot on a website, we're seeing that that's really key for facilities that already have some virtual care in place, and then there's other facilities where virtual care has really never been even on the radar or something that they felt that they needed to prioritize for the immediate future where they've approached us and said we need solution yesterday and we've been really impressed about how people have been able to piece these tools together and get up and running, and a lot of these maybe short-term solutions that they are definitely solving the clinical and business problem at hand which is providing the services at a time where it's really a true surge.


- Dr. Collier, how complicated are these solutions in piecing all of these different aspects together whether it's the collaboration and network connectivity or bringing in the security factor or as Kate talked about a lot of the cameras that can be used. So stitching it together I would imagine is not as easy as just piecing it together.


- The answer as with many things is it depends, which I know drives people crazy, but it really does. You want a solution that's going to fit your needs, that is as simple as it can be and no simpler to steal a quote from a smarter person than me, but you want it to be elegant, you want it to be the simplest solution that meets the needs maintains that cybersecurity, provides that excellence in care and not over-complicate it especially in a crisis situation like this, you need to be able to move quickly. Certainly that's an area where we've been able to provide a lot of value to our customers and partners is by coming in and having that expertise to do a lot of the heavy lifting for the organizations we work for.


- So a lot of what we talked about already is the technology aspect of this but what maybe gets lost in the shuffle a little bit at least from our end is the patient outcomes and that's an incredibly important, this technology is leading to the next level which is helping improve the condition of the patient or helping treat the virus, so can you talk about some of the things we've experienced in terms of how this is parlaying itself into patient outcomes?


- Sure, I could touch on that, and I know Dr. Cordes has some great ideas as well to share. There are two aspects that I think are pretty important. One is that the world is finally waking up to the fact that telemedicine is just medicine. Yeah, it leverages our technology technology tools but it's largely technology tools that have been around for a while, and in pretty broad use across all industries. We don't think that's necessarily going to change other than continue to accelerate coming out of the crisis, so I think that's one key aspect where patients are being able to be cared for in a more convenient way and a more rapid way and in many cases monitored more closely than ever before just by leveraging the technology that's been around and been available maybe leveraging it in a little bit different way but definitely providing a lot of benefit.


- Yeah, I would agree and to your point with the simplicity I think at the end of the day what this has done for me as a physician is reminded all of us that we need to care for patients and there's been so many barriers and things put in place and one example is they've surveyed physicians over and over over the last few years and over 90% of them at some point said that they would like to be able to provide these services but there're barriers, there are reimbursement issues, regulatory issues and we're really just in a position right now where we've sort of stripped all that away and said we need to care for patients and to me I think that's a really amazing catalyst to try to make some of these changes that we're seeing right now so yeah I would absolutely agree with bringing in these simple solutions, video conferencing at its bare minimum to be able to do it. Even things like signage; you have drive-up tents that have popped up and just being able to triage patients before they even need to get out of the car to protect the safety of both the patient and the staff and to Kate's point, limit PPE. That's a simple solution, that's a simple thing, but it's just gotten lost with this healthcare and in many ways has just gotten very complex and sometimes that patient outcomes and patient experience has taken a backseat to that, so I definitely see that being as a positive outcome of something that's been quite a stressful pandemic era for us in healthcare.


- One other area that I would chime in and add to that is that in these environments where patient visitation is extremely limited, we can't lose sight of how big of an impact loneliness and isolation can have on the health and healing process, so a lot of these tools not only provide for better clinical care but also can provide that connection back to friends and family in an environment where you can't have visitors, so being able to keep people connected has been a vital, vital piece of the puzzle.


- One thing that I would add on as well is I think as we see some of these restrictions be stripped away and patient wanting to take more advantage of the remote healthcare capabilities, in the future that becomes something that is patient-driven, once a patient has a positive experience like that, that may not be something that they want to go away from, that may be something that they rely on more heavily in the future as well, so a lot of these solutions are not necessarily going to stay temporary solutions, and I think that's going to be patient-driven.


- That's a very good point. There definitely will be a maturation process of a lot of these technologies and platforms, a lot of these approaches. That's something that health systems need to go ahead and begin thinking about and developing strategies for is that new normal or at least the next normal.


- Absolutely, and so a lot of the technology and solutions we've been talking about has been within a scenario of traditional healthcare whether it's a hospital or doctor's office or in the case of some of this remote stuff, hospital to at a person's home but there's another layer to all of this which is these improvised treatment facilities that we're seeing pop up whether it's for a man-made disaster like a tornado or a pandemic such as we're in right now these treatment facilities are incredibly vital to not only maintaining the continuity of the traditional healthcare places like hospitals and doctor's offices, but also helping treat the broader public, so let's talk about these improvised facilities a little bit and the role that technology plays in getting those stood up on, Dr. Collier I guess we can start with you.


- Sure, a lot of times you'll also hear these referred to as alternate care locations or alternate treatment locations. That's something that definitely has become extremely important as facilities have been preparing for surge capacity that's one use case of being able to rapidly spin up a new location where patients could be cared for whether that's a conference center or an arena or another location that had another purpose in the past. Certainly that has particular complexities when you're standing up a clinical location in a space that was never designed for that, again the importance is keeping it as simple as it can be, moving as quickly as you can but making sure that you're providing for excellent patient care in the process. Connectivity is a big piece of that, making sure that clinicians of all types who are going to be caring for patients in that environment have access to video-phone capabilities and data connections to the right clinical systems and clinical information to be able to care for these patients and then the patient monitoring capabilities as well, so that's I think one of the use-cases that we see a lot of headlines about. Another thing that we've seen quite a bit of and helped quite a bit of is the standing up of these whether they're drive-thru triage tents, drive-thru testing tents or even remote clinics separate from the hospital. There has been just a huge, huge number of these that have been created and they're serving a fantastic purpose. You see many states where that's even being opened up now for testing of the general public not just limited to those that may have symptoms, there's a variety of different ways that they're being used today. They really help to streamline a process, provide that adding capacity but also potentially keep people who don't need to be in the facility out of the facility. No need to have necessary exposure of the public, no need to unnecessarily expose all of your clinicians to every patient, so it's beneficial on both sides of that coin. I think one of the other things that we're going to see as we continue to move past this is a lot of those locations being used as clinics begin to try to reopen or as new services come back online, the elective procedures, chronic care follow-up visits and those types of things, I think we'll see a lot of those locations being used for people who are expected to not be infected so that they can be kept separate from the population that maybe is a higher risk for exposure.


- Dr. Cordes, we talked about these locations where are we talking about exactly, is there any rhyme or reason to where they're popping up or is there any place that's better than another, or what are we seeing with some of our customers?


- Yeah I think that Dr. Collier focused on the external facilities expanding beyond the hospital walls which I think we're seeing across all organizations there's a need for that, I'd say there's also within the hospital walls we've seen a lot of creativity and innovation happen overnight and Kate, her solution, you can chime in here Kate, some examples I can give are rooms that really weren't meant to be isolation rooms, they weren't meant to be observation rooms they might just be an empty OB Ward on a different floor, and we're seeing hospitals become very innovative and say, hey, how can we can convert this quickly into a place where we can care for COVID patients, protect our staff, limit PPE use and that's where solutions like the Meraki cameras or even getting really creative and putting other video tools on things that weren't meant to be videocarts but you need a solution very quickly and so setting up mobile solutions. Some health systems have come very far already with surveillance centers, command centers, we all know of the rapid response command centers that exist and sort of that model also kind of escalating that to care for COVID patients so putting one care provider whether it's a nurse or a physician in front of a command center dashboard where these tools like cameras and other things are used, so within the hospital walls we're seeing a lot of innovation where we've been able to come in to help support with some of these solutions, and Kate I don't know if you can add to that since that's your area of expertise as well.


- Yeah, Kate so talk about some of the challenges that we see because these rooms weren't necessarily meant for those purposes previously, and organizations are having to move very quickly which can set up its own set of of challenges, so what types of challenges are we seeing in that regard and what are some of these innovations solutions or innovative solutions that we're seeing being deployed?


- So when we start to talk about these alternate locations healthcare providers do have a lot of challenges to overcome including connectivity access and controlling access physical security as well as securing the networks, so Dr. Collier talk about it earlier there's a lot more endpoints on the network that may have sensitive patient data that needs to be secured and when we start to look at the Meraki cameras, it's a very unique solution because these are cloud-based cameras so with that we are able to ensure that the firmware on those cameras is always staying up-to-date and that those endpoints are always staying secure and it requires very little management. The cloud can actually automate all of that for the customer.


- Aside from the security, these cameras, Dr. Collier, as you mentioned a little bit earlier too, just being able to save the staff some time in terms of being potentially exposed to these patients or on the other end of the spectrum these patients having some of that interaction which is avoiding loneliness, these are really creating a big step forward in this type of treatment, right?


- I agree, I agree and I don't think it's something that necessarily is going to go away after the pandemic is over in fact we may see it expand, I think we'll see new paradigms in terms of patient experience and delivering that concierge-level of care where that becomes a little bit the new normal where patients are able to digitally interact even in cases where they could have visitors able to interact with those who are outside the hospital, and I think we'll see also more of that video interaction playing out in addition to or in some cases instead of more traditional nurse call systems. How much nicer is it when you can have a video encounter with the person that you're talking to on the other end than audio-only the same reason that we see everyone preferring video chats over traditional phone calls, it's more of a human interaction.


- So certainly organizations are doing their best at this moment to try to accommodate for these types of environments and need and once this all passes we'll start to get into the review phase to see how organizations did in terms of handling this demand, this rush and this care. What can some of these healthcare organizations do to not only satisfy some of the immediate needs but really start to build a long-term plan that allows them to take a more proactive approach as opposed to a reactive approach if and when the next type of disaster or pandemic or whatever the case might be arises?


- So organizations have always had some types of disaster drills and disaster planning often in coordination with others in their region and the state and government agencies. I don't know that we ever really truly had prepared enough for potential pandemic situations, so I think that's going to become more the norm, and I think a lot of the lessons learned here need to be shared across organizations so that's one of the key things that I would say I would advise anyone in healthcare really to become a student of every other organization, every other piece of the puzzle in healthcare learn what worked well learn where the pitfalls were, learn what could have been done better and truly treat it as part of our learning health system. Put cycles into really incorporating those strategies long-term, but also look at the technologies and solutions that were deployed, find other ways to leverage them. Continue the innovative thinking that has served us well to this point and find other innovative solutions that can solve other healthcare challenges don't just limit that long-term strategy to thinking about what do we do for the next pandemic or the next wave if that makes some sense.


- And we do have a lot of resources on our platform, WWT.com by the means of getting some these organizations not only prepared immediately but starting to put those blocks in place, Dr. Collier, just a little bit more maybe about some of these briefing or assessments that we're able to offer?


- For sure, so the same platform where you're viewing this video now just do a quick search for healthcare and it will provide you with a variety of articles, lots and lots of case studies and some really pretty exciting technology labs as well. If there's a particular solution that you're interested in, telehealth for example or telemedicine we definitely have materials available to review and you can sign up for a briefing on any of the topics that you see that are of interest; feel free to put in those requests, and if there's a specific technology need even aside from that you can submit that request and we'll respond to it within 24 hours typically of receiving that request.


- I would add to that that we've kind of focused on health systems but there are a lot of care providers out there that are having these same issues so as you do seek sources and visit our site just keep in mind that we are also working with a lot of out-patient organizations, specialty practices where they have very unique needs for these tele services. Some specialties need to have interactive equipment or be able to really observe the patient doing various things so just to put that out there even if you're not a health system but you're providing care in another capacity that's had to abruptly stop because of what's happened there are a lot of things that can be done as simple as with mobile phones that we can help work through it and make sure that we can get your clinicians back in front of patients who have had to put a hold on their care plans.


- Those patients need you, let us help you get started again.


- So let's dive a little bit deeper into the video-patient monitoring aspect, we've talked about it a number of times already and just the absolute critical nature and ability that it has to enabling this type of continuity and treating patients and also staff of these hospitals or doctors office. Kate, maybe a little bit more, maybe something we haven't touched on yet in terms of why these are such an effective or smart solution to deploy?


- Absolutely, and one of the articles that you'll come across on that platform if you do that healthcare search is really a deep dive on why this is a great solution for healthcare but just at a high-level when we're utilizing Meraki smart cameras or other cloud-based IP camera solutions we're doing couple of things. Firstly, we are separating patient monitoring from patient interaction so this really allows us to provide that true 24/7 eyes-on patients-monitoring, and as Dr. Cordes mentioned, that may be in a room that was built for privacy and we now need to get eyes in that room so we are able to do that with this video solution. Next, we're creating an environment that allows us to retain a very high quality of care but removes that need for a physical interaction, which again improves clinical staff safety and reduces the usage strain on that PPE equipment and lastly the solution is able to be deployed very quickly and very securely.


- One of the things that I would add to that, Kate great point, just to add on to that the other thing is you can choose whether or not you want to record the video so that is a setting that we can help health systems to think through all the different pros and cons of whether they decide that they want to retain video or they decide that it should strictly be real-time monitoring so there are a lot of consideration that can be added. Kate, I know that we were talking the other day about some other neat add-on features that you've been investigating and helping some health systems with. I don't know if you want to touch on those.


- Absolutely, so from a technology perspective, with these being cloud-based we're able, again reducing physical interaction all of the configuration can be completed remotely and what we we're seeing is the hospital staff that use it, hospitals are utilizing their own staff that's trained and maneuvering around patients as many of these rooms are already occupied and trained in utilizing PPE equipment properly for safety and they are physically mounting the camera in the room and anything else that's required can be configured remotely and that includes some of the things that Dr. Collier was leading me to in the ability to trace digital rails around patient beds and configure an alert that goes to clinical staff if there's motion outside of that patient's bed because that's when they would potentially be at risk of falling. You can add privacy walls around an area of the camera that should not be filmed within that view and also the ability to turn that recording off; there's other things that we can do with that video stream as well, so we're able to keep that stream on the customer's local area network to stay compliant with any of the HIPAA regulations that are required that video stream will never leave that LAN. We're also able to utilize an RTSP stream that the customer already has HIPAA-compliant storage device so that we can send the video recording there instead of storing it on the camera itself, so this is flexible, configurable and really solves the needs that are out there today.


- So camera technology is probably not top of mind for a lot of these healthcare organizations at least I wouldn't think so on the onset of just talking about the actual technology area, so what types of things do they need to be thinking about as they start to either deploy these solutions already or think about how they might deploy them in their own setting?


- So a couple of things that they're gonna want to keep in mind because we did explore a few other solutions including utilizing video chat for monitoring and different things of that sort so what you want to take a look at is the ability to monitor multiple patients simultaneously and when we start to talk about a video chat if you have multiple patients in the same video chat they're going to be able to hear each other's patient information once that interaction is started. You also want to think about the length of time that you're going to be having that video up and running. It's not necessarily ideal to have a video chat that is consistently running 24 hours a day and 7 days a week, so that's where we want to, again, go back to separating the monitoring and the video stream of that monitoring from the required interaction with that patient so that we can really make this a 24/7 operation. The other thing to keep in mind, I know Dr. Cordes touched on it, some of the areas of the hospital are changing and so when I talked earlier about an operation center, that could be a separate area of the hospital that because patients family members cannot be in the hospitals with them at this time or maybe common areas that are not currently in use or that Operation Center can kind of be siphoned off and set up to keep that clinical staff safe and away from any of the infected patients and minimize the number of people that are interacting with them as well.


- One of the other things that we've heard is a benefit from our nurses who have been interacting with systems like this is that they're able to interact with patient and find out everything that the patient needs to happen that next time that they go in the room so there's also an ability to provide even just a higher level of service that further reduces the need for exposures and the need to enter and exit that room as frequently as it was before.


- We've talked about the camera technology in terms of helping in this current situation in hospitals or improvised treatment facilities, but Dr. Cordes or Dr. Collier, do we think that this camera technology would start to creep into other areas of the healthcare industry moving forward whether it's having an endpoint at everybody's home and your primary care physicians using this type of thing?


- Yeah, I mean it's interesting as we've talked to a lot of health systems I hear the same commentary which is we've had virtual care and telemedicine on our roadmap as a strategic initiative for the next five years, and this is where we want to be in five years. Almost every health system has had some roadmap around that and as we talked about earlier, it's just been jump-starting it, right? I think that there's just a lot of process again just for simplicity's sake and as Dr. Collier mentioned, a lot of process that has to go into getting from point A to point D in five years, and I think what this has done has sort of reminded everyone that innovation can happen quickly and there's a huge benefit and a simple example to Kate's point where she's speaking of nurses and really being able to have bi-directional communication and then Dr. Collier's point of allowing nurses to work on top-of-license to go in to the rooms where there's need of care, to that a simple example would be telesitters. We've had some health systems that are already taking advantage of that to allow top-of-license care so traditional medicine is a one-on-one literally a person in the room observing a high-risk patient whether it's falls or fall risks or other risks and some health systems had already put this in place with a virtual model with a technician or someone with then free up the nurses to go in when there's an actual need, and so I think this has opened the eyes of a lot of health systems to say, this is kind of a simple thing to implement, right? We literally can use a camera and simply have audio on and allow video and audio monitoring of these patients that were traditionally getting one-on-one one-to-many one tech to a handful of patients and then using other tools that already exist within rooms typically there some sort of call button or things like that to then escalate and then bring in the staff that needs to go in, so that's one example of that's a nice-to-have and that's on our roadmap, but we'll get to that when we can sort of pass through the process has now become, "Wow we can kind of do that overnight" and so I think that's been a really, again a positive outcome of something that has been a huge challenge and obviously a negative pandemic that we've been dealing with.


- And Dr. Cordes very much to your point while we've seen E-ICU initiatives in many hospitals in the past, we're definitely seeing those accelerate today but we're also seeing that applied outside the ICU. So just the ability to have that centralized monitoring to be able to provide that closer look and closer care really prevents a lot of failure-to-rescue scenarios. It definitely provides a higher level of patient safety and truly escalates and elevates the patient care.


- We've talked about a lot today, Telehealth and improvised facilities and this patient video monitoring, Dr. Collier, so what can organizations, they're probably going to be at some point looking to take a more comprehensive effective strategy something that would really help in these times and whatever those times might be in the future so what can healthcare organizations do today or maybe in the near future to develop that sort of long-term comprehensive strategy that will help enable them during future events?


- So I would tell you that during the COVID period as we're all going through this together and all on the same team, we are happy to provide briefings free of charge to anyone that wants to dive deeply into any of these solutions or look holistically at their overall strategy. We're able to share a lot of the information that we're learning from across the healthcare industry and in some cases even from other sectors, different solutions and how we're seeing those play out in real-time the pros and cons pitfalls to avoid, the successes that need to be shared and the innovations that we'd like to have spread much more quickly so that's that's definitely one mechanism we would be happy to help with that could be short as 30 minutes, it could be as long as a couple of hours potentially depending on how much time our customers or for those in need have they can invest in and how deeply they want to go into some of these topics.


- Could you explain a little bit about what some of these what the typical outcomes are of these briefings, do the health organizations get just a better understanding of where they sit today or do they leave with actionable insights or points that they can kind of go and improve on?


- Yes and part of it is education, so part of it is just providing them with additional insights and an understanding of what's happening across the broader industry but in addition to that we like to look at better understanding their current state where they may be having challenges and provide them with ideas for solutions and potentially even could provide a very high-level roadmap for further engagement.


- We talk a lot about the new normal and that's not just related to healthcare but essentially every industry what will the new normal look like once we emerge from this pandemic, so I guess I'll open it up to everybody here and whoever wants to answer what is the the new normal what does the future hold for for healthcare and telehealth as it relates to treating patients?


- I think right now there are a lot of moving parts and I think it's just a matter of kind a race to get the necessary parts in place so we talked a lot about moving to tele and video conferencing and using technologies like that but there are also things that are happening with regulations and reimbursement and things that we don't think about necessarily because we're very focused on, rightfully so, taking care of patients and protecting staff, but there are people on the administrative side of healthcare that are now kind of having to scramble to figure out NREHR how do we now expand to documentation of some of these visits, what are the appropriate pieces that need to go there on the billing and rep cycle side, the coding and making sure that these new regulatory and reimbursement codes and things like that are in place so there's been a lot of moving parts and a lot of leadership that we've spoken to at health systems are already talking about that, where do we go from here? We've plugged in these solutions and some of them are great, and they need to be taken to the next level and then how do we cohesively now bring it all together to be a sustainable and scalable model moving forward and so if we just look at one piece even the video piece, right, now folks are starting to think about how do we need to integrate this into RDHR or do we need to integrate it into the billing system, we've been working outside of some of our normal systems because we've had to and it's working to control the COVID environment, but long-term how do we integrate these things and so I think that it's a given to some extent that this is our new normal and we are headed this way and the consumer is going to direct that, right? When we've already had 90% of consumers in various surveys say they want telecare after this I don't think that that number is going to go back to the 25% usage, right? So with the patient-centric, consumer-centric approach, that's going to be one driver to make this happen and then leadership is already sort of thinking about yeah, how do we make this become a long-term play. So I think really just bringing those different pieces together which I think during our briefings we can also definitely look at each system's individual processes and really start to put in the glue to create an end-to-end solution that can grow with the system.


- I would add to that that I think that what we're looking at in the future is not necessarily a single new normal, I think we're going to have a series of next normals if that makes some sense. I think it's going to proceed in waves in and have a maturity curve to it, we're going to see different things playing out at different rates, different paces depending on the state or the locality of a particular organization and what they're facing; it's not going to be single process or a single destination so making sure to really understand the environment that you're and the fact that change is going to be pretty constant for a while because very important but definitely encourage everyone to be thinking about what is your plan as you restart, what are the potential phases that you think you're going to go through and really compare notes with advisors like ourselves or with other organizations. That would be my addition there.


- Yeah and I would second and emphasize everything that was just stated and as somebody that has already taken advantage of some of the tele-services specifically physical therapy, the ease of use, the two-way video capabilities, the time saved on travel and then the convenience is just so incredible from the patient perspective that I do think it will continue to be patient-driven and again will not be a temporary technology.


- Well, great. I want to thank each of you for joining me today and what I'm sure is a very crazy schedule and busy time for the three of you and also thanks to our viewers and those that took an interest in the topic today. As Dr. Collier, Dr. Cordes and Kate mentioned, we have plenty of resources on our platform, WWT.com whether it's articles, case-studies, briefings or assessments basically anywhere healthcare organizations may find themselves on their journey towards improving, we have some resources available to help you guys along the way so thank you again to the guests, thank you again to the viewers and we'll talk to you next time.


- Thank you.


- Thanks. Let us know how we can help.