How should we track and measure telehealth success?

09.30.2020 · Christina Borden, Director, Product Development, NCQA

Although telehealth and virtual care have long been around in some form, COVID accelerated the health care industry to warp speed for making it “the new normal” for almost every provider and patient.

Take a look at these statistics: According to a recent McKinsey & Company article, providers report that the use of telehealth in 2020 is up 50–175 times from 2019. Last year, patients reported that 11% of their doctor visits were telehealth appointments—in 2020 that number is 76%.

The telehealth boom could mean that the way we do business is changing forever. Tracking and measuring what this entails is vital, but we know one thing already: Health care providers are stressed.

During these challenging times, NCQA wants to work with providers to understand how we can comprehend—and measure—telehealth’s impact on delivery of health care while ensuring quality in all aspects of care.

Some care delivery frameworks were established before the pandemic, but in recent months more organizations, associations and government agencies have begun to define and configure delivery of virtual care—with the result that it is becoming increasingly difficult to find a consistent definition across settings that everyone can agree on.

What about quality measurement? The National Quality Forum (NQF) published a Telehealth Measurement Framework that outlines a set of domains for measuring access, financial cost, experience and effectiveness of telehealth. What aspects of telehealth, telemedicine or virtual care do you think should be measured? Consider these categories:

· Visit metrics. What types of visits are appropriate? This includes measuring utilization—for example, telehealth visits vs. in person visits; type of telehealth/virtual visit; growth of telehealth and virtual visits over time; time spent on telehealth/virtual visits, including video and telephone visits.

· Patient metrics. How do patients measure their telehealth experience? This includes new vs. return users of telehealth/virtual visits; wait times; total visit time; satisfaction/experience; willingness to recommend; retention after a telehealth appointment.

· Staff and clinician metrics. How do staff and clinicians measure telehealth engagement and overall experience? This includes measurement of total work time spent (including pre-, during and post-telehealth/virtual visit) and overall satisfaction/experience.

· Financial metrics. How do providers recoup telehealth costs and changes to billing structure? This includes differences in reimbursement and cost by visit type.

· Technology and service metrics. How do system technology and service delivery perform overall? This includes whether communications are getting delivered, bounce rates, issues/bugs and down times.

We’d like to hear your thoughts in the community forum on what can—and what should—be measured, so we can emerge from the COVID crisis with a plan for making telehealth work for everyone.

Christina Borden, Director, Product Development, NCQA

Christina is the Director for Product Development for NCQA's Recognition Programs. In her eleventh year with NCQA, Christina oversees the development, implementation, and promotion of NCQA’s Recognition Programs (RP) and oversees new product design, such as the development of NCQA’s telehealth initiatives. She maintains and improves NCQA programs as clinical measures and standards change. Additionally, she works to educate stakeholders, interpret, and maintain guidelines for RP programs and ensure NCQA’s programs properly align with federal guidelines and NCQA’s mission to ensure high quality healthcare. When appropriate, Christina represents the organization publicly, including in forums for sponsors, state and federal agencies, practices, professional organizations,and other partners. Christina’s work in NCQA’s Recognition Programs has been to improve patient outcomes and provider healthcare delivery through the design and implementation of patient-centric standards. Before joining NCQA, Christina worked at the Association for Community Affiliated Plans (ACAP) representing non-profit safety net health plans and, previously, as a health liaison on Capitol Hill.