Asynchronous Telehealth Can Extend Primary Care at Community Health Networks

Store-and-forward or asynchronous telehealth often stays out of the headlines, but one community health network is using the telehealth modality to extend primary care services for their patients.

Experts say the technology is best fit for clinical situations where a provider can gather and analyze data before coming to a clinical decision. That’s because asynchronous telehealth allows for the electronic transmission of medical information that does not need to be read or interpreted live.

In a primary care setting, this allows the primary care physician to connect with specialty care providers and handle all the patient’s needs in one visit. Patients do not need to take extra time off from work or wait potentially months to be connected with a specialist. All of a patient’s concerns can be handled in one care visit.

“Asynchronous telehealth has the most potential to change how care is delivered,” Richard Albrecht, telehealth network director of Community Health Network of CT Holdings, Inc. told Insights during a conversation about the division’s latest research. “I see virtual text care or AI-empowered text access for our patients as being the next thing.”

Telehealth’s use undeniably exploded during the last year, but asynchronous services fill a different gap in care than video telehealth. Asynchronous telehealth is particularly useful in specialty care and, when rolled out across one hospital, it can improve patient outcomes by reducing the risk of rehospitalization and death.

Community Health Network of CT Holdings, Inc. is among a handful of provider organizations that is pioneering asynchronous telehealth. In fact, the organization started its entire telehealth program with asynchronous services.

Asynchronous telehealth is efficient and allows many specialty services to be conducted in a primary care setting, which, as traditionally one of the lowest cost of care settings, can generate a return on investment quickly.

“By utilizing asynchronous services, you can do more in the primary care setting without disrupting the workflow too much,” Albrecht furthered.

A truly integrated asynchronous program could show specialist recommendations in the EHR, so when the primary care provider is seeing the patient, she can address the specialist recommendations concurrently.

Still, one of the biggest challenges to implementing any telehealth program is supportive funding and asynchronous programs are no exception. Provider organizations without technology to support asynchronous services have an even larger upfront investment to purchase the technology, implement it across their organization, and train providers to use it.

To overcome this challenge, Community Health Network of CT Holdings, Inc. got creative. First, the organization outlined the problem they were trying to address—they were seeing a higher rate of patients with diabetes than the national average. A key quality measure of diabetes care is routine eye screenings, so the organization looked for teleophthalmology partners.

“After looking across the marketplace, we found a solution that was a good fit for primary care,” he explained. But they still lacked funding to bring in the solution to their community health centers.

“I found funding from some non-traditional places,” Albrecht continued. The Lions Club of American actually became their trusted partner and helped fund the program as it aligned with their mission to preserve vision.

“I met with the local chapter one night and told them about our vision for saving vision. And they came back with some funding to help us initiate the program,” Albrecht furthered.

The two organizations formed a long-term partnership, and the Lions Club helped fund the program for several years until it was successful enough to be self-funded.

Today, the program has grown to four- to five-times its original size, according to Albrecht, and it is one of the largest asynchronous ophthalmology programs in the Northeast.

Leveraging a non-traditional funding source, Community Health Network of CT Holdings, Inc. grew an idea for asynchronous vision care into a self-sustaining program that helps close patient care gaps.

Aside from supportive funding, Albrecht says his organization’s success is tied to leadership buy-in.

“You most need the leadership and the belief from leadership to push telehealth into the organization,” he explained. “That’s going to proliferate through the organization.”

Without buy-in from leadership, change can be challenging. People like Albrecht can easily become the bad guy when asking providers to change the way they are delivering care.

“I’m the person who’s bringing something new to people who are crazy busy,” he continued.

With leadership buy-in, his job becomes easier. The onus shifts from the individual provider changing the way she has delivered care for years to the organization to rethink its values. Many organizations are currently undergoing this transformation as the pandemic forced telehealth into the spotlight.

But asynchronous telehealth is still the most infrequently used telehealth modality, used by only 17 percent of provider organizations. Other telehealth solutions like live video conferencing and remote patient monitoring see higher uptake, with adoption rates at 96 percent and 35 percent, respectively, according to the same survey.

Continuing to grow a telehealth department and strategy will require investments into all forms of telehealth services as each has a niche role to play in a hybrid care delivery world. Asynchronous telehealth should not be dismissed as its evident with supportive, sometimes creative, funding and leadership buy-in the technology can help provider organizations improve patient outcomes.

This interview was conducted as a part of Insights by Xtelligent Healthcare Media’s research work. Findings from this interview and others are compiled in Telehealth Growth and Development: Telehealth’s Place in the Industry Beyond the Pandemic. For a deeper dive into the state of telehealth, check out the full report here.