Using Data Analytics to Enhance Telehealth Services

With telehealth becoming increasingly integrated into care delivery at provider organizations across the country, some are going one step further and optimizing it.

For Children's National, a health system based in Washington, D.C., this means using data analytics to understand telehealth use better and identify gaps in care.

"Our primary goal is really to make sure that children in the region, nationally, and internationally, that we provide care to have high-quality care through telehealth and can access the care," said Shireen Atabaki, MD, emergency medicine physician and associate medical director for telemedicine at Children's National, in a phone interview. "So, our primary goal is really to make sure that we are bridging any kind of digital divide that might exist based on geography or socioeconomic status."

The pediatric telehealth program

Children's National includes a 323-bed acute care hospital, 16 specialty care centers, and 16 primary care offices. Like other organizations, Children's National leverages telehealth via video, telephone, and text messaging for various care needs, including endocrinology, immunology, and oncology.

But being a children's health system, the organization had to keep a few key considerations in mind as they developed their telehealth program.

"Care for children in general, specialty care for children in general, is different from that for adults because they are not usually the direct seekers of care," Atabaki said. "They have to have an adult seek the care for them."

Because children typically can't access the technology needed for telehealth on their own, Children's National had to make sure that it was engaging parents, schools, and primary care providers to widen telehealth access for children.

Overall, telehealth appears to be a popular choice for parents. A survey conducted last year showed that the majority (92 percent) of parents said they were satisfied with their child's virtual visit.

Incorporating data analytics

In October 2020, Children's National struck a partnership with Vidoori, a consulting firm that provides IT services and products, to implement a data analytics platform and dashboard.

The platform analyzes various types of data to provide insights into telehealth patients and providers. The data is gathered by Children's National and de-identified, a process through which personal identifiers are removed from the data. The information collected includes patient data, claims data from the health system's finance team, and information on the departments within the health system using telehealth and the types of care they are providing.

"[The platform] provides insights such as what are the top diagnoses that are coming from these patient encounters," said Tim Odom, director with Vidoori, in a phone interview. "Who are the top physicians that are actually interacting [virtually] with the patients?"

The platform enables the information collected to be overlayed with other relevant data. For example, data from the US Department of Agriculture, or census tract data, centered on rural or underserved areas. This can help provide demographic and geographic information on telehealth use.

"One of the things that was important with this project was to make sure that we didn't replace things that the hospital already has in place," Odom said. "So, we're filling a gap to accentuate the data and some of the analytics related to it."

The analyzed data is displayed to clinicians through a dashboard.

"The platform has really provided us as program directors, and healthcare professionals, and health systems teams, with a consumer-friendly way to view the data and be able to really look at it with the lens that we interested in," Atabaki said.

As a result, the dashboard can be used by clinicians with a medical informatics background, like Atabaki, or those without that background.

"The reporting is…very user-friendly," she said. "It's very easy to communicate with the team on our needs for this program and other programs as we add them to the dashboard and the metrics that we want to look at and analyze."

For example, some of the Geographic Information System (GIS) data appears the same as Google Maps on the dashboard since people are more familiar with the latter, Odom said. This can help provide the health system with a visual representation of their telehealth patients' areas or zip codes.

Leveraging data analytics capabilities

One of the key ways Children's National has been using the dashboard is to follow trends in direct-to-consumer ambulatory virtual visits.

Over the course of the COVID-19 pandemic, direct-to-consumer telehealth visits spiked dramatically for the health system — from about 100 in February 2020 to 13,000 in April of the same year.

"We really quickly had to shift," Atabaki said. "One of the things we wanted to do as we were shifting was, we wanted to make sure that we were still providing the same equitable care to all patient populations."

For example, early in the pandemic, behavioral health was among the top 10 diagnoses for which patients requested care by telehealth, she explained. Even as COVID-19 surges slowed last year, mental healthcare patients largely chose to stick with telehealth, enabling Children's to make sure virtual care remained available for these patients.

This is important to note as a mental health epidemic is raging among America's youth, according to experts. Last October, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association declared a national emergency in children's mental health spurred by the COVID-19 pandemic. A few months later, in December, US Surgeon General Vivek Murthy, MD, issued a new advisory calling for a swift and coordinated response to the mental health crisis among American youth.

"We see a behavioral health crisis epidemic as well now among young children and young adults in the United States," Atabaki said. "Really being able to target those specific types of issues and provide appropriate healthcare is really important."

Looking ahead, Children's National plans to use the analytics capabilities to target children in need and those in medically and socioeconomically underserved areas.

"I think it really takes a team to be able to provide a regional telehealth program of this magnitude for children and families," Atabaki said. "To make sure that access to care is both equitable and that children can get access to outstanding specialty care and subspecialty pediatric care no matter where they live."