MD Anderson, Business School Develop Design Framework for Virtual Care

University of Texas MD Anderson Cancer Center and the Texas A&M University Mays Business School have developed a new virtual care design framework that focuses on four categories: documentation, integration, best practices, and support, according to an article authored by leaders from the organizations in Harvard Business Review.

Known as the DIBS framework, it is based on MD Anderson's experiences implementing virtual care services as well as operating procedures and guidelines from other institutions, including the University of Pittsburgh Medical Center and Jefferson Health.

The first branch of recommendations centers on documentation, meaning that providers should consider creating a blueprint that compares in-person and virtual processes enabling a health system to identify the elements of a care encounter that can be reproduced, removed, or enhanced in the virtual environment. 

The second step, called integration, involves device-and technology-related training. Many people using virtual care technology have limited experience with it, putting them at a disadvantage during the rapid adoption of health IT tools. However, health systems can limit these issues by proactively teaching clinicians and patients to use audio and video equipment.

The best practices component entails ensuring evidence-based decision-making regarding the use of virtual care. This includes various processes, like identifying whether a particular visit is meant to take place in a virtual setting and providers making sure they are familiar with patient records before the visit.

The support category pertains to aiding all technical difficulties and assisting patients in leveraging self-monitoring platforms. Efforts in this arena can help lessen the digital divide, thereby eliminating disparities and access barriers, according to the authors.

But the DIBS framework is not an objective resource that assists all in the same way, the authors cautioned.

"They are a set of guideposts organizations can use as they dynamically scale up the telehealth systems that are becoming inevitable, integral components of delivering high-quality care efficiently and equitably," they wrote.

The COVID-19 pandemic spurred organizations' efforts to implement and optimize telehealth.

In July 2021, a survey reported that 37 percent of practices did not offer telehealth before the pandemic. However, this rose to 66 percent during the pandemic. The survey also found that the inability of older patients to use the technology and general technical challenges were the main barriers to use. But participants indicated that they would continue to use telehealth in the coming years.

Another report released in June 2021 defined the most common challenges to telehealth adoption during the COVID-19 pandemic. Technological infrastructure, state licensing requirements, and adjusting workflow were all included in the list of main issues.