Does Telehealth Really Lead to Patient Loyalty?

New analysis from Sanjula Jain, chief research officer at Trilliant and faculty member at the Johns Hopkins School of Medicine, suggests that focusing on the wrong success metrics might be negatively impacting telehealth’s effectiveness as a digital front door.

  • In theory, a digital front door is a consumer-friendly and low-acuity engagement, like telehealth, that provides a health system with an opportunity to earn a greater share of an individual’s downstream services. 
  • In practice, telehealth’s ability to serve as a digital front door is hampered by low switching costs between similar services, with many consumers willing to shift from their current provider to a more affordable new entrant, such as Amazon Care.

Jain analyzed the behavior of insured individuals within and outside one of the country’s largest health systems, referred to as Health System A, finding that downstream capture from telehealth services did not indicate strong consumer loyalty.

  • The Findings – Roughly 13% of individuals within Health System A’s 2.7m consumer total addressable market accessed telehealth at least once in 2020, in line with the national average. Of those telehealth patients, Health System A captured a ~34% aggregate downstream share of care (based on revenue). 
  • The Impact – The low downstream share reflects the ability to capture an additional 65% of follow-up care prompted by the initial “front door” interaction. For comparison, Health System A’s service segment with the highest downstream capture was its Emergency Department (69%), indicating that telehealth might not be as effective of a digital front door as commonly perceived. 

The Takeaway

Telehealth is routinely serving as a digital front door, providing patients with their first exposure to a new health system, but more work is needed to validate its effectiveness. For telehealth to serve as a successful gateway to other services, health systems need better measurements of downstream care capture and consumer loyalty.

Fixing Problems Before They Happen

While the acceleration of digital health adoption has created many positive outcomes, adding “tech support” to the job description of clinicians was probably not one of them.

A Possible Solution: Johns Hopkins Medicine recently unveiled an EHR-embedded calculator that assigns telehealth patients a technical risk score so that IT support teams can proactively address tech challenges prior to an appointment. 

The calculator works by assigning a 0-4 score based on the following factors:

  • Two points for the patient not having an active account in MyChart
  • One point for the patient not having completed the eCheck-in process
  • One point for the patient not attending a telehealth visit in the past three months 

Pilot Program: Johns Hopkins created a two-stage pilot program to test the efficacy of the technical risk score. Phase 1 involved text-only outreach and found that 7 of 384 patients contacted via text proceeded to seek IT support. Phase 2 involved text plus phone outreach and had 44 of 98 patients successfully reached via telephone, but found preemptive IT support difficult to schedule.

The Takeaway

Despite the inconclusive pilot program, Johns Hopkins found that its calculator anecdotally eased the burden on IT support staff while creating more equitable telehealth visits for patients.

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-- The Digital Health Wire team