by Tim Smith, Principal, Deloitte Consulting LLP


This week’s blog by Tim Smith, Deloitte’s national leader for Healthcare Information Technology (HIT) in the US, featured on the US Center for Health Solutions blog, A view from the Center, in March 2018.1 Following the HIMSS18 conference in the March 2018, Tim used the blog to explore the importance, challenges and considerations of virtual care programmes for organisations looking to implement them.

Walking the floors of HIMSS18 in March 2018, I was excited to see the opportunities and the technology innovation around virtual health. As my colleague Ken Abrams pointed out in a recent blog article, the conversation around virtual health is less about why organizations should be thinking about it, but more about how and where to invest. This can be a daunting area to navigate.

Virtual health is changing the way health care is delivered and has the potential to impact and improve the quality and value of care. Through conversations with clients, I have noticed that there is significant variation in the adoption of virtual health across the health care industry. Some organizations have already implemented full-fledged programs, and others are just beginning to dabble in the space, yet few have reached an integrated solution.

Whether organizations are looking to expand/augment an existing virtual health program, or to implement a new program altogether, they likely will be faced with many potential options for the technology solution. It is important to take a long-term approach to the technology decisions. Organizations often face issues when careful consideration is not given to their long-term objectives, needs, execution model, and desired capabilities. A thoughtful, strategic approach should be applied to ensure the technology of choice will ultimately deliver an effective virtual health solution that drives connected, coordinated care.

Before creating a technology plan, it is important for organizations to consider areas of opportunity and determine their goals and objectives. Using this information, they can assess their unique profile and overall market position to identify where they stand in terms of overall capability maturity. An evaluation of the current virtual health capabilities can include primary segmentation, overall size and geography, patient mix and population, service offerings, value-based reimbursement mix, and IT maturity.

When this assessment is complete, organizations can begin to make focused decisions around where their biggest organizational priorities and opportunities exist, and which mix of virtual health technologies and capabilities most effectively meet those needs. There are some important questions that organizations should consider to help guide their decision-making approach. These include:

  • What is the current technology infrastructure? Do you already have integrated electronic health record (EHR) capabilities? How integrated are those capabilities?
  • Which vendors do you partner with? Do they have virtual health products? Is it on their product roadmap?
  • Have you integrated other technologies recently; and if so, how was the process? What were some of the challenges that may affect implementing virtual health?
  • Do you already share information electronically with outside providers beyond what is required for meaningful use? To what extent do you share across the continuum of care?
  • How can your current technology platforms scale to support your approach?

There are multiple ways to go about making these technology decisions, and organizations will differ in their preferred method of choice. One option is to work with the current EHR vendor to build upon the existing technology. Another is to partner with the extensive ecosystem of specialized third party vendors. Organizations could partner with a single external vendor to deliver an enterprise solution, or work with multiple external vendors to develop multiple point solutions of virtual health capabilities across the enterprise. Lastly, organizations could even consider creating a customized internal platform – although I’m finding this to be less of a solution of choice these days.

In choosing which model works best for an organization, several components must be taken into account. The maturity, financial health, desired capabilities, current technology infrastructure, and technology support capabilities are all crucial aspects of standing up a virtual health solution. Additionally, the skills and experience of available staff should come into play, as the level of ongoing support, maintenance, and upgrade needs will vary depending on the execution model. Ultimately, an organization must select the execution option that works best for them and provides the highest potential for long-lasting success.

Regardless of which direction an organization goes, there are three key technology considerations that should be prioritized when standing up an enterprise virtual health program:

  1. First and foremost is long-term viability. An organization must have the necessary technological infrastructure required to support current state and allow for future advancements. Even more crucially, they must have stakeholder buy-in – the technology has to align with leadership’s long-term strategy, and to integrate seamlessly into the clinical and operational workflows.
  2. The second key consideration is scalability. The technology solution has to function properly and efficiently at the organization’s desired level of deployment, as well as possess the potential to accommodate future growth without sacrificing performance or disrupting information sharing channels.
  3. Lastly, organizations have to consider interoperability. The technology solution should seamlessly connect to and/or augment existing and future EHR and clinical systems, and enable the high-speed transfer of data between storage sources.

I believe that the technology solution is a key enabler of a successful virtual health program. It is impossible to deliver high-quality, coordinated virtual care without an effective technology enabling it. Organizations looking to implement a new virtual health program need a thoughtful, methodical approach to planning out their technology solution. There is no one-size-fits-all answer – the best technology is that which matches the needs and capacities of the organization with their goals and desired capabilities for virtual health.

Timothy Smith

Timothy Smith - Principal, Deloitte Consulting LLP

Timothy Smith, Principal, Deloitte Consulting LLP, is the national leader for the Healthcare Information Technology (HIT) practice. Tim has been with the firm for over 18 years and has led some of Deloitte’s key health care system implementations, with an emphasis on large scale systems integration and operational redesign projects, and leveraging such packages as Epic Systems, Cerner, Siemens Soarian, and others..

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