Promoting Telemedicine Quality through Outcomes Measurement and Improvement

The rise in adoption of telemedicine has generated an increased focus on the technology, its benefits, its challenges, and its outcomes. We recently wrote about the expansion of telehealth services by CMS for Medicare Advantage plans as just one example of this increased focus.

However, a number of stakeholders continue to be skeptical about the value of telemedicine in terms of its ability to produce clinical and financial outcomes equal to, or better than, face-to-face provider/patient encounters.

To support quality, safety and compliance in the ever-evolving nature of virtual care transactions, CHQI launched in Spring 2018 the CHQI Telemedicine Accreditation Program. The program’s accreditation standards address outcomes by requiring applicants to set outcome benchmarks by service line for three categories: operations, clinical services and patient satisfaction.

Obviously, being accredited by an independent, third-party organization represents a solid first step in addressing concerns regarding telemedicine outcomes. But the need still exists for standards that specifically address best practices in the measurement and management of telemedicine outcomes.

Thus, in Fall 2018, CHQI formed a workgroup tasked with identifying recommended performance indicators and determining how to best establish a formal telemedicine outcomes program.

After meeting for six months, the CHQI Telemedicine Outcomes Workgroup completed a draft of proposed telemedicine outcomes standards. The standards are available for public review and comment from August 7, 2019 through September 7, 2019. Read the press release for more information.

In addition to building on the current Telemedicine Accreditation Standards, the workgroup also incorporated recommendations published by the National Quality Forum in its report, Creating a Framework to Support the Measurement of Telehealth.

When the standards are finalized, applicants will utilize them to apply for CHQI’s Telemedicine Outcomes Supplement, an optional component of the existing Telemedicine Accreditation Program.

The Telemedicine Outcomes Supplement will require applicants to implement a quality assurance program to track performance through a complete measurement cycle. Five categories must be covered:  1) access to care; 2) clinical effectiveness; 3) clinical experience/ satisfaction; 4) financial impact;  and 5) operations. At this juncture, CHQI does not mandate specific measures but makes recommendations under each category.

Once the new telemedicine outcome standards are finalized, CHQI can begin to address the following public policy opportunities:

  • Operationalize recommendations by the National Quality Forum as cited in its report
  • Encourage telemedicine providers to develop, implement and maintain a full outcome measurement cycle beyond the current Telemedicine Accreditation Program standards
  • Require applicants to track, analyze and report on outcomes for the five measurement categories referenced above
  • Provide feedback loops to telemedicine providers and other third parties about what works and what does not work
  • Require telemedicine providers to address deficiencies and make operational improvements
  • Help demonstrate to payers and others the clinical, operational and financial efficacy of successful telemedicine programs
  • Respond to emerging value-based and bundled payment initiatives that rely on performance indicators
  • Encourage public and private payers to become more sophisticated in how they use, and reimburse for, telemedicine services

CHQI is confident that through its new telemedicine outcomes standards, telemedicine programs large and small can begin to efficiently and effectively implement, track, validate and communicate the success of their outcomes measurement programs.

If you would like to learn more about CHQI’s Telemedicine Accreditation Program, please contact us at (410) 756-1300 or info@chqi.com.

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