Virtual Waiting Rooms and Telehealth Workflow – Telehealth Features Series

In this Telehealth Feature Series, we’re going to cover the long list of potential telehealth features available today.  As you’re considering your own approach to telehealth, we will provide you a look at all the possible features telehealth companies are offering on the market.  Plus, we’ll offer our insight into the nuances of each feature so you can select the right telehealth company or companies you use.  Not all telehealth is created equal, so taking the time to understand all the possible features and options is worth the effort.

The next feature we’re going to cover is Virtual Waiting Room and Telehealth Workflow.

Of all the features I’ve covered in this series, this is probably the hardest one.  The reason this one is so difficult is largely because I don’t think we know yet what the ideal telehealth workflow should be.  Should their be a waiting room?  What should the waiting room include?  Does the workflow need to include the front desk and nurse or can they go straight to the doctor?  What about when the doctor is complete?  Can the nurse “go back in” after the doctor?

Telehealth Workflow

Honestly, the explosion of telehealth has asked a lot of questions of healthcare and what is needed for a successful patient visit.  What we’re also finding is that every organization is going to approach this a little bit different.  Let me give you a few examples.

The first example is an urgent care clinic vs a traditional practice with appointments.  It’s obvious to see how those two workflows are going to be quite different.  In the urgent care clinic, the patients are put in a virtual line and the clinician takes the next available patient.  There’s no true appointment with the patient and they’re not assigned to a clinician.  This workflow is very different than a patient who’s on a specific clinician’s schedule and the clinician just works down the schedule of appointments.

Let’s use another example of a clinic that wants the nurse or MA to do the initial workup for the visit before the doctor joins the visit.  How does the telehealth vendor handle this?  Does the patient get put in a virtual “room” once the MA starts the session and then the clinician can join later once the MA and nurse are done?  Or does the patient get pushed back to a kind of lobby “waiting room” while they wait for the clinician to join?  How does the MA or nurse communicate that they’re done since they no longer have the flags on the virtual “room”?

You can see how this workflow can get complex really quick.  Not to mention the need for various staff to communicate with each other and to be able to do so virtually.  Plus, there is a lot to think about when it comes to creating a great patient experience.  In a virtual waiting room or virtual exam room, the patient can’t just ask the front desk or step out into the hall to ask the nurse why the wait is so long.  If the wait is too long and clear communication with the patient isn’t done, then you can easily see patients dropping off the telehealth visit.

This can be made even more complex if the workflow is waiting room -> nurse -> doctor -> nurse -> doctor -> nurse -> billing.  What’s crazy is that this workflow is common for an in-person visit.  It’s less common for virtual visits, but you can see how this would be a challenge to do virtually.

The reality is that most healthcare organizations have just simplified their telehealth visits to avoid these complexities since most telehealth companies haven’t built a sophisticated workflow engine to manage various telehealth workflows.  Many practices have even removed the front desk, nurse, and MA from the process completely and just had the doctor see the patient directly.  Is this the best way to practice telehealth?  If it is, then what was the purpose of the nurse and MA intake and should we reevaluate that in person as well?  Could we replace that intake with a virtual questionnaire?

I’m not sure we fully have the answers to these questions yet, but we’re going to find out.  My best guess tells me that the nurse and MA intake is valuable and needs to come back to make clinicians more efficient in their visit, but we’ll see if that’s true.  Maybe this can be done virtually and the patient can go to the doctor directly.

Looking at this more broadly, will a telehealth workflow engine that can handle all of the above scenarios and more be a requirement of telehealth companies in the future?  I think it probably will unless you’re focused on a very specific niche.

Virtual Waiting Rooms

Changing gears back to the waiting room, that’s ready to go through a full evolution as well.  While there seems to be some anecdotal evidence that patients are waiting less for telehealth visits than they were/are for in-person visits (which begs lots of other questions, but I digress), the nature of patient visits is that there’s going to still be some waiting by patients.  What should that waiting look like?

There are two ways to look at the virtual waiting room.  First, is from an entertainment perspective.  There’s a reason why there are TVs and magazines (or at least there were) in waiting rooms and exam rooms.  That investment by healthcare organizations helped patients pass the time while they wait.  Are we going to see a whole series of “entertainment” offered to patients in the virtual telehealth waiting rooms?  Is this an opportunity for those education/entertainment companies to fill this space of course backed by pharma advertising?  Or is this something that doesn’t matter as much and isn’t as valuable since patients are waiting in their own home where they have access to their own preferred entertainment?  Plus, we all know that cell phones have made this less important for years.

The second piece of the virtual waiting room is informing the patient of how long they have to wait.  Some might argue that there’s more art than science to this.  The reality is that over time, a telehealth vendor could turn this into a science that could take into account data from all their providers, but also be specifically customized to a clinician and how long they take with patients based on appointment type and other data.

While it’s scary for a telehealth provider to predict the wait time for a patient, it is worse for that patient to drop off the line right before the doctor arrives.  For those not brave enough to create an approximate wait time for the patient, another model is to share where the patient is in line.  Are they the next patient to be seen?  Are there 3 patients in front of them?  Even small indications like this can make a big difference for a patient as they wait.

On the other side, I’ll be interested to see if telehealth vendors start building in subtle queues for clinicians to be able to know how long the patient has been waiting.  As the doctor joins the telehealth visit, it would be valuable to share how long the patient has been waiting for the visit and how long after the visit time it has been.  That could give the doctor the chance to sincerely apologize for the wait if needed.  Plus, it has the added benefit of informing the doctor on how far behind they are on the schedule.

Unfortunately, many of these workflow and virtual waiting room features haven’t been built yet.  Now that telehealth has blown up, I think we’ll start to see them really evolve as companies invest in really fleshing out their telehealth offerings.  Have you seen a telehealth vendor that has executed the waiting room and patient workflow well?  I’d love to hear who is excelling at this in the comments.  So far everything I’ve seen is quite basic.

Be sure to check out our full list of telehealth features, our deep dive into each telehealth feature, and our list of telehealth companies.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

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