EP357: Standing Up Telehealth That Actually Advances Providers’ Core Business, With Liliana Petrova

Here’s the biggest problem with a lot of telehealth endeavors: Someone decides that they need to be doing telehealth, for whatever reason. Maybe there’s a pandemic, for example. And the basic plan is this: Install some technology, give everyone a username and password and a link for patients, check that box, and move on to the next thing.

My guest in this healthcare podcast, Liliana Petrova, has seen and talked about how, far too many times, the whole concept of telehealth is narrowed down to the exact moment where a patient and a doctor have a visit together. That’s it … that transaction.

There’s little effort, if any effort, made to integrate telehealth into the existing clinical workflow, into the existing patient/customer experience, into the core business, into anything longitudinal. Telehealth becomes a weird island of a service only used by intrepid clinicians willing to put in the time and effort required to deal with its vagaries and inconveniences. Only used also by patients who manage to find the telehealth link buried on some Web site somewhere and then figure out how to schedule their telehealth appointments within a scheduling system mostly unable to accommodate virtual visits without a party-sized amount of technical expertise and, probably, chutzpah.

There are consequences to this narrow and pretty slapdash thinking. One of them is that you have very few clinicians and patients willing to brave the organization’s telehealth experience or lack thereof, so they don’t use it. And then at some point the organization does a survey of how much telehealth is going on—and wow! Surprising news: Incredibly few are using telehealth. So, the conclusion is drawn that patients and/or clinicians don’t want telehealth. What happens then? Further funding is withdrawn and/or the whole telehealth thing goes down on the chopping block.

It reminds me of a cartoon I saw the other day. It was a picture of a bar chart showing some survey results. One of the bars in the bar chart was huge, and then the other one was, like, zero. It was a poll. There were two questions in the poll. Here are the two questions: Do you respond to polls, or don’t you respond to polls? And as per the poll results in the bar chart in the cartoon, turns out, 100% of people respond to polls.

Funny but, at the same time, true. Many organizations don’t really think through the provenance of the “data” they’re using to make really important decisions, and when it comes to telehealth, there’s a lot of dirty data flying around.

This dirty data, though, might be one explanation for the delta between the conclusions of all those studies showing that three out of four patients, always a comfortable majority of patients, intend to use telehealth versus the many health systems and/or provider organizations or even some doctors themselves sniffing and turning up their noses and saying that none of their patients are interested in using telehealth because no one is using telehealth in their office.

Right. The only thing that’s being anecdotally determined by these anecdotal conclusions is that patients don’t like and/or even know about that office’s telehealth solution. It says nothing of the larger trend.

When organizations make decisions to not do telehealth well or at all because they didn’t do it well and no one could figure out how to use it, then the value that telehealth could bring to both patients and clinicians is forfeit. Sad. Also, considering the X on the backs of some specialists and health systems in general these days, this could have longer-term consequences. Some good clinicians could find themselves way behind the curve after making what amounts to a very poor strategic decision.

In this episode, I am speaking with Liliana Petrova, CEO of The Petrova Experience. Liliana is an expert on customer and patient experience. She hails originally from the aviation industry, where she was director of customer experience at JetBlue, where she built and maintained customer centricity across organizations.

Today we’re talking about telehealth. Last time Liliana was on the show (EP236), we talked about customer centricity—so go back and listen to that one if you’re interested. In that show, we talked about, as one aspect, lobby design—the impact of having front desk people and clinicians literally barricaded behind cement and glass like they work in some bodega in a bad part of town that gets held up every other day. I never really thought about that and the message that it sends before.  

Liliana served this past year on the NODE patient committee and did a whole lot of work exploring telehealth and its potential and challenges. NODE stands for the Network of Digital Evidence. 

In this show, we go through the essentials to pull off a telehealth program that is actually going to deliver returns. In short, here’s the ingredients:

1. A telehealth “board” comprised of all the cross-disciplinary folks needed to pull this off: clinicians, IT, and also administrative peeps for a few very critical reasons that we talk about. Having executives on this board with enough power in the organization to define long-term goals that supersede all the short-term ones that usually define and plague organizations, especially public ones, is also very essential here.

2. Redefining IT and the role of IT. This is an interesting one. Liliana talks about how the legacy role of IT is changing. IT leaders can no longer just be the help desk or maintainer of computers or manager of outsource contracts for the place far away that you call when you can’t get on the portal. Today’s IT teams need to think like they’re a vital part of supporting the needs of patients and clinicians. After all, you can’t have technology-augmented care when the IT group is shacked up in the basement doing their own thing.

3. Identifying a physician ambassador for the telehealth internally (the telehealth program).

4. Getting patient feedback. I was shocked, literally shocked, to discover that some of the most vocally “patient-centric” health systems do not collect patient feedback systemically. WTH, really? Liliana gets granular here.

5. What might be the silver bullet? Patient navigation. We talk about this at some length.

6. Map the end-to-end patient visit.

7. Continuous improvement—you’re never done.

Also, March 8, 2022, is International Women’s Day, by the way. This episode honors women in healthcare doing great things.

You can learn more at thepetrovaexperience.com or join the patient NODE group by emailing Liliana at liliana@thepetrovaexperience.com.

Liliana Petrova, CCXP, is a visionary and a proven leader in the field of customer experience and innovation. She pioneered a new customer-centric culture, energizing the more than 15,000 JetBlue employees with her vision. She has been recognized for her JFK Lobby redesign and facial recognition program with awards from Future Travel Experience and Popular Science.

Liliana is committed to creating seamless, successful experiences for customers and delivering greater value for brands. In 2019, she founded an international customer experience consulting firm that helps brands improve their customer experience. The Petrova Experience focuses on three pillars of customer experience: organizational culture that inspires employees to be brand ambassadors, design and implementation of customer centric journeys, and technology implementations with customer experience value in mind.

06:59 Who should be on the telehealth board to incorporate telehealth successfully?
08:44 What is the population that you’re serving, and how does telehealth serve that population?
09:45 “When they think of this as a project versus a program or a strategic imperative, then there is no business case.”
11:49 “How do you integrate telehealth in your core business?”
12:32 What does a CIO need to do to be best equipped to serve their organization?
14:05 Why are CIOs and CFOs naturally in conflict these days?
15:30 Why is it important to have a physician be an ambassador for telehealth implementation?
17:05 Why is it important to utilize patient feedback properly?
18:37 Why must the patient own their own health?
20:29 “The key is, if you start at the strategic level with cross-functional leaders, then the working team will also be cross-functional.”
21:49 “You won’t have a successful telehealth experience if you don’t think through the end-to-end experience.”
21:55 EP332 with Tony DiGioia, MD.
23:40 Who is the digital navigator in implementing telehealth?
24:55 What is a digital navigator, and how does it show up in the telehealth journey?
30:55 Why is it important to have continuous growth in telehealth?

You can learn more at thepetrovaexperience.com or join the patient NODE group by emailing Liliana at liliana@thepetrovaexperience.com.