National Healthcareer Association

In response to COVID-19, policy changes paved the way for a rapid expansion of telehealth. As we reflect on the past year, we can learn from the opportunities and challenges that communications technology has yielded and take steps to prepare for what might come next.

In late January 2020, the first case of coronavirus was confirmed in the United States. Less than a month later, the CDC recommended that healthcare facilities and providers in areas affected by COVID-19 offer clinical services virtually. Following policy changes, telehealth expanded immediately and exponentially with unprecedented growth. There was a 154% increase in telehealth visits during the last week of March 2020, compared with the same period in 2019.

The COVID-19 pandemic has been a launching pad for the accelerated growth of telehealth. Communications technology has been opened up in healthcare like never before, which has created both opportunities and challenges. Here’s an overview of where we’ve been, where we are, and where we are going with telemedicine and other communications technology.

Relaxed regulations that kickstarted the telehealth explosion

In March 2020, the Centers for Medicare & Medicaid Services (CMS) announced temporary relaxation and expansion of telehealth regulations, removing barriers to make telehealth opportunities accessible during the pandemic. These changes included:

Physicians can be paid the same rate for telehealth services as in-person visits

Patients can be home or in any other setting to receive telehealth services

An existing patient-provider relationship does not need to be established to conduct telehealth visits

Cost-sharing for telehealth visits can be waived or reduced

Physicians licensed in one state are allowed to see patients in a different state

“Once those policies and regulations were lifted, patients were able to better access healthcare,” said Chelsea Johnson, MD, FAAP. Dr. Johnson was an advocate of telehealth prior to the pandemic and is currently the Associate Pediatric Lead at K Health: the most downloaded medical app that allows patients to chat with clinicians virtually anywhere.

“We can now interact with our patients so much easier, because we get paid, we can be at the right place at the right time, and because we don't have restrictions on things like waiting for a state license. It's been phenomenal being able to provide that care.”

How telemedicine is being used and who is using it

Nearly half of all patients (46%) say they use telehealth for some visits, compared to just 11% in 2019.

 Virtual visits have slowed slightly since the beginning of the pandemic, but they are here to stay: 83% of patients say they are likely to continue using telemedicine after COVID-19.

COVID-19 is responsible for telehealth’s rapid growth, but most virtual visits are non-COVID related. From January to March of 2020, 93% of telehealth patients sought care for conditions other than COVID-19. These telehealth encounters were mostly for adults ages 18-49, and 63% were female.1 The top three conditions patients sought telemedicine treatment for were:

Beyond patient visits, telehealth is also being used for better provider tools and collaboration. Many are using “store-and-forward” consultation applications, where medical data/images are sent to specialists who review and provide feedback at a later time. Remote monitoring tools that collect data such as weight, blood pressures, and blood sugar levels can be powerful in managing chronic illnesses like heart failure, diabetes, hypertension, and chronic obstructive pulmonary disease.

Other communications technology is being examined and innovated, and the stresses of COVID-19 has accelerated adoption. As demand for services increased due to the coronavirus, hospitals have turned to technology to help alleviate pressure on an already strained system.

“What COVID really revealed to us is that we’ve all got to get our acts together and get organized around our [mobile] strategy, 

because people die when we don’t get things to the right people at the right time,

” said Kourtney Govro, Managing Director of KDG Innovations. Govro has 20 years of experience partnering with hospitals to design mobile strategies and has seen technology in healthcare settings evolve.

By 2022, 97% of nurses will use mobile devices at the bedside. Hospitals that have embraced mobile technology cite improvements including reduced cost of patient care and improved quality of patient care.

 When healthcare workers have the ability to be more efficient communicators, they can more effectively work with patients and other care providers.

“There are certain things you have to do on your computer because of the way you have to enter information, but a lot of this information is going to be faster on your smartphone. And for allied health professionals, it's huge. Imagine if your pharmacy technician, or whomever, is assigned to a group of units. They may be assigned to the whole hospital and need to get information to the right space. Those kinds of communication pieces right now are super fragmented,” Govro said.

The drive toward patient-centered, collaborative care promises improved patient outcomes, but technology needs to keep up to be most effective at not only promoting team-based care, but also in addressing clinical healthcare worker burnout — which Govro says is the number one problem for 2021. “We need to be more collaborative to reduce workload. And we look at everything as workload,” she said. “From the physical act of entering a patient’s information into their electronic file to the emotional decision of which patient gets your attention at that moment in time… it’s all work, and it can feel like a heavy load.”

It’s been over a year since the world of telehealth was opened up in response to COVID-19. What have we learned in that time?

, and a big reason for that is because of all the benefits it has yielded, including:

91% of patients agree that telemedicine would help with appointment and prescription adherence.

Virtual visits have allowed for on-demand healthcare access and allowed patients to connect with providers who might otherwise be out of reach.

Out of 1,000 telehealth patients surveyed, over 75% were very or completely satisfied with their virtual care experiences.

Pre-screening patients for possible infectious disease can reduce exposure and prevent sick people from having to come to a healthcare office.

Telehealth can reduce overhead costs in the form of fewer exam rooms and less need for office support. Additionally, it creates the ability to see more patients, which can increase revenue.

 Telehealth allows greater flexibility for both patients and providers. This can be especially impactful for those who are not mobile or for parents who stay home with children and have difficulty making it to appointments.

The rise of telehealth has improved healthcare access and connected clinicians and patients in new ways, but there are some growing pains to overcome (as one would expect with a sudden and drastic shift). Some of these challenges include:

Limited access to adequate broadband services in rural areas

Reimbursement issues (fee for service model)

Limitations when certain examinations must be conducted in-person

Telehealth cannot completely replace in-person care, but it can provide care for both acute and chronic illnesses when a face-to-face visit isn’t necessary. Some challenges are policy-related, such as reimbursement, and many leaders in the healthcare space are optimistic that things are headed in the right direction.

“We are waiting to see how much we'll return to pre-pandemic restrictions and how much of it's going to continue to be as it were now, and hopefully change and improve access,” said Dr. Johnson.

Policymakers are currently introducing bills that would expand broadband access nationwide, which would remove a big barrier for rural patients. It’s likely that this is one of many developments that could impact telehealth in a big way.

Further advancements and changes to anticipate in the future

Time will tell what the permanent impacts of COVID-19 will be to healthcare technology. As we look to the future, some predicted advancements include:

Expanded use of remote patient monitoring

More focus on value-based care models of reimbursement

Easier sharing of patient records (among providers)

Increased use of smartphones for communication and monitoring

Using AI to drive efficiencies, particularly as clinical decision support6

More direct-to-consumer healthcare companies that challenge traditional healthcare models

Technology has come to the top of healthcare leaders’ priority list. Prior to the pandemic, a survey from the Center for Connected Medicine (CCM) revealed that just 26% of healthcare executives said that the shift to telehealth and virtual care was a top innovation priority … a number which has now jumped to 49%.

 In the same survey, those who implemented quick, short-term solutions said they are looking forward to improving integration, infrastructure, and security for an updated telehealth strategy.

“I'm really looking forward to some of these changes, but it's going to take innovators and disruptors and people looking at the problem differently to impart new, creative solutions to way our healthcare system is,” Dr. Johnson said. “It will happen. It may not be this year, but more and more change is taking place in the right direction.”

How current and future healthcare professionals can prepare

In healthcare, as in any industry, advancement is one of the only constants. Although the lift of restrictions that enabled telemedicine to explode were temporary, it’s likely that telehealth is here to stay. Healthcare-related organizations and advocacy groups are pleading with Congressional leaders to make permanent changes, and current and future healthcare professionals should prepare themselves.

Healthcare educators are already incorporating telehealth training in their curriculum. In addition to being comfortable with technology, there’s a need for healthcare workers to learn good “web-side manner.” With virtual visits, some nonverbal communication is lost, and effective communication skills are needed to establish and maintain a strong patient-provider relationship. In the case of chat-based visits, such as those on the K Health app, it can be especially nuanced. Dr. Johnson said that you can impart empathy, even through chat, but that training is essential because it doesn’t come naturally.

Training solutions that help address this need are already available and are being used by healthcare educators and employers. Kognito, a company that is part of the Ascend Learning family, is a health simulation company that has incorporated telehealth visits into many of its simulated training solutions to better prepare clinicians for today’s healthcare environment. They also developed a “pre-visit checklist” to help providers better prepare for virtual visits.

“Our simulations do teach you what to say, but unlike most other training you’ll find, they also teach you how to say it,” said Gurnek Singh, Head of Product, Healthcare, Kognito. 

“It’s difficult to anticipate how you might come across the first few times, and you want to make sure that you’re overcoming some of the barriers of the technology to continue to deliver a strong, empathic, and caring type of provider visit.”

The adoption of telehealth and technology has been a silver lining of the pandemic. As we move to a new blend of virtual and in-person care, the future is unknown. But one thing is certain: the way people receive and prefer to receive care has changed. While in-person visits won’t vanish, it’s likely that the telehealth momentum the pandemic created will change the healthcare landscape for good.

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 Koonin LM, Hoots B, Tsang CA, et al. Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic — United States, January–March 2020. MMWR Morb Mortal Wkly Rep 2020;69:1595–1599. DOI: 

 McKinsey COVID-19 Consumer Survey, April 27, 2020

Telemedicine Adoption in the Age of COVID-19 and Beyond.

 https://cdn2.hubspot.net/hubfs/3053445/Doctor_Telemedicine_Survey_Infografic.pdf

 Zebra. (2017). The Future of Healthcare: 2022 Hospital Vision Study. https://www.zebra.com/content/dam/zebra_new_ia/en-us/solutions-verticals/vertical-solutions/healthcare/white-paper/2022-hospital-vision-study-en-global.pdf

https://www.kyruus.com/patient-perspectives-on-virtual-care-report-2020

 Center for Connected Medicine & KLAS Research. (2021). 

Top of Mind for Top Health Systems: Digital health priorities in the era of COVID-

Articles

There was a 154% increase in telehealth visits during the last week of March 2020, compared with the same period in 2019.

Surviving to Thriving: How the COVID-19 Pandemic Expanded Telehealth 

In this episode of OnScript, Jeremy and Jessica have 

Pharmacy Times Continuing Education™ (PTce)

, as a guest to discuss continuing education and advanced training offerings for pharmacy technicians and what they have on the horizon for 2021.

Keeping pharmacy’s efforts in combating COVID-19 top of mind, PTce has developed a certificate program for pharmacy technicians and pharmacists to meet the CDC’s provider training recommendations for providing the COVID-19 vaccine.

As a bonus, PTce has extended a discount to OnScript listeners, allowing them to access all 10 accredited webinars (10 total credits) for just $75. Just use code 

. Once completed, a certificate of completion will be provided. 

In addition to this great training resource, PTce continues to offer, at no charge, 

 and pharmacists… you don’t want to miss this episode!

Click here for the full episode of OnScript by the National Healthcareer Association.

Podcasts

An overview of continuing education and advanced training offerings for pharmacy technicians and what is on the horizon for 2021.

Spotlight on Continuing Education for Pharmacy Technicians

Good communication is perhaps more important in healthcare than in any other field. Quality care only happens when providers, clinicians and pharmacies all communicate clearly and effectively with the patient, with other healthcare providers and, most importantly, within their own teams.

When communication breaks down, it can cause serious patient safety issues: a study of ten years’ worth of medical errors found that 66% of those errors were caused by 

. Pharmacy teams are no exception; as the bridge between the pharmacist and the patient, it’s especially important for pharmacy technicians to develop good communication skills.

Let’s take a look at how communication plays an important role in a pharmacy technician’s essential duties.

As the bridge between the pharmacy, the provider, and the patient, it’s essential for pharmacy technicians to develop and maintain good relationships with everyone involved in a patient’s care.

Providers prefer to work with a pharmacy they can trust to provide a good patient experience (more on that later). If a provider thinks a pharmacy is making it difficult for their patient to get the proper care, they’ll think twice about sending anyone else there. 

 play a key role in shaping the patient’s experience, which is why their communication skills need to be top-notch.

Communication is also a vital part of building good relationships between members of the pharmacy team. Pharmacy technicians are the glue that holds the team together, and they need to know how to communicate with other technicians, pharmacy staff, and pharmacists.

Pharmacy technicians often have to give instructions or delegate tasks to others, and that requires good communication skills. Other team members should clearly understand what they’re being asked to do; more importantly, they should understand why they’re doing it. Knowing what to say is only half the battle — the other half is knowing 

Person A may just want the facts: what needs to be done and when. Person B, on the other hand, may need more information: what needs to be done, why it’s important, what happens if it’s not done, and so on. Good communication skills help pharmacy technicians identify what resonates best with each person, as well as how to tailor the message to ensure it is properly received.

 found that customer service was the second most important factor for patients when choosing a pharmacy. Being friendly is one aspect of good customer service, but it’s far from the only one. Helping patients understand copays, answering medication or dosage questions, letting patients know their options if their insurer denies coverage -- all of these factor into how patients view their pharmacy experience.

Just like with team communication, good patient communication also depends on pharmacy technicians’ ability to identify and adapt to the communication style that is most comfortable for the patient.

Nonverbal communication skills are important for patient satisfaction as well. For example, maybe a patient has questions about their new medication, but there’s a line and they don’t want to make others wait. Nonverbal communication skills will help the technician pick up on the patient’s discomfort, and they can then apply their verbal communication skills to help address the patient’s needs.

Additionally, as more and more community members line up for COVID-19 vaccines at their neighborhood pharmacy, the need for solid soft skills becomes even more crucial for pharmacy technicians to avoid conflict, poor reviews and patient frustration.

As more and more community members line up for COVID-19 vaccines at their neighborhood pharmacy, the need for solid soft skills becomes even more crucial for pharmacy technicians to avoid conflict, poor reviews and patient frustration.

Thirty years ago, most pharmacy patients had one doctor who prescribed all their medication. But patient needs have become more complex since then, and, as a result, patients are more likely to have different specialists for different needs. Good communication skills are indispensable when it comes to navigating the various members of a patient’s care team.

If one specialist prescribes a medication that could interact negatively with a medication prescribed by another specialist, 

the pharmacy technician is one of the last lines of defense protecting the patient from an adverse interaction

. But without communication skills, they may not know how to address it with the pharmacist, the providers, or even the patient.

By the same token, pharmacy technicians are often the last people to verify an order before it’s given to the patient. If the pharmacist or another tech has made an error, the pharmacy tech needs to be comfortable communicating their concerns or addressing the error appropriately.

While learning on the job is a valid way to gain experience in soft skills, sometimes, a challenging patient-technician interaction can wreak havoc. Yes, the technician has learned a lesson of some sort, but at expensive price. Fortunately, NHA’s virtual simulation learning resource, 

PersonAbility™, has recently been made available for pharmacy technicians

, walking learners through real-life scenarios in a virtual pharmacy setting.

For pharmacy education programs and pharmacy employers, NHA’s interactive, all-in-one learning and assessment tool can equip current and aspiring technicians to handle those typical, day-to-day interactions with ease.

According to employers, the most important soft skills in a healthcare professional are critical thinking, professionalism and communication.

PersonAbility™ for Pharmacy Technicians

PersonAbility™ meets the need for a soft skills certification/training solution

 that effectively helps clinicians improve in key areas such as communication, empathy, and professionalism. These soft skills can help drive career growth, strengthen care teams, and improve the patient experience.

In PersonAbility™, you’ll find interactive lessons where pharmacy technicians can hone their skills in a variety of different areas, including:

Appropriate communication techniques for patients, coworkers, and providers

Effective communication with different patient populations

Pharmacy technicians learn the importance of effective communication and ways to improve communication before putting those skills to work with interactive practice examples.

A pharmacy is only as good as the team supporting it, and pharmacy technicians play a significant role in team performance. With practice and interactive training modules from PersonAbility™, pharmacy technicians can improve their communication skills to improve performance and become an even more valuable part of the pharmacy team.

Effective Communication is Vital for Pharmacy Technicians

Success in the pharmacy profession requires more than scientific achievement and technical ability.

Although pharmacy education has historically concentrated on scientific knowledge, pharmacists and other pharmacy personnel must display essential soft skills.

 In a health care environment that is increasingly focused on patient-centered care, pharmacies that excel in adaptability, communication, empathy, and teamwork have the potential to achieve better operational and patient outcomes, decrease errors, and improve relationships with coworkers, patients, and providers. Continuing education and training opportunities can improve these soft skills, which can in turn advance a care provider’s career as a pharmacist or pharmacy technician (tech) and improve the overall practice.

It is important for pharmacists and pharmacy team members, such as techs, to hone their communication skills, as the interactions they have every day can affect the patient experience and outcomes. This includes communication with not only patients but also colleagues and providers.

Patient-provider conversations are powerful, and if done effectively they can improve patients’ use of medications and ensure optimal therapeutic outcomes.

 Through patient counseling and education, pharmacists can improve adherence,

 but it is important to understand that the relationship is collaborative. Tactics such as motivational interviewing can help pharmacy professionals gather the patient information they need to provide better drug therapy and help individuals achieve their health goals.

To gain a better understanding of a patient’s background and care, it is also vital that the health care professionals who prescribe medications and therapies and the pharmacy team are having meaningful communications. Research shows that effective pharmacist-provider communication can prevent medical errors, promote patient safety, and reduce costs.

 Unfortunately, many pharmacists have admitted they lack confidence in communicating with physicians and other health care providers,

 and the results of a recent survey showed that only one-fourth of primary care physicians had much personal contact with pharmacists.

 Written communication is most common, but the phone and, when possible, face-to-face interactions can provide better opportunities for collaboration.

The interactions that happen most frequently in a pharmacy are among pharmacy team members, such as interns, pharmacists, and techs. In an environment that encourages open communication, individuals can report errors without fear and present ideas to improve efficiencies and processes.

Having empathy or understanding a patient’s concerns and perspective is essential to providing quality care. Clinical empathy allows pharmacy professionals to converse with patients about their feelings and thoughts concerning their medication(s) and helps them understand key prescription information about insurance and payment. This can help identify ongoing pharmaceutical problems and help patients get the most from their treatment and overall experience.

 Acknowledging concerns, active listening, and establishing a shared understanding demonstrate empathy, and pharmacy professionals can learn these skills.

Empathy becomes especially important to improving care regarding patients with behavioral disorders, such as addiction and mental illness. Research shows that pharmacists are very knowledgeable about mental illness and management options, but there are also high levels of stigma in the profession, including a desire to socially distance and discomfort when treating patients with mental illness.

 By improving their empathy skills, pharmacy professionals can help create a comfortable environment and provide improved care to all patients. Seeing, understanding, and treating those with behavioral disorders help pharmacy professionals realize how much their counsel and prescription means to patients.

Advances in regulation, education, and training; innovative models of care; and new technology have created a new scope of practice in the pharmacy. As pharmacies expand their offerings, the roles of pharmacists and techs are also growing. Consider that for techs, 90% of employers now encourage or require certification, and 40% report that techs have more responsibility this year compared with last,

 demonstrating the need for advanced skills. Additionally, the results of a survey of pharmacy employers showed that techs’ “ability to adapt to practice change” was the third-most-important factor in making hiring decisions, just below training and emotional intelligence.

Adaptability and change have been in pharmacy professionals’ DNA since perhaps the beginning of the practice. In a professional pharmacy publication dating back to 1888, author John Humphrey discussed the importance of adaptability

“There must exist a willingness to change whenever due cause is shown. Our minds must remain plastic…we see around us, both near at hand and far off, evidence of the increasing determination of pharmacists to unceasingly endeavor to adapt themselves to circumstances, much as these may change.” 

Change is constant, especially in the world of pharmacy, and to elevate a pharmacy career, techs must be willing to adapt, grow, and learn as the practice evolves.

Pharmacists and techs work in close quarters and often busy conditions. They are also in communication with providers. Although each professional plays an essential role, working together as a cohesive team is important and can yield the best results.

Teamwork requires mutual respect and trust, from the bottom up and the top down. It also requires that everyone be on the same page, with every team member willing to pitch in when needed. Failing to do so can potentially reduce morale. For example, if a tech is working hard and sees a pharmacist not pulling his or her weight, the tech may be likely to slow down and could even take out their frustration on customers. Likewise, pharmacists may be less likely to entrust advanced tasks to techs who underperform.

Members of high-functioning teams collaborate, feel safe asking questions, trust each member, and are willing to support one another. It is an age-old rule, but it holds true: We can achieve more together than we can on our own. 

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Clinical knowledge is essential, but soft skills are also critical in patient-centered care.