Over the past decade, telehealth has transformed from a fledgling tool into a comprehensive solution that enables healthcare systems to connect to their patients without limitations of geography or time. The majority of healthcare organizations have launched or are actively exploring how telehealth technology can solve ubiquitous pain points including physician shortages, unequitable access to care, payment reform, chronic disease management and increasing consumer demand for convenient, cost effective care. However, the path to a unified, system-level telehealth approach, as well as an easy trajectory towards a return on investment, is not always clear and varies considerably across markets.

 Reimbursement and policy

One of the main determinants of telehealth adoption is the national and local reimbursement landscape. While reimbursement has improved dramatically over the past 3 years, gaps in coverage have traditionally presented a substantial financial hurdle for most health systems. Without proper coverage and reimbursement, organizations are hesitant to invest in the technology.

That being said, recent US legislation expanding reimbursement from Medicare, Medicaid, and private payers has provided a significant incentive to make the leap from traditional in-person care to virtual services. Medicaid reimbursement has soared of the past 2 years with every state offering some type of Medicaid reimbursement for telehealth. Many states have waived geographic limitations for reimbursement thus allowing sites like the patient’s home or schools to be considered eligible originating sites of telehealth services. In addition, 32 states plus D.C. have enacted parity laws for private insurers requiring these payers to reimburse telehealth services at the same rate as in-person care.

 Organizational culture and structure

In addition to properly aligned financial incentives, a health system’s culture and organizational structure is a key factor in ensuring the development of a successful and sustainable telehealth program. Many organizations start small and pilot a telehealth program in a single service line or only for a specific patient cohort. While this approach is typically successful in the short-term, it can lead to a siloed telehealth approach with multiple workflows and consumer-grade video communications spanning multiple areas of the organization. This often results in user experience issues associated with disconnected workflows, hampering utilization and adoption.

Progressive organizations are skilled at consolidating early, individual telehealth efforts into a single internal department enabling the integration, coordination and expansion of a unified telehealth vision across the broader health system. A key success factor is the investment in a telehealth solution that provides a vendor agnostic, integration framework that allows expansion of telehealth strategies by pulling together applications across multiple devices and enabling telehealth use cases from any location.

 An integrated solution

We’re excited to announce the release of Extended Care – a virtual video integration platform that enables scheduled consultations supporting provider to patient or provider to provider workflows and can also enable non-scheduled, on-demand video visits. This vendor-agnostic solution enables video integration with any relevant workflow offered by a third party solution thus offering endless opportunities to extend and expand quality care.

Cisco Extended Care leverages API frameworks and Dynamic Link capabilities to receive scheduled appointment data from the EMR or portal application’s telehealth workflow and then uses that to launch the virtual video experience. With capabilities like a native virtual waiting room, flexible redirect options for video endpoints, and running EMR client applications in a virtual desktop environment, Extended Care offers a natural and scalable experience for both patients and providers.

Stay tuned for two more installments in our Extending Care blog series, which focuses on telehealth, and learn more about Cisco Extended Care at cs.co/extendedcare.


Allison Heddon

Global Strategy Lead, Healthcare & Lifesciences

Digital Transformation Group