New NQF report considers how to evaluate telehealth initiatives
A report from the National Quality Forum has been published. The report, commissioned by the Department of Health and Human Services, was designed to create a framework for telehealth adoption. The NQF examined 68 telehealth studies to establish an efficacy measurement framework, studying access to care; patient, provider and community experiences; the cost and financial impact of telehealth; and on the efficacy of telehealth services, including technical, operational and clinical factors. The telehealth services include live video, store and forward sessions, remote monitoring and the use of healthcare apps. The assessment of telehealth’s efficacy must consider how the technology could improve the need for travel, the speed of care and the provision of useful caregiver data. It also requires the assessment of patient empowerment, the coordination of care, and the improvement of personalized medical treatment.

Increased investment in telehealth for providers, employers, and payers has become a reality, a forward momentum that is unlikely to be turned around. But even as adoption ticks up and state and national legislatures open the doors for more telehealth use and reimbursement, recent studies have shown mixed results about the efficacy of the technology.

About a year ago, in an effort to standardize the conversation around telemedicine efficacy, the Department of Health and Human Services commissioned the National Quality Forum to create a framework for telehealth measures. Now, after receiving and incorporating public comments, that framework has been published.

"The US Department of Health and Human Services (HHS) initiated this project, explicitly for the National Quality Forum (NQF) to convene a multistakeholder committee to recommend various methods to measure the use of telehealth as a means of providing care," NQF writes in the report. "The Committee was charged with developing a measurement framework that identifies measures and measure concepts and serves as a conceptual foundation for new measures, where needed, to assess the quality of care provided using telehealth modalities."

NQF looked at 68 existing telehealth studies to break down the different measurement possibilities. The resulting document covers live video telehealth, store and forward, remote monitoring, and health apps. It breaks measures down into four broad domains: access to care; cost and financial impacts; patient, provider, and community experience; and effectiveness, including clinical, operational, and technical effectiveness.

An assessment of telehealth should look at how the technology impacts the need for travel, how it affects the timeliness of care, and what actionable information it creates for caregivers. Other factors to consider include the impact on patient empowerment, care coordination, and the ability of remote monitoring to enhance personalized medicine efforts.

The 81-page report includes more details on the proposed measures, a series of case studies exemplifying the measures, and a discussion of how these measures interact with MACRA and with other NQF projects.