The term telehealth refers to using information and communications technologies to deliver health services and transmit health information over long and short distances. Telehealth is revolutionary because it moves voice, data, images and information between consumers and clinicians instead of requiring consumers to travel to a clinician’s workplace. Depending on the ailment, diagnosis, education and treatment can all be provided using telehealth. When we think about telehealth we might think about video-conferencing between hospitals to allow a city-based specialist to guide local doctors in performing emergency operations, using very high resolution, large screen telepresence. However, telehealth also includes ordinary interactions using familiar technologies. For example, talking to your GP on your mobile phone is a form of telehealth.
Telehealth is important because it can make access to health services possible for people living in remote places or who have limited mobility. It is also claimed to support earlier identification and preventative action for health issues, to cost less and be more convenient. Telehealth is proven and valued in Australia’s rural and remote locations, but barriers have prevented large scale adoption in urban medical practices.
Before COVID-19 barriers to widespread telehealth adoption in Australian towns and cities included health policy and regulations, cultural and social influences and economic conditions (lack of financial incentives and inappropriate reimbursement). These were strong disincentives. Most Australian health care delivery in 2019 followed a model familiar to our grandparents; travel to a special location, wait in a specially designated area and then have a face to face discussion with a clinician.
The COVID-19 pandemic produced strong motivation for adoption and adaptation of all innovations that minimised face to face contact, especially given fears that incremental increases in virus exposure contributed to the deaths of nurses and doctors. Patients and healthcare providers were highly motivated to minimise face to face contact to stop the virus spreading. This contributed to the Australian Government expanding the type of telehealth consultations eligible for reimbursement through Medicare. From March 13, 274 new Medicare Benefits Schedule item numbers were created and publicised, contributing to 700,000 telehealth consultations occurring per week.
Innovation theory tells us that innovations frequently require adaptation to the context in which they are used. Adaptation of telehealth in times of COVID-19 can be seen to have produced hybrid, low tech models, not dependent upon specialised hardware or software. A GP consultation performed half by phone with the patient sitting in their car outside suburban surgery and half face to face is a practical and effective way of using telehealth to minimise the risk of virus transmission.
Lewin’s foundational model, originating in the 1940s, conceptualised the process of change as starting with an event to “unfreeze” the status quo in an organisation or society. This model is still relevant to change management efforts today. Generally, the event to unfreeze habitual routines is framed in terms of business competition or environmental threats. However few things communicate an urgent need to change like the threat of death.
The “unfreezing event” of COVID-19 has provided the opportunity and motivation for people to rapidly trial ways of conducting business that were previously viewed as too risky, expensive or just not acceptable to staff or clients. Healthcare is not the only industry to have proven this under pandemic conditions. In relation to Australian’s uptake of digital payments in the last few months the chief executive of one of Australia’s largest banks has said, “Permanent change, in my mind, has just been made in 10 weeks … [that] … would have taken us another five years”.
Heifetz, Linsky and Grashow, strongly advise “diagnosing” the type of problem you face to understand and prepare for the demands it will place upon the people tasked with solving it. Is it an “adaptive challenge” (requiring the equivalent of a tectonic shift in the way people work and involving their values, beliefs and loyalties) or a “technical challenge” (a familiar issue that experts can rapidly solve)? These two types of problems require different approaches and make different demands upon people. The image below provides a visual representation of how the duration, difficulty and distress of finding and implementing solutions differ between adaptive and technical challenges.
Their book provides strategies for leading people through the arduous process of dealing with adaptive challenges.
It is worthwhile remembering that the challenges presented by COVID-19 are by no means all addressed yet. COVID-19 has presented us with many adaptive challenges that require novel solutions. The potency of a pandemicsupports radical solutions that would have been unthinkable and rejected a month earlier by service providers and clients, and so may help humanity to innovate and adapt.
In your COVID-19 recovery plans think about what changes you’ve made to your business under the threat of contagion that actually improve your customer satisfaction or your bottom line. The great unfreezing event provided by COVID-19 can be an opportunity to permanently move to better ways of doing business.
Kate Hayes is an Adjunct Associate Professor in the Department of Business Strategy and Innovation.