Stanford researchers: Telemedicine optimization requires training, interoperability

Stanford-affiliated researchers Ran Sun, Douglas W. Blayney and Tina Hernandez-Boussard saw firsthand how the use of telehealth shot up during the COVID-19 pandemic.  

The rapid growth in care, they said in an article published this week in the Journal of the American Medical Informatics Association, has also inspired discussions on the best way to use telemedicine for disease management.    

“To optimize patient and provider experience through telemedicine, stakeholders need to focus on enhancing technology interoperability and usability and providing sufficient training for efficient telemedicine use,” wrote Sun, Blayney and Hernandez-Boussard.   

Sun, who was affiliated with the Stanford University Department of Medicine at the time she was listed as first author on the piece, now works at Johnson and Johnson.  


The research team noted that it is unlikely that care will return to pre-COVID-19 levels when it comes to the balance between in-person and virtual services.  

Because of that, they said, policymakers and informaticists should take action now to develop an optimal telemedicine care model.  

“These guidelines are a necessary step in a larger agenda that will help assess the ethics, regulation and effectiveness of telemedicine as a platform for healthcare delivery,” they wrote in the JAMIA piece.  

Components of an optimal model, they said, include:

  • Support for secure multidisciplinary consults across the care team
  • Optimization of clinician and patient experience, including through provider training
  • Embedded quality, value and patient-reported outcome metrics  

The researchers also stressed the imperative to identify and implement possible solutions to address the needs of vulnerable populations who may be adversely affected by the telemedicine surge.   

“Policies and infrastructure that facilitate equitable telemedicine access need to be established to mitigate the digital divide – the chasm between those who have ready access to computers and the Internet and those who do not,” they wrote.   

It’s also vital to note, they said, that telehealth is not always appropriate.  

“Moving forward, AI-enabled technologies can be applied to match the right patient to the right form of care,” they suggested.  

“Future work will need to identify an optimal formula leveraging a hybrid care model combining both virtual and in-person visits to create a cohesive care experience,” they added.  


Because the huge increase in telehealth use is still fairly recent, the Stanford team noted that data around outcomes is also highly necessary.   

“As a frequently used form of care delivery, the implementation of telemedicine needs to be supported by rigorous evidence including clinical trials that can best guide the seamless integration of telemedicine into routine care to ensure the safety and quality of virtual care delivered,” they wrote.  

They’re not alone. Much of the proposed telemedicine-related legislation in Congress includes provisions mandating more research on its utilization.  

For instance, the CONNECT for Health Act, which is co-sponsored by half the U.S. Senate, would require a study to learn more about how telehealth has been used during the current COVID-19 pandemic   

Meanwhile, the Protecting Access to Post-COVID-19 Telehealth Act of 2021, introduced in January of this year, includes a similar requirement.

Neither bill has made significant progress on the Hill.  


“While in-person visits are essential in many conditions, telemedicine may be a viable alternative for certain patient populations and care needs; understanding and prioritizing patients who are most appropriate for telemedicine and in which clinical situations are important future steps,” wrote the researchers in the JAMIA piece.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.

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