To launch or expand your telehealth program, you need to begin by defining your program’s goals and objectives. While you may have broad objectives for your program, for example, to reduce readmissions, expand access to care or improve communication, to determine the success of your telehealth program and areas for improvement, you will need to set Specific, Measurable, Attainable, Relevant, and Time-bound (SMART) goals for your program.
Depending on the type of healthcare organization, the goals of your program may change, but utilizing SMART goals will ensure that the objectives of your telehealth program align with those of your organization. In this blog, we’ll outline the steps to setting SMART goals for your telehealth program and will review examples for each step of the process.
Specific
Depending on your patient populations, organization type, and overall organization objectives, the goals of your telehealth program may vary. Across all healthcare organizations, the most common telehealth goals include improving patient outcomes, increasing patient engagement and satisfaction, reducing cost of care, and reducing hospital readmissions. However, in their current form, these objectives are too broad to be accurately and consistently measured. SMART goals must begin by being specific.
When establishing a specific goal, you should attempt to answer the following questions:
- What do we want to accomplish?
- Why is this goal important?
- Who is involved?
- Where is it located?
- Which resources or limits are involved?
For example, a home health organization within a health system may aim to reduce hospital readmissions. To outline a specific goal, the above questions and answers might look like this:
What do we want to accomplish?
A reduction in 30-day hospital readmissions to below the 19% state average for Medicare patients.
Why is this goal important?
Hospital readmissions are costly for health providers and take an especially taxing toll on patients and their families. Our current readmission rate is 23%, significantly higher than our competitors and the state average.
Who is involved?
For internal staff, the telehealth program will require a program manager, clinicians to monitor patient vitals, installers to set up new patients, involvement physicians within the home health and health system to refer patients, and executive leadership.
For patients, we’ve established that our CHF and COPD patients are the most vulnerable patients upon discharge and have the highest risk for readmission. The telehealth program will target CHF and COPD patients.
Where is it located?
The telehealth program is focused within the home health agency in coordination with relevant, referring departments within the health system.
Which resources or limits are involved?
Limited number of staff available to monitor patients or to provide 24/7 monitoring.
We will require 300 telehealth kits with bluetooth peripherals to provide the telehealth service to our patients (we are offering telehealth to 20% of our patient population).
By answering the above questions, the telehealth program's goal has become far more specific. The program goal has shifted from “reducing hospital readmissions” to “reducing hospital readmissions among CHF and COPD patients from the current readmission rate of 23% to at least below the state medicare average of 19%.
In addition, outlining the specific goal has outlined other potential questions or requirements for the program. For example, if staffing is limited but we want to provide 24/7 monitoring, what clinical monitoring services can our telehealth provider offer?
Measurable
Setting specific goals will ensure that your goals are measurable. Without measurable goals, it’s impossible to track your program’s progress, assess its success, or identify necessary changes. When assessing if your goal is measurable, you’ll again want to answer several questions: what is the target outcome, what metrics will be needed to track this outcome, are there multiple metrics that can measure success?
For this example, we’ll look at SMART goals around clinical efficiency. As a home health agency, one reason you’ve opted to launch a telehealth program is to increase clinical efficiency. While telehealth can improve clinical efficiency in numerous ways, an example of a specific goal is to reduce windshield time for your nurses traveling to and from patient homes by 20%.
The target outcome has been clearly defined: reduce windshield time by 20%. Now you can outline what metrics will help you evaluate your progress towards this goal. Of course, you’ll want to track travel time for your nurses, but there may be additional metrics you’ll want to measure to provide further insight. For example, how many virtual visits are you providing patients per week? While not directly impacting windshield time, virtual visits can augment or replace in-person visits in many cases. This, in turn, reduces windshield time.
Attainable
Your SMART goals must be attainable. While goals are designed to stretch your capabilities and challenge your program and team, they must be realistic. Ask yourself, what will the program or your team require in order to achieve the goal? Do you have the necessary requirements to support your team and meet this goal?
As an example, we’ll return to the first case of reducing readmissions. As we determined earlier, the program goal thus far is to reduce hospital readmissions from 23% among our CHF and COPD patients to below the national Medicare average of 19%. After setting the specific goal and outlining metrics, the next step is to assess if this goal is reasonable and attainable.
To evaluate feasibility you'll again want to assess available resources and limitations such as financial, staffing, education, or training constraints that would prohibit your team from achieving such a significant reduction in readmissions.
Depending on program constraints, you may need to adjust your goal, add required features to your telehealth platform, or outline a more detailed plan with your telehealth partner.
Relevant
Is the goal relevant to your program, staff, and organization as a whole? For many organizations implementing telehealth, particularly when aiming to treat elderly populations, patient satisfaction may be a goal, for example obtaining an average patient satisfaction rate above 85%.
The importance of patient satisfaction cannot be understated. Particularly with elderly populations likely unfamiliar with telehealth, remote monitoring, and virtual visits, ensuring patients are comfortable and satisfied using the platform is a necessity for program success. Looking at the relevance more broadly, does this goal fit within the larger objectives of the organization? Perhaps your organization is looking to obtain a 5-star rating from CMS which balances several quality metrics including patient satisfaction. In this case, achieving a high patient satisfaction rate is not only relevant to the telehealth program and its goals, but to the organization as a whole.
Time-Bound
Finally, you should set a timeline for your goal with a defined start and end date. Setting a timeline contributes to making the goal specific and realistic; as well, it allows you to establish check-in points to track your progress and make adjustments if needed. When setting a timeline for your goal, you’ll once again want to consider limitations, best practices, and perhaps even regulations. For this example, we’ll look at the goal of obtaining reimbursement from private payors for your telehealth services.
When approaching commercial payors, the HRS Reimbursement Team provides clients with several best practices, including the type of data and metrics required for a payor presentation. A key element of the presentation and data collection is ensuring the data is consistent and statistically significant; HRS typically recommends 12 to 18 months of data. With this requirement, a goal to receive reimbursement within six months of program launch is not only unrealistic but also does not include time to review and adjust the program as needed.
The most important thing to remember when setting SMART goals for your telehealth program or any agency initiative is that goals are designed to shift. Your SMART goals should drive your team forward and provide your program with something to strive for; however, these goals may need to be adjusted as your program develops. To assist with your SMART goals, you can download a template and sample, here.
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