A staffing expert shows how telehealth is stepping in to fill the staffing shortage

A staffing expert shows how telehealth is stepping in to fill the staffing shortage Bill Siwicki

The staffing shortage is a huge challenge in healthcare today. Another challenge is finding a solution to this vexing problem.

But telehealth may be becoming an emerging strategy to help fill in gaps within hospitals and health systems, contended Chris Franklin, president of LocumTenens.com, a self-service job board and a full-service physician and advanced practice recruitment agency working in high-demand medical specialties.

Healthcare IT News sat down with Franklin to discuss changes occurring in healthcare staffing, what he calls hybrid staffing strategies, and the results of a new LocumTenens.com survey.

Q. Overall, what changes are you seeing occurring in healthcare staffing?

A. The changes we've seen in the broader economy regarding contingent employment over the past three years are incredibly impactful on healthcare staffing. There are a few key numbers that tell the story.

There currently are 3.5 million fewer workers in the U.S. than there were two years ago. Since February 2020, job openings have gone up by 50%, while total employment in the U.S. has gone slightly down. Because demand is outpacing the available supply, workers are demanding not just increases in pay, but also more choice and control over when, how and where they work. This is incredibly true in healthcare, based on every indicator we watch.

New data shows more than 300,000 healthcare workers dropped out of the workforce in the last two years. Physicians report they are choosing early retirement or leaving the full-time practice of medicine for other kinds of work, in and outside of our industry.

Nurses on the frontline have made the news due to the difficulties they have experienced, and also because of the freedoms they are newly experiencing due to the uptick in travel nursing. According to a 2021 study from Health Affairs, nearly 100,000 nurses exited the profession last year – most of them under the age of 50.

Another 32% of nurses have said they may leave the profession. The Bureau of Labor Statistics estimates we'll need to fill nearly 200,000 nurse vacancies a year until 2030.

Patients are sicker than they have ever been. Over the past year, nearly every hospital has seen increases in patient acuity, largely driven by care that was delayed during the pandemic. And chronic disease and obesity continue to be primary drivers of healthcare consumption in the U.S.

Even though it's been on the horizon for years, the impact of a big population of aging baby boomers (the oldest turned 75 this year) is finally here, and demand for healthcare is about to increase dramatically as a result.

Burnout also is at an all-time high. A recent survey from MGMA and Jackson Physician Search highlights a sobering pair of statistics: Nearly two-thirds of physicians (65%) report they are experiencing burnout in 2022, up four percentage points from the 2021 study. Of those experiencing burnout, more than one in three physicians (35%) said their levels of burnout significantly increased in 2022.

All of this points to a big, industry-wide shake-up, and we are seeing first-hand that traditional workforce staffing models are no longer working, especially in healthcare.

What's emerging is something very different – hybrid models that anticipate both permanent and contingent workers, an uptick in models that combine site-based care with a robust telehealth presence, an increase in APP staffing overall, and in general, a growing commitment to giving providers access to the kind of work-life balance they are desperately seeking.

Q. You say you are seeing a hybrid staffing strategy that includes elements of locum tenens, more advanced practice providers and more telehealth coverage. Please elaborate on this.

A. Healthcare leaders are looking for new and creative solutions now more than ever – and all amidst this backdrop of healthcare workforce shortages.

We have seen first-hand the impact the gig economy is directly having on the healthcare workforce and know the biggest concerns for healthcare facilities are attracting talent, retaining talent, and avoiding or mitigating burnout.

To help clinicians' desire to achieve a more viable work-life balance, healthcare leaders are evolving their hiring models to reflect a new appreciation for the flexibility that hybrid staffing models represent. Solely relying on traditional staffing models and solutions just won't work anymore. Through staffing innovation, hospitals and healthcare organizations are actively seeking options to improve access to care with more sustainable models.

Healthcare staffing is complex and there's never a one-size fits all solution, but we are seeing an increase in interest in alternative models of staffing, including a growing use of locum tenens staff and improving patient access to care with advanced practice providers (APPs) and telehealth expansion.

Awareness of and interest in locum tenens is at an all-time high for both healthcare organizations and clinicians. People are actually taking their own well-being into account in terms of their employment, opting into contingent work as a way to manage their levels of stress and burnout.

We had a locum tenens physician tell an audience at a recent conference: "If you have burnout in locums, you are not doing it right." There's no doubt flexibility of locum tenens offers a desirable outcome on what physicians are wanting out of life.

According to the recent survey:

·   Nearly 90% of healthcare facilities already use locum tenens staffing.

·   Nearly 57% of facilities that have not used locums staffing in the past are planning to use it in the next year.

According to a recent survey we conducted on innovation and flexibility in staffing, when most administrators consider locum tenens, they most commonly think about onsite physician care. Data shows hospitals utilize onsite locum tenens more than three times as often as telehealth, but that is starting to change.

Facilities that were previously reliant on onsite are now embracing telehealth. COVID-19 expedited this adoption, as hospitals looked beyond traditional models to meet their patients' needs. In some cases, hospitals are taking a flexible, hybrid approach that integrates telehealth and onsite care, providing the best of both worlds and delivering value to patients.

Additionally, the use of APPs in combination with physicians as a strategy is growing, with 73.9% affirmatively responding to the question, "Do you plan to expand APP coverage?"

Q. Your company recently did a survey of hospital administrators to get a clearer view of the challenges in today's landscape. What did you learn as it relates to telehealth?

A. Our recent survey results – which are detailed in the Innovation & Flexibility: Journey to Sustainable Healthcare Report – revealed that hospital administrators have strong feedback when it comes to managing today's challenging landscape.

With regard to how it relates to telehealth, more facilities are using telehealth than ever before. COVID-19 expedited this adoption, but over the coming year, most hospitals expect to expand their use of telehealth even further – there is no turning back.

Patients across the board now are more comfortable using telehealth as the COVID-19 pandemic drove a surge in virtual visits, including those who have historically hesitated to use technology. Traditionally, psychiatric services dominated locum tenens telehealth services, with behavioral health accounting for 79% of telehealth services for LocumTenens.com.

However, utilization has started to shift as hospitals look at other specialties, including oncology, cardiology and physiatry. By expanding telehealth offerings, facilities can expand access to care and reach more patients in new locations.

Over the past year, many facilities have been able to deliver a higher level of specialty care to satellite or remote locations through telehealth. Going forward, better reconciling reimbursements to align with the level of care provided in a telehealth setting will lead to broader adoption.

Q. Where do you see the telehealth component of staffing in five years?

A. The feedback we have gotten shows that more than half (60%) of those surveyed plan to expand telehealth. Through innovation, healthcare providers will continue to adapt to flexibility and improved access to care. These flexible solutions create a more sustainable model to provide quality care to patients and their communities.

As clinicians are passionate about patients receiving quality healthcare delivered in a timely manner, I see telehealth programs being the key to improving patient outcomes and the overall healthcare experience.

The beauty of telehealth is that it provides access to a qualified provider at any time. For example, we have a client that provides psychiatric services across the country. During a busy day a patient presented who was experiencing domestic violence trauma, and she wasn't comfortable talking with a male doctor.

The problem was there were only male psychiatrists on call at her presenting hospital. The hospital contacted our team, and we in turn reached out to two privileged and credentialed female providers that weren't on-call that day.

Although one was heading out to attend a wedding, she accepted the assignment to immediately provide care for this patient. So, even though this psychiatrist worked five states away from the hospital, she was able to provide care because of the access to telehealth.

The result: The patient received the "right care" that she needed at the right time with an experienced provider.

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Email the writer: bsiwicki@himss.org
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