In the early 1990s, we heard claims of the World Wide Web changing the future of communication. The internet was a novelty, newly introduced to the world, and just as with any other innovation, people were a little apprehensive. I don’t suppose we can point to a particular event or time in the past three decades when the internet became an integral part of the way we communicate with each other. Today, it’s as easy as pressing a button on your phone because that is all it takes! It’s one tap to FaceTime, or to jump on Zoom for meetings, or to catch up on the events of the world.
For telehealth, the adoption curve is a bit clearer. In a little over six months, life as we know it has been turned upside down. Since the outbreak of Covid-19, many things have changed, including telehealth’s position in healthcare delivery. People are working from home, travel has been restricted, schools and public events have been halted. With over 125,oo0 deaths in the United States and the continued need for testing and personal protective equipment (PPEs), the fear of contracting Covid-19 is understandable.
Amid these events, healthcare has seen a rise in telehealth. The public appetite for healthcare options that offer a safe and convenient method of seeking care has increased and telehealth has been an obvious vehicle. Whether healthcare organizations are ready or not, the era of virtual care has arrived, with telehealth spearheading the change.
Telehealth on the rise
Given how the rapid spread of the Coronavirus is impacting the traditional methods of healthcare delivery, telehealth is now being used much more widely to screen and diagnose patients without risking exposure to the virus. A 2019 survey conducted by M3 Global Research demonstrated that the adoption of telehealth had increased more three-fold: 22 percent of respondents conducted video sessions with patients, up from 5 percent in 2015. Among those who used it, 93 percent agreed that telehealth improved patients’ access to care.
The requirement for social distancing measures is impacting the way hospitals and medical practices manage incoming patients. Even providers who previously did not offer any telehealth services are now gearing up to implement the technology in some form, a move that has been supported by the Centers for Medicare and Medicaid Services (CMS).
The challenges in telehealth and virtual care
Until recently, the key challenges in the widespread adoption of telehealth were geographic limitations and the originating site of care. CMS had restricted Medicare reimbursement to telehealth services that met one of the following three criteria:
- A site located in designated rural health professional shortage area
- The program is part of a federal telemedicine project
- The patient receiving treatment was located in an approved facility such as a provider’s office or a hospital.
The declaration of COVID-19 has led CMS to use waivers to remove these obstacles, at least for now. However, telehealth has other challenges in its way.
A majority of people still lack access to the basic infrastructure that could facilitate a virtual visit. 72 percent of respondents in a survey by the Primary Care Collaborative reported that they have some patients that do not have capabilities for virtual visits and non-stable chronic visits, well-child visits, and developmental assessments are considered least suitable for both phone and video visits. Even on the provider’s side, the technical aspects could be the sticking point for many. Some providers have not invested in the infrastructure that could enable virtual visits is now an added challenge.
Additionally, reimbursement of these services has been a significant challenge. As of 2019, 41 states and D.C. had laws governing reimbursement to telehealth visits in fully-insured private plans, but the laws enacted by states vary. Payment parity, meaning telehealth services covered by private plans have to be reimbursed at the same rate as in-person services, has long been considered a linchpin to nationwide telehealth adoption. The sweeping regulatory changes by CMS declare that providers can bill for telehealth visits at the same rate as in-person visits, which is something to look forward to.
Third, and arguably the most important is the change in the provider-patient relationship in virtual visits. According to a Sykes report on Americans’ perceptions of telehealth during COVID-19, 23 percent of respondents feel uncomfortable speaking with an unfamiliar healthcare provider which presents an opportunity for physicians who chose to adopt telehealth technology to further engage existing patients. For those telehealth providers that primarily handle one-time urgent issues, it’s critical that telehealth providers take the time to plan out their patient’s care journey, and understand their situation to engage with them in a meaningful way.
The road ahead: putting telehealth into action
Hospitals and healthcare systems with a patient-centered approach to care need an effective strategy to communicate with their patients. They have begun to leverage healthcare data platforms that can support secure and real-time virtual visits to reach more patients, triage them quickly and to improve care coordination. Additionally, virtual visits have the potential of saving up valuable and scarce resources during the pandemic. Ramping up telehealth adoption in a planned manner can make a significant contribution to screening, testing and treatment efforts against coronavirus. Even for patients that have medical conditions unrelated to Covid-19, virtual care makes it possible to deliver care remotely, without bringing the risk of virus exposure on either side into the equation.
These are, without a doubt, challenging times for us. Telehealth is far from perfect in the current world and many of the adjustments are temporary. But the reign of Coronavirus will end one day, and just like the internet, telehealth will remain predominant in U.S. healthcare.
Photo credit: Andrey Suslov, Getty