I recently had the opportunity to join a Zoom meeting with state and local government leaders, hospital CEOs and top physicians from various organizations. The topic was the impact Covid-19 was having on our healthcare systems. As the physician leaders spoke about the struggles and opportunities their teams were facing, an interesting theme began to emerge.
One-by-one, each physician began to tout the benefits of telemedicine and how it has become an essential tool to care for patients during the pandemic. While there are a growing number of webinars, articles, and news stories highlighting the benefits of telemedicine, this was the first time I had heard a group of physician leaders passionately share how it was positively affecting patient care.
Even though some forward-looking health systems and providers were using telemedicine prior to Covid-19, there were still many more that had not rolled it out. In many ways, the pandemic has thrust technology even further into the spotlight as companies in all sectors look for innovative ways to meet customer needs. Healthcare is no exception to this.
The question I am asked frequently is, ‘Will telemedicine continue to have an impact once Covid is no longer a concern?’ I believe that for any solution to be viable long-term, it must meet certain criteria and provide value to all parties who are involved. The following five areas are the key ingredients that must be met in order for telemedicine to be successful and sustainable in the long run.
Many great ideas and solutions have failed because the technology did not meet the expectations of those using the solution. If the technology is not user-friendly, intuitive, and reliable, it will not be sustainable in the future. Recently, several vendors have developed some great platforms that can be used for telehealth. In addition, cameras are now standard in most smartphones and becoming a standard in many laptops as well. The good news is that the technology exists today to support telehealth.
Now that we have robust platforms, the larger issue we need to address is access. The technology may be robust, but if individuals do not have access to it, it is of no benefit to them. This is especially true in remote rural and underserved areas.
In many cases, these are the individuals who would benefit most from chronic disease management. There are several great programs across the country that are focusing on improving access in underserved areas. My hope is that more organizations and people step forward to help close this technology gap.
- Consumer/Patient Engagement
For telemedicine to be widely adopted, it needs to meet the needs of patients and consumers. Today’s consumers demand services that revolve around their schedules and fit their lifestyles. Healthcare continues to face pressures to become more consumer-focused and provide the convenience that people have come to expect from other services.
Telemedicine can help meet this need by bringing care to patients at the location and time of their choosing. A Press Ganey survey conducted in early 2020 found that “patients are overwhelmingly positive about their virtual interactions with their care providers, even when technical issues posed challenges.”
While organizations are still trying to find out the best way to optimize their telemedicine platforms, it is clear that people are happy with the care they are receiving and want to continue to use this method of care. As telemedicine continues to expand into areas such as specialty consults and behavioral health, the convenience and privacy this offers will make telehealth a valuable care delivery option in the future.
- Provider Engagement
Another critical ingredient necessary for making telemedicine a success is provider buy-in. If providers are reluctant to use this technology, they will discourage their patients from utilizing it as well.
If providers are going to adopt this method of care, it cannot add to their clinical, administrative, or technical burdens. In my discussions with several providers, they have made it clear that a telemedicine solution integrated into their EHR is critical to ensure they do not need to document in yet another electronic system. Providers need relevant clinical data at their fingertips during a patient visit. The more easily providers can access this information, they better experience they’ll have.
In a survey of more than 1,500 physicians and healthcare providers, the Covid-19 Healthcare Coalition uncovered the following results:
- 60 percent reported that telehealth has improved the health of their patients
- 68 percent are motivated to increase telehealth use in their practices
- 55 percent indicated that telehealth improved satisfaction
- More than 80 percent said telehealth improved the timeliness of care
As this technology continues to mature, integration into the EHR will become standard practice, and clinic workflows and practices will be created to support this type of visit. As a result, I expect adoption and physician satisfaction to increase even further.
- Clinical Outcomes
Even if all of the demand and support for telemedicine is in place, it will be forever doomed if it delivers unfavorable clinical outcomes.
As an example, the healthcare industry continues to focus on ensuring antibiotics are not overprescribed, and imaging is not overused. The use of telemedicine cannot have a negative impact on these types of clinical objectives.
In an article written for Harvard Business Review, Intermountain Health CEO Dr. Marc Harrison cites 7 “lessons learned” in the area of telemedicine. After studying clinical outcomes, they credited their telehealth program with a 36.5 percent reduction in mortality in one year, which equated to 125 fewer deaths. They also found that the rate of antibiotic use was the same with telemedicine as it was in brick-and-mortar facilities.
Clinical outcomes continue to be evaluated as more patients and providers adopt telemedicine. Although these results need to be tracked long-term, early evidence continues to show that patients utilizing telemedicine have an equal or better clinical outcome in several areas.
The final ingredient needed to ensure the long-term success of telemedicine is financial viability. Prior to the pandemic, many commercial and government (state and federal) payers did not have a consistent model allowing for reimbursement of telemedicine services. In many ways, this was the biggest factor in limiting adoption. Many payers did not reimburse for this care or did so at a greatly reduced rate, which made it difficult for providers to view it as a feasible option for care.
In response to Covid-19, large payers such as Medicare, Medicaid, Blue Cross and Blue Shield, and Humana have either expanded payments or agreed to reimburse telemedicine visits at the same rate as in-person visits. In doing so, they removed the financial barrier that has kept many health systems and providers from fully adopting telehealth.
Several payers have made these changes permanent, paving the way for this model of care delivery to become sustainable long-term.
I believe, based on these five areas, that telehealth has all of the ingredients for a bright and sustainable future. We need to continue to focus on expanding telehealth services into broader clinical areas, on standardization and integration of wearable technology, and on addressing the growing access problem in underserved rural and urban areas. Even with the challenges and opportunities that lay ahead, it is clear that telehealth will play an essential part in the evolution of healthcare delivery, both now and in the future.