Telemedicine technology has been around for years. Just because patients could connect with their doctors virtually doesn’t mean they actually wanted to. And even if they had, reimbursement from insurers was inconsistent. The adoption of telehealth was off to a slow start.
As COVID-19 caused hospitals, clinics and providers to halt regular in-person visits, the demand for telehealth exploded. In addition, both private insurers and Centers for Medicare & Medicaid Services (CMS) had to quickly authorize e-visits via telehealth and phone visits after the U.S. federal government declared a public health emergency. Regulation changes made it easier for patients to get care while minimizing exposure to coronavirus in healthcare settings. That’s when Telehealth rolled out more quickly across the medical community.
A 2021 survey by customer engagement company Sykes showed significant growth in the use of telemedicine year over year. Telehealth was so convenient that nearly 88% of respondents said they would continue using it for non-urgent consultations when the pandemic is over.
Providers embraced it, too. Nearly three-quarters (73%) said that they would like to continue using telemedicine to conduct chronic disease management appointments, according to a survey of physicians published in Becker’s Hospital Review.
The question remains: After the emergency decree is lifted, will things go back to the way they were or will recent experiments be the foundation for future Teleheath?
“Hospitals and providers are pushing for telehealth to be more widely available and accessible because then they can better compete in their areas,” said Cheryl Rodenfels, chief technology officer-field at business consultancy Stratascale and former chief technology officer of Americas healthcare at Nutanix.
“They have another business line of revenue from this. Healthcare organizations are trying to figure out the right balance because telehealth is here to stay.”
If telehealth continues to grow post-COVID-19, how will it evolve?
Rodenfels has seen many telehealth technologies rise and fall. She said early on, many providers wanted a comprehensive telehealth program. One early example helped sitters keep an eye on patients who tried to leave the bed, room hospital.
“Instead of hiring one sitter per person, now you've got somebody centrally located who can cover four or eight rooms. They can take the notes, put all of their observations in the system as part of a patient’s medical record.”
Another early use case was for internal telehealth, where nurses and physicians could connect with other doctors to view video of a patient and get a quick consultation.
“This was more easily controlled as it's internal facing, not external to the public,” Rodenfels said.
They used tools like Zoom, Microsoft Teams and Google Hangouts, just as employees use those tools for live video conferences and meetings.
“When the pandemic health emergency hit, all of a sudden some began using these externally, but they weren't set up for capacity and didn’t have processes,” she said. “Many worried those technologies weren't secure or encrypted, but they are.”
From a technology perspective, many healthcare organizations treated video meetings with patients just as they treat phone calls, and they came online quickly. Since many solutions were cloud-based rather than on-premise they were easy to implement and operationalize.
Rodenfels saw one healthcare provider go from zero to six different kinds of telehealth technologies running at once all within two weeks.
“They were seeing up to 7000 patients a week through telehealth,” she said.
Now providers are trying to figure out the right balance because they believe telehealth is here to stay. During the pandemic, a lot of administrative and bureaucratic hurdles were eliminated because they needed to provide service quickly.
“E-visits became priority projects and moved to the front of the queue,” Rodenfels said. “Now organizations are relying on working their security personnel to make sure the products are integrated and secured appropriately. They are also re-evaluating the use of tactical and strategic solutions.”
Before the pandemic, many video platforms didn’t offer healthcare-specific products, but that’s changing. Zoom for Healthcare is compliant with industry requirements and integrates with several systems. Microsoft Teams, Webex and others easily integrate with calendars, and allow for self-service appointment scheduling. Patients click to schedule appointments just as if they were scheduling a business meeting with these products.
“Telehealth has to work right every time and it needs to be easy for patients and clinicians to use”, said Rodenfels.
“Doctors don't have much patience for things that don't work right and either do patients,” she said. “These solutions need to be built into workflows for the clinician. In some cases, nurses or medical assistants initiate the call and set up everything before the doctor gets online. This isn’t a good use of a nurse’s time.”
Another challenge is the rise of shadow IT, where different business units or teams set up their own technology solutions without pulling their own IT department into the process.
Unlike business or personal use of video services, most healthcare providers don’t record sessions with patients. At least not yet.
“For one, they don't have the storage space for video,” said Rodenfels.
Telehealth visits are treated like in-person visits, which are not recorded. The legal community continues to research the impact and risk associated with recording telehealth visits.
Rodenfels said many hospitals and providers are pushing for more telehealth services because they can serve patients in a wider geographic area, which generates business growth.
The healthcare industry had to quickly learn about telehealth as a result of the COVID-19 public health emergency. There were a lot of lessons learned and these may shape technology, innovation, and legislation for the future of patient care.