COVID-19 sent telemedicine on the fast track for widespread adoption, helping doctors manage and care for their patients — especially those at high risk — during the nationwide shelter-in-place ordinance. But for patients in low-income families, there wasn’t such a simple solution.
While the ACA makes health insurance accessible for a significant number of Americans, there are still millions of vulnerable people who rely on receiving care from free clinics like CommunityHealth. So when COVID-19 hit the U.S. in March 2020 and strict shelter-in-place orders went into effect across the Chicagoland area, many low-income patients were left unable to seek basic treatment for their preexisting, ongoing, or newly-developed medical needs.
At CommunityHealth, the nation’s largest volunteer-based free clinic, we strive to deliver high-quality care to those who need it most, providing 15,000 medical and dental visits to thousands of Chicagoans who are underserved and uninsured each year. Up to 65 percent of our patients live at or below the federal poverty line, which is $24,300 for a family of four. Many also suffer from chronic conditions such as diabetes and hypertension, which require ongoing medical treatment.
While most healthcare providers turned to telehealth solutions to continue providing care to their high-risk patients during the pandemic, we knew that many of our low-income families wouldn’t be able to download additional software in advance of a virtual visit — a common prerequisite for many telemedicine tools — or even have reliable access to high-speed internet.
What we needed was a solution that worked with any smartphone as seamlessly as possible, and an easy-to-use telehealth solution that could be rapidly deployed across our network of providers. We also needed a simple platform for physicians and, most importantly, a user-friendly and accessible solution for our patients.
When the COVID-19 pandemic struck, free and charitable clinics across the country quickly pivoted to telehealth to keep staff, volunteers and patients safe. A year later, the ability to provide low-income, uninsured patients with a new, more convenient way to connect with their care team has been embraced by healthcare providers and patients alike.
There’s a good reason for this almost universal adoption. Telehealth facilitates virtual video appointments with providers using a patient’s computer or smartphone. It’s a game changer for patients with transportation or mobility issues as well as those working multiple jobs or in need of childcare, or in many cases, both.
The National Association of Free & Charitable Clinics reports 67 percent of free and charitable clinics across the country successfully implemented telehealth services in response to the pandemic. Many other safety net clinics so vital for the healthcare of underserved communities in the U.S., would do they same but they are still struggling to find the funding, training and the technical assistance necessary to make telehealth viable at their facilities.
The reality is, a third of free and charitable clinics in this country have operating budgets of less than $100,000. Many rely on volunteer providers and staff, and most simply don’t have the technical or financial resources to pivot to telemedicine.
Yet for the low-income communities they serve, telehealth increases access to care. It provides patients with the flexibility to attend appointments without having to miss work and lose much-needed income, coordinate childcare, or find reliable transportation—barriers that often stand in the way of low-income patients and their healthcare.
The world is becoming more digitized, with technology now being used to enhance all sectors including healthcare. There are lots of developments that are evidence of this including the use of artificial intelligence, machine learning, telehealth services, wearable technology, and more to offer accessible and improved healthcare services.
Telehealth services, in particular, stands out because it allows patients to consult with physicians, set appointments, and receive healthcare services wherever they may be. In this article, we are going to explore how telehealth is transforming healthcare, especially in the current pandemic.
Improved Access To Healthcare
An obvious way that telehealth has transformed healthcare is that it has helped improves access to healthcare among patients who otherwise would not have access to healthcare. These include people suffering from chronic illnesses such as heart disease and hypertension who are afraid of visiting hospitals for fear of contracting COVID-19.
Telehealth, telemedicine, and virtual care are often used interchangeably to describe remote healthcare visits. But virtual care means something much more than just telehealth or telemedicine. In fact, virtual care is in a category all its own. It is the logical, necessary next step in providing access to healthcare for all.
Telemedicine is Evolving
Remote monitoring and telehealth are nothing new. For decades, doctors have been able to monitor patients remotely or provide medical consults over the phone. Anxious parents have called in to 24-7 nurse hotlines to get advice about childhood illnesses and accidents. More recently, with the advancement of smart phones and web cams, new business models were created to connect patients with doctors over the internet.
However, most people still preferred to visit their doctors in person, and most doctors and healthcare centers weren’t considering a major shift to video any time soon.
Then COVID hit. It accelerated peoples’ desire for virtual healthcare visits and helped them feel more comfortable using video conferencing technology. Zoom, FaceTime, Google Meet and Skype became the go-to solutions for clinics large and small that didn’t yet have telehealth in place.
Video conferencing did good things for healthcare:
• Prevented even higher rates of delayed care
• Enabled providers to triage patients from a distance
• Gave quarantined providers a way to treat patients remotely
• Kept more clinics open and providers working
• Improved access to care for more patients
And while these video conference technologies solved an immediate problem, they quickly showed their limitations. These bandage solutions solved one issue while encountering (and even creating) many more problems.
Rapid expansion of video conferencing for healthcare exposed its weaknesses from HIPAA compliance issues, non-secure connections, the inability to bring a third party onto the call, wasted time as patients and/or doctors wait for the other party to join, limited number of users, concurrent calls, and call minutes and even the limited length of calls. The pandemic accelerated everything, even the “bad habits” of telemedicine.
Even before the pandemic, rural hospitals were closing at record rates. According to a report by the Chartis Center for Rural Health, 19 hospitals in rural America closed in 2019. By 2020, one in four hospitals were at risk of closing — and COVID-19 has only worsened their financial challenges. This is particularly problematic for aging populations and the rural communities that already face barriers to proper healthcare.
As a result, many healthcare organizations are left wondering how they can improve the patient’s journey in healthcare and overcome major obstacles moving forward. They’re handling the drastic increase in telehealth visits, rescheduling clinical trials, promoting digital relationships with doctors, re-evaluating health portfolios, and more.
Given the various challenges healthcare providers and professionals face, what is the best path forward? It starts with establishing a patient-first approach. The industry has to take what it’s learned from an unprecedented 2020 and consider how to reach more patients in 2021 and beyond.
Digital Transformation and the Patient-First Approach
This starts with the role of digital in the changing industry. Advancements and shifts in the digital healthcare experience are likely here to stay. Many of the new tech-based processes brought about by the pandemic (e.g., telehealth, virtual check-ins, new technologies for remote intake) will become standard elements of the digital patient journey.
While industry professionals initially scrambled to adopt these tools, the benefits of digital transformations in healthcare were immediately apparent: convenience, reduced exposure to illness, and increased accessibility. Healthcare organizations became more proactive in reaching their patients, which led to better treatment and quality of care.
But digital transformation is not happening in a vacuum. The push to implement more technology in healthcare processes has also created a push for a more local, results-based approach to healthcare. Decentralized healthcare systems work to improve efficiency and quality of care; they can also enhance communication between a referring provider and the partner organization, ensuring a smooth continuation of care when it’s needed.
The ultimate goal of this push is to open up a “digital front door in healthcare.” This strategic and patient-first approach creates engagement during every interaction with the healthcare system. Why? A well-rounded healthcare strategy doesn’t rely on one component of the patient experience to determine the quality of care — and neither should a digital strategy. Instead, it must take a comprehensive approach that keeps patients engaged and informed.
The marriage between a patient-first approach and a digital front door strategy has the potential to be incredibly powerful. A digital-first, patient-centric approach can propel your organization into the future of healthcare. Here are three suggestions to get you started:
The start of the global pandemic put incredible stress on the numerous healthcare heroes as well as their facilities, and the industry at large. Medical professionals, already faced with inordinate pressure under normal circumstances, have been working nonstop to perform heroic work day in and day out since the onset of the COVID-19 pandemic.
One thing this crisis has clearly illustrated is the need for medical professionals to have access to the latest tools that provide the greatest degree of flexibility, efficiency, and mobility. These tools certainly include the IT backbone underpinning healthcare facilities big and small, from the networks and software to the new wave of smaller, mobile devices.
Two areas of IT have seen tremendous uptake in the healthcare industry as it has adapted to the crisis, the first being through the accelerated shift to telemedicine. Telemedicine allows patients to get almost instant medical attention without the concerns of traveling to a doctor’s office or hospital during the coronavirus outbreak. Indeed, the telemedicine market is expected to swell to $155.1 billion by 2027 in large part due to the pandemic.
Overall, telemedicine is an efficient way for providers to see the highest possible number of patients at a lower cost with shorter waiting times. Doctors can schedule more appointments than they would during normal rounds while still maintaining a quality practice that offers individualized attention to each case.
Additionally, telehealth visits can be recorded, allowing clinicians to document progress and share information with relevant specialists on the go. Telemedicine fosters collaboration by combining high-speed internet and high-definition video for communication between colleagues who are sometimes seeing hundreds of people a day because of the coronavirus.
When I wrote about megatrends last year, the predictions were, naturally, forward-looking. Telehealth, for example, was important because of increased healthcare consumerism and the convergence of technologies to make its use quick and easy for payers, providers and patients.
Now when I look at telehealth as one of several 2021 megatrends, it’s tinged by the coronavirus pandemic. Rather than telehealth being a nice-to-have in 2020 with adoption over time, the service has become a necessity needed in real-time caused by the pandemic’s social distancing mandate and the highly communicable nature of the virus.
Each 2021 megatrend has the pandemic front and center. The pandemic exposed many issues facing the healthcare industry. Challenges and problems that weren’t a surprise, but simply rose to the top astonishingly quickly as the healthcare industry responded to the pandemic. The pandemic is and will continue to propel many analytics challenges and needs throughout healthcare.
Coronavirus sets the stage
Now that we’ve established the pandemic as the dominant megatrend across healthcare businesses worldwide, we’re going to take a deeper look at the pandemic’s impact on the industry: payers and providers, members and patients.
As COVID-19 rapidly descended, many different types of organizations changed to partial or fully remote workforce operations and took necessary measures to preserve the safety and health of employees. After securing operations, organizations quickly started to understand how they could help clients navigate the pandemic.
Much of the work in healthcare IT (HIT) was shaped by COVID-19. We wanted to help payers and providers understand the impact of the pandemic on business, financial and clinical outcomes to help healthcare remain viable for the many people working for the organizations or receiving care.
The following are 2021’s healthcare megatrends.
Telehealth goes mainstream as the new normal
The first major pandemic-propelled trend that everyone is talking about is increased telehealth usage. Many of us, my family included, began seeing our doctors online for the first time because of the pandemic.
The U.S. Department of Health and Human Services reported a staggering change for Medicare and Medicaid populations. Telehealth use was 0.1% of overall health services in January 2020, but by April it had increased to 45.9% of utilization. (Telehealth use by Medicare and Medicaid patients later decreased to 20%.)
Meanwhile, Definitive Healthcare reported in June 2020 that 33 percent of inpatient hospitals offered telehealth in 2019. By June 2020 that was up to 75%; another staggering increase. We see telehealth here to stay after COVID-19 is controlled. Utilization likely will come down from current pandemic levels, but industry analysts almost universally predict telehealth adoption will remain high as mainstream patients adopt and become comfortable with the technology. (Last year, an increase in the use of telehealth was one of our megatrends, though for different reasons.)
By Tara Mahoney, head of healthcare practice, Avaya.
COVID-19 has forever changed the U.S. healthcare system with the acceleration of digital transformation and remote collaboration. As 2020 past us now, we’re getting a clearer picture of what post-pandemic healthcare in the U.S. will look like (or rather, require). Based on my industry background at Avaya, here are four predictions as we continue into 2021:
Prediction #1: Telehealth is here to stay and it’s forcing us to reimagine current care models. It must and will evolve.
The pandemic thrusted organizations into the inevitable telehealth revolution, but it’s not likely COVID-19 will push the timetable forward as much as some claim. Telehealth is about much more than “just” video-based physician visits. It will evolve to cover many workflows where patients and care teams cannot be together, including virtual rounding, remote patient monitoring, bedside consultation. It’s about being able to seamlessly coordinate across the entire health organization in a way that positively impacts key measures of clinical quality – all while addressing information security concerns and abiding by HIPAA regulations.
It’s about the use of the Internet of Medical Things (IoMT) for collecting important healthcare data in real-time to enable proactive, remote care delivery. It’s about Artificial Intelligence (AI) and data analytics to make critical predictions about patient diagnoses, treatment side effects, staffing, and expenses. It’s a complex journey, only made more complex by historically slow-to-change industry policies.
Health systems pulled together in 2020, but that’s not enough for sustainable digital transformation. Organizations will take their time navigating the complexities of digitization and remote collaboration as they embrace a new future of operations and patient care. We will see current care models change, albeit incrementally.
Well before the world was forced to go remote, there was a transformation taking place in the medical sphere that held the keys to a whole new way of serving patients. A myriad of connected devices and digital workflows were being developed in healthcare that would streamline manual processes and improve efficiency for both patients and providers alike.
When in-person visits for relatively healthy patients proved too risky beginning in the spring of 2020, Medicare temporarily waived restrictions on certain telehealth initiatives predating the smartphone era, and patients and providers didn’t hesitate to buy in. This transformation has stuck, as providers and patients have largely found a comfortable balance in meeting each other digitally.
Siemens Healthineers, for instance, found that while many of their healthcare provider customers felt strained adapting their services at the beginning of the pandemic, new remote strategies that were put in place as stopgap measures, like having workers who aren’t directly involved with patient care log on remotely, proved to solve a slew of chronic challenges.
Digitally-delivered remote care can also have a substantial impact on patient experience even when caregivers and patients are in the same building. Just as non-critical-care health professionals (ie. Patient Administration) can access office work from home, nurses and doctors who may be in the same building as those in their care can treat patients at a safe distance by leveraging a bevy of remote working tools.
The three primary benefits of remote care and telehealth on the short and long term include:
Ensuring patient and worker safety: While limiting human exposure to viral infection is an immediate concern that telehealth addresses, we’re learning lessons today that we’ll apply across the board when it comes to patient and provider safety via telemedicine. For instance, providing care becomes less hazardous at a distance when doctors and nurses aren’t exposed to radiation during cardiovascular treatments. Telehealth also limits the need for time-consuming hygiene protocols when there’s less physical interaction between patients and caregivers.
Solving resource and capacity limitations: While there were many reports about a lack of ventilators during the first peak of the pandemic in the US, there was also a dearth of professionals available to actually operate this machinery. Remote healthcare solutions can be implemented in times like this to connect experienced operators with staff-strapped hospitals to share their expertise, all while monitoring a patient’s vital signs from afar. Many patients also find it more convenient to schedule telehealth appointments with their providers as this offers more schedule flexibility since travel requirements hinders their ability to visit the provider’s office.
Improving efficiency and care quality: When non-critical workers in the healthcare field don’t have to worry about exposure to the stresses (and viruses) of the doctor’s office or hospital, there’s a significantly lower risk of burnout. This has the potential to, in turn, lower the incident of treatment errors, while increasing productivity and morale.
However, the rush to remote care and away from the doctor’s office isn’t going to represent a total reversal overnight on how the industry operates, even though it succeeded in times of stress. For many healthcare providers centered in more ISP-rich population hubs, reaching rural communities involves ensuring the delivery of traffic across a bevy of stakeholders (local ISPs, transit networks, etc.).
Many healthcare professionals are now providing telemedicine calls and video conferences as an option to their patients due to the COVID-19 pandemic. Although this is a wonderful tool for both patients and doctors, many people have not taken full advantage of the easy access they now have to their doctors. In addition, doctors have not yet understood the full scope of benefits that this form of communication has to offer.
Unfortunately, many hospitals are fearful about the HIPAA compliance, technological advancements, and legal implications of using this form of care. There are expert lawyers that are trained to handle CA telemedicine violations if a client believes that their privacy was violated. After the legal requirements are adhered to, there are a few reasons why telemedicine will improve your pipeline of business.
1. Patient Loyalty
Often, patients visit a doctor once every few years, with little to no contact in between consultations. When you only see your doctor every few years, it is difficult to develop a trusted relationship. Without a relationship, you are likely to prospect other doctors that have more flexible schedules or cheaper services. When you provide telemedicine capabilities to your client, you can begin a loyal relationship. This relationship will help the customer develop trust for your services and loyalty to your organization.
2. Cost Savings
When you use telemedicine, both the doctor and the client save money. For patients, it is expensive to visit the physician every time you have a question or concern. For hospitals and offices, it is cumbersome to reapply hygiene essentials and conduct routine examinations for each and every patient. By having certain consultations that can be completed over video conferencing, both parties will save time and money.