The COVID-19 crisis is accelerating the future of healthcare. In fact, I’d like to argue that the future is here today as demonstrated in digital health. Within weeks, this pandemic spread across our healthcare system, shutting down the traditional care delivery model and forcing us to adopt technology.
Supporting patients in a social distancing time did not provide many options but to turn to the advancements that already exist. We simply had to turn to the existing technology available and flip the switch to deploy our future healthcare model.
This is most evident with the rise of telehealth usage in lieu of point-of-care facilities such as doctor’s offices. Since the coronavirus outbreak telehealth has experienced a surge of 1,700%, particularly supporting mental health patients.
But what do patients need during this crisis and will they adopt technology as future healthcare models? We recently surveyed Medisafe users to better understand their concerns and needs during this outbreak. What we discovered is that patients are extremely appreciative of the ability to touch base, acknowledge this crisis and ask “how can we help?”
Noting that this is a primary concern, and with more than 7,000 patients responding, a majority of whom are very concerned about the coronavirus and its effects, we need to think about how to best reach a community in need an empathetic solution is needed more than ever.
Additionally, with the recent surge in telehealth to compensate for social distancing it is evident that are gaps in the daily connections and check-ins required from patients managing medications.
A majority of patients are in some form of social distancing and 55% of patients indicated that they are concerned that the coronavirus will interfere with their medication regimens. Enter the role of the digital companions. From a telemedicine solution, digital companions can offer additional insights as well as aiding in isolation by deploying guidance in a rapid response while offering a human touch in times of isolation.
Digital health technologies also offer support beyond a virtual “check-in” that can digitally handhold patients with their everyday needs, especially those managing chronic conditions or multiple medications. Digital companions keep patients continuously connected with condition management and care givers. For example, patients on multiple medications or managing complex doses or even taking injections require additional support at while at home to remain adherent to their treatment.
Digital health platforms are adept to support patients during this time, bridging isolation and bringing healthcare support into their home. In fact, more than 42% of our patients indicated that they have changed their traditional treatment routines by adopting telehealth. In addition to telehealth, digital companions offer features to keep patients connected.
Following the survey, we opened unlimited Medfriend capabilities which digitally connects family or friends with the patient’s medication schedules. Immediately, we saw Medfriend engagement activity triple. In fact, one user replied, “My mental health isn’t great right now, so knowing that you’ll tell my Medfriend if I haven’t taken [my medication] is great.”
Connection to care givers is also critical to digitize the care support teams. Fewer field support home visits are also creating concerns with patients, “I appreciate the help you’re giving. My doctor put me in home isolation 2.5 weeks ago for my sake, the only people I see are my caregivers but now they are not allowed to visit.”
Digital health that connects the daily interactions of patients with care support teams fill a critical gap. Clinicians can monitor their patient panels by following tracked activities and in fact scale their monitoring capabilities of one to many. Digital companions keep patients on therapy but also notify care support teams when patients behavior is at-risk. The combination of high-tech and high-touch is quite powerful to support patients managing chronic conditions.
Ultimately, humanizing your digital capabilities goes a long way. Digital health at its core operates on sophisticated data-driven AI to deliver personalized interventions at time of need. It’s within each of these interactions that the digital support becomes more and more relevant for patients establishing a digital relationship, trust and loyalty. However, during a crisis we also need to make sure to “check-in.”
We are all human on each end of this digital connection and when dealing with medical conditions alone during a crisis a human touch goes a long way, best stated by a patient: “I’m good. Just knowing that you are out there is a good feeling.”
As the coronavirus outbreak limits individual movement across the country, organizations are turning to remote solutions to stay operational.
As a result, demand for telehealth has skyrocketed — prompting health insurance payers, who haven’t always covered telehealth services, to reconsider coverage.
In April, the Centers for Medicare and Medicaid Services (CMS) made one of the most significant changes to Medicare/Medicaid coverage of the past few years. It announced it would expand coverage to more than 80 different telehealth services. Now, some insurers in the private sector are beginning to follow suit.
Here is how the pandemic is changing attitudes toward telehealth — and also the potential long-term impacts of coronavirus and telehealth service expansion.
Medicaid/Medicare and Telehealth Coverage Expansion
Many patients, wanting to reduce their chance of contracting or spreading COVID-19, are electing to avoid doctor’s offices. For some people — like the immuno-compromised and elderly — it’s no longer safe to have a checkup or routine visit. At the same time, many doctors have temporarily shut their practices and begun offering telehealth services to those who still need consultations and regular check-ins.
Others who have kept their practices open aren’t sure for how long it will be possible or responsible to do so.
The result has been an explosion in demand for telehealth services, as well as expanded offerings. Many of them, however, weren’t previously covered by Medicare or Medicaid, the public health programs that insure 34% of all Americans.
Early in April, the pressure pushed CMS to expand Medicare and Medicaid to cover 85 additional telehealth codes — including group psychotherapy, physical therapy evaluations and prosthetic training. The move came after Congress passed a coronavirus spending bill that included $500 million in telehealth coverage and several major private insurers announced they would waive copays for virtual doctor’s visits and other telehealth services.
Potential Impacts of Expanded Telehealth
The most immediate impact of the coverage expansion will be making medical services much more accessible. Current research shows that, while in-person visits are typically more effective, telehealth is great at expanding the availability of medical services. It may also help health care facilities reduce costs and improve patient satisfaction.
Struggling rural hospitals face financial pain amidst the coronavirus outbreak. Revenue has been lost as elective procedures have been canceled since patients can’t safely visit in person for fear of being infected or spreading the disease. As a result, rural communities may lose access to critical care as the pandemic progresses.
Rural residents hurt
The financial and operational pressures on rural healthcare facilities can leave patients who are displaying COVID-19 symptoms or require ongoing care for chronic conditions with limited access to critical care, especially considering many rural residents live more than 30 miles away from the nearest hospital. Plus, rural populations are often more vulnerable to severe to serious outcomes with COVID-19. Compared to urban populations, rural Americans:
Are older: More than 20% of the population in completely rural counties are ages 65+, according to U.S. census data, compared to around 15% in mostly urban centers.
Have higher rates of: obesity, diabetes, high blood pressure, and cigarette smoking
Have increased mortality rates from: heart disease, cancer, lower respiratory disease, stroke, and unintentional injuries.
Technology must be used to solve the problem
Mobile, Alabama-based healthcare technology company CPSI understands the challenges facing rural hospitals and clinics, so the company is providing a free telehealth portal so doctors can continue to provide quality care.
While telehealth regulations were quickly changed amidst COVID-19, allowing providers to be reimbursed at $220 per remote appointment instead of at $13, telemedicine is not a reality for cash-strapped rural hospitals that:
Lack the technological infrastructure and resources required to implement telemedicine
Require a highly secure, HIPAA-compliant platform (Zoom, Skype, Microsoft Teams are not secure options)
Need a platform that operates smoothly on low-bandwidth connectivity, common in rural areas
Treat patients who don’t have computers or webcam capabilities
Rural hospitals need an affordable, secure, easy-to-use telehealth platform that can be set up in hours, not months, to give their patients quality care while allowing them to tap into a desperately needed revenue stream that could help them stay afloat. They need CPSI’s turnkey telehealth solution: Talk With Your Doc.
With the COVID-19 pandemic unleashing its impact on a global scale, numerous nations are scrambling to adopt various strategies and protocols to mitigate further spread of the virus. One common protocol initiated across more than 25 nations is social distancing.
In a bid to ensure this social distancing, worldwide economies have begun the implementation of partial or complete lockdowns. While this is considered to be a largely helpful endeavor, one challenge arising from these lockdowns is limitations in access to healthcare. This presents a significant conundrum for global populations as the need for healthcare access is becoming increasingly important in the current scenario.
Amid these concerns, however, technology presents a lucrative solution; telemedicine.
Many healthcare facilities and regulatory authorities are rapidly seeking alternative healthcare solutions to offer seamless medical aid whilst mitigating risk of exposure. Telemedicine shows immense potential in this regard, by limiting the need for hospital visits, and implementing more optimized allocations of hospital capacity to integral cases, by offering access to robust healthcare through digital means.
The telemedicine market is also witnessing great support from global regulatory authorities like WHO and CDC in recent times, in an effort to safeguard medical staff and other frontline workers, without influencing the delivery of healthcare services.
The evolution of telemedicine
Telemedicine refers to the use of software and electronic communication devices to deliver clinical services to patients, without the need to make in-person visits to the hospital. Telemedicine technology is used extensively for chronic condition management, medication management, follow-up visits, and a host of such healthcare services, via secure audio and video connections.
While telemedicine has emerged as a prominent entity only in recent years, it has been in existence for several years. The origins of the telemedicine industry can be traced as far back as the 1950s, when certain university medial centers and hospital systems began to experiment with methods to share images and information through the telephone. Two Pennsylvania health centers were among the first to achieve success with this technology, through the transmission of radiologic images via telephone.
Over time, telemedicine technologies began to evolve, and witnessed a significant turn with the rise of the internet. With the emergence of smart devices, designed to facilitate high-quality video transmission, delivery of remote healthcare solutions to patients in their workplaces, homes or assisted living facilities became more prevalent, thus presenting an ideal alternative to in-person clinical visits for both specialized and primary healthcare.
Rising risk of COVID-19 transmission through contact is necessitating the development of effective telemedicine solutions
As concerns arising from the global pandemic continue to surge, telemedicine is beginning to emerge as a lucrative and sustainable preventative and treatment solution to curb the spread of the COVID-19 virus.
Virtual care services are helping bridge the gap between the population, health systems, and physicians. These solutions enable everybody, particularly symptomatic patients, to seek medical health from the comfort of their homes and communicate seamlessly with their doctors via digital means, thus reducing the risk of exposure for both medical staff as well as the general population.
For the past month or more, doctors in the US have had their hands full with the rapid onset and spread of the coronavirus. Affecting thousands of citizens each day, it’s all hands on deck to try to treat patients in need.
With an increased attention on patients suffering from this deadly virus, however, many doctors worry about their non-coronavirus patients. From those fighting off the flu or some other virus to those with preexisting conditions like diabetes, heart disease, and cancer, lots of people aren’t getting the care they should be.
Some patients are afraid to come forward out of fear they’ll contract COVID-19, others hold off on contacting their doctor to avoid taking up precious time or available hospital beds for those they feel are in greater need right now. In any event, the concern is that there could be a lot of people out there suffering in silence. If you run a healthcare practice and have some of these same concerns, know that there are some effective solutions to help you treat and support your non-COVID-19 patients.
Telehealth
Many healthcare facilities across the country have implemented telehealth options. It is a digital platform that allows medical professionals to provide care and treatment to their patients remotely. Not only can this type of platform be instrumental in helping you to pre-screen potential COVID-19 patients, but it can be used to help non-coronavirus patients as well.
Advising your patients to utilize this application when in need of medical attention allows you to meet with the patient virtually and assess their health status. You can prescribe medication, provide self-care tips to treat their problem at home, or, if necessary, advise them to get to a healthcare facility or hospital for immediate attention. This prevents them from coming in the office unnecessarily (saving thousands of lives), but still provides them with an option to get medical care if they need to.
Virtual visits help providers increase productivity by adding revenue and reducing travel to different clinical settings. However, despite these obvious advantages, 2019 saw an abysmally low utilization rate of less than 10%. Things have monumentally changed. As a local physician characterized telehealth today, convenience is the new quality. Love it or hate it, telehealth is here to stay.
The primary care collaborative conducts a weekly survey of physicians, nurse practitioners, and physician assistants working in primary care on how their practices are responding to the COVID-19 outbreak. Over 80% of respondents indicate their patients accept telehealth visits and nearly half of the respondents plan to continue using telehealth after the COVID-19 crisis is controlled.
Prior to the pandemic, telehealth was seen as convenient and time efficient for patients. It also showed promise for providing access to care for various underserved populations. Today we’ve gone beyond convenience as telehealth has become a necessity for both patients and providers. Increased utilization has been made possible by the relaxation of rules and requirements by both government and commercial health plans. Notably, the use of telehealth had been restricted by design.
Health plans wanted to control how and where telehealth was offered along with who could provide the service. For the duration of the COVID-19 health emergency, most health plans are allowing telehealth to be used in place of in-person encounters. Many are waiving patient cost share and paying providers the same rate as an in-person visit.
Medicare has made the following changes effective during the COVID-19 health emergency: telehealth can be used with both new and established patients, telehealth via telephone will be reimbursed, and providers are allowed to treat patients across state lines. In addition, the Centers for Medicare and Medicaid Services (CMS) is waiving HIPAA violation penalties for utilizing technologies such as FaceTime or Skype.
By A.J. Hanna, vice president client advocacy, SYKES.
People’s knowledge of telehealth isn’t necessarily leading to usage — at least, that is what we found at SYKES as a part of our survey on attitudes toward telehealth. Telehealth, in its purest form, has existed for decades. Physicians, whether by phone, radio, or other forms of transmission, have been calling on clinicians from outside of their communities to assist them with second opinions or provide specialty expertise for many years.
And while the internet has opened up new and more expansive opportunities for telehealth — including making it easier for the remote caregiver and the patient to interact via both video and audio — regulatory restrictions, reimbursement inconsistency, attitudes toward effectiveness and other factors have prevented it from finding its full promise.
COVID-19 and its ability to spread easily and rapidly has pushed the healthcare system in the United States and around the world to take a more expansive view of how telehealth can be used. Given the growing importance of this tool for triage of those potentially infected by the novel coronavirus, we wanted to first assess how many people even knew what telehealth was.
When presented with the question, “Telehealth is the use of communication technologies to support long-distance health care, instead of an in-person appointment. Are you familiar with telehealth?,” over 42 percent of those contacted for this survey were not even aware of the service (in excess of 1400 people). While usage of telehealth services has increased over the last several years, there are still many people who do not equate services available to them as being telehealth.
Of those few in our survey who knew what telehealth was and had actually used the service, satisfaction rates were very high. This follows trends from other studies that find that telehealth satisfaction levels exceed other parts of the healthcare industry. And not surprisingly, the primary benefit that they cite is the ability to avoid being with others in a clinical waiting room. But for those who had not been engaged in a telehealth visit, or had not considered the service, some expressed concern that telehealth would only be effective for minor illnesses and diagnoses. Others felt that a diagnosis would be difficult without the “touch and feel” aspect of a care visit.
Perhaps not surprisingly, respondents in the 55+ age group were less likely to have used telehealth or expressed concerns about its effectiveness. Because many in the upper level of this age group are likely Medicare beneficiaries, and because coverage by Medicare has been restricted to specific conditions, geographic regions and care settings, this is not surprising. Recent decisions by the federal government to relax restrictions for Medicare coverage of telehealth as a result of the novel coronavirus pandemic may help to close the gap in utilization represented in our survey.
If there is any outcome of the current pandemic as it relates to telehealth, it may be that it will encourage more people to consider using it. Nearly 60 percent of respondents indicated that COVID-19 has made them more likely to consider using a telehealth service in the future. Almost 25 percent of our respondents had not linked COVID-19 to their opinion of using telehealth. However, those numbers will surely change as the health system in the United States continues to utilize all means necessary to care for the health of people in ways that prevent further spread of the disease.
Coronavirus has forced practices nationwide to undertake dramatic changes in how they practice medicine. But whatever the means we use to deliver care, there is still nothing as dramatic as saving a life.
Although I had been thinking about and planning to use telehealth for about a year, the sudden arrival of the COVID-19 pandemic left me with no choice. I recognized that there was no way to safeguard my patients or staff if I kept my office open.
I still had some reservations. Would patients use telehealth technology? Would they accept it? Most importantly, would telehealth allow me to deliver the same quality as an in-person office visit?
The answers came quickly and clearly. With healow TeleVisits from eClinicalWorks, getting started was simple and easy for my staff. Patients were thrilled to have a way to receive care without having to risk exposure to the coronavirus by traveling to my office. We transformed our more than 20 daily in-office visits to more than 20 televisits in just 10 days.
Saving a patient’s life via telehealth
And my remaining doubts about the efficacy and quality of remote care were erased in a single encounter.
I was meeting with a new patient who was complaining about vomiting, diarrhea, and abdominal pain. When I asked him to show me what the vomit looked like, he placed a jar containing black vomit in front of the camera.
I immediately knew that he was suffering internal bleeding and instructed him to get to a hospital. His wife ended the call and took him to the ER, where he was admitted. The bleeding was stopped and he received a transfusion.
Five days later, we had a follow-up televisit. He was in good spirits and told me that his life had been saved because of that first televisit.
For the past month or more, doctors in the US have had their hands full with the rapid onset and spread of the coronavirus. Affecting thousands of citizens each day, it’s all hands on deck to try to treat patients in need.
Virtual visits help providers increase productivity by adding revenue and reducing travel to different clinical settings. However, despite these obvious advantages, 2019 saw an abysmally low utilization rate of less than 10%. Things have monumentally changed. As a local physician characterized telehealth today, convenience is the new quality. Love it or hate it, telehealth is here to stay.
People’s knowledge of telehealth isn’t necessarily leading to usage — at least, that is what we found at SYKES as a part of 