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.
By Dr. John Showalter, MD, MSIS, Chief Product Officer, Jvion.
COVID-19 catalyzed a rapid shift to telehealth that was years in the making. Reimbursement, once a barrier to adoption, was overcome when CMS announced that Medicare would cover telehealth to allow socially-distant care to continue. As a result, 69% of all patient encounters were done via telehealth in April, with that proportion even higher in areas with severe outbreaks of COVID-19.
Today, April feels like a lifetime ago, and telehealth accounts for only 21% of visits. But the consensus is clear: telehealth is here to stay.
A recent survey found almost 70% of providers were more motivated to continue using telehealth after the pandemic, citing better access to care (68%), more timely care (83%), improved patient health (60%), and improved financial health for their practices (57%). And now that CMS has permanently expanded telehealth coverage, any uncertainty over the long-term financial viability of telehealth can be put to rest.
Of course, not everything can be done via telehealth. Telehealth works great for chronic disease management, behavioral health, hospital/ED follow-ups and preventative care, but there are many procedures that can only be done in person. How then can providers determine which patients should be seen in person and who can be seen via telehealth?
This question is now more urgent than ever, as hospitals nationwide confront a surge in patients admitted with Covid-19. To manage capacity and keep patients safe, providers will want to see patients virtually whenever possible.
Deferred care is another concern for providers. Some 41% of US adults deferred medical care they needed this year to avoid the coronavirus. To prevent these patients from deteriorating and suffering worse health outcomes in the future, it’s critical that providers re-engage with these patients as soon as possible before it’s too late. Telehealth is often the safest way to do so.
By Rahul Varshneya, founder and president, Arkenea.
Rural communities, often located amid isolated yet beautiful landscapes, are a defining feature of much of the United States of America. But those same landscapes can, at times, make it arduous for people to gain access to something as basic as a healthcare facility.
In these regions, patients are often tens of hundreds of miles from the location of their nearest caregiver. Community hospitals, with limited budgets and low volumes, generally don’t have specialists. And even if they do, there are too few to ensure constant coverage.
Telehealth is transforming these situations to everyone’s advantage.
A recent study of Intermountain’s neonatal telehealth program evaluated the effect of video-assisted resuscitation on the transfer of newborns from eight community hospitals to newborn ICUs in Level 3 trauma centers. The service produced a 29.4% reduction in a newborn’s odds of being transferred, which corresponds annually to 67 fewer transfers — and estimated savings of $1.2 million for affected families.
By leveraging telehealth, patients can receive expert treatment locally without the added cost and risk of transfer to a bigger hospital. Local hospitals retain vital revenue and ameliorate their services. Community members get better care that’s based on evidence-based best practices. Health care is far better overall.
1) Bringing Patients and Care Providers Closer for Better Outcomes
Most patients in the rural or suburban settings of the southwest, like the ones living in the remote terrains of Nevada, lack the necessary resources to travel to a healthcare facility.
Even for patients living in the urban areas, public transportation can be grueling and tedious. Less mobile or older patients might also not always have family or acquaintances who can be their caretaker and take them for frequent clinical visits.
Telemedicine can help such patients feel more independent. One study found that the use of a specific home-telemedicine strategy for care coordination improved functional independence in non-institutionalized veterans with chronic conditions.
Not only does telemedicine adoption help patients manage their conditions, it is equally beneficial for healthcare providers too.
Hospitals, clinics, public health offices and private practice healthcare providers in the southwest have been receiving free technical assistance for implementing or expanding their current telemedicine programs from various government authorities for quite some time now.
Since laws governing telehealth and reimbursement greatly differ by state, various Telehealth Research Centers (TRCs) spread across the country help providers discover the latest telemedicine and telehealth laws and regulations that apply in the state where the provider’s practice is based.
TRCs are also helping providers – generally free of charge – in developing a business model for telehealth in their healthcare setting, selecting the appropriate telemedicine platform as well as equipment, and providing education to patients alike on how to leverage telemedicine technologies to improve health outcomes and access to healthcare services.
Since the invention of the stethoscope, technology and innovation have been transforming how the healthcare industry delivers improved standards of care for individuals in every field of medicine. A more recent example of this is the widespread adoption of telehealth capabilities to bring care directly to patients no matter where they are.
This adoption trend has accelerated in response to COVID-19, when the use of telehealth technology skyrocketed with 48% of physicians meeting patients online in April. Since then, telehealth appointments have begun to level off and decline, but over the past year and the foreseeable future, telehealth and the delivery of care through screens and mobile devices will likely play a key role in the future of healthcare.
However, the increased use of telehealth creates additional risks stemming from increased data generation and data sharing such as video recordings, email exchanges between physicians and patients, and broader sharing of protected health information (PHI) between patients, providers and third-party organizations. This level of sharing increases the likelihood that data may become stored in an unsecured location. As for the healthcare providers and all other organizations that handle PHI, the challenge is now to get a better grasp on compliance, protect patient data and mitigate the risk of malicious actors or reputation damaging fines. Here’s how to do it:
Understanding the Rising Risk to Patient Data
The Health Insurance Portability and Accountability Act (HIPAA) was established in 1996 and has since served to give patients power over their health records and hold healthcare organizations and their partners accountable for safeguarding the PHI data of patients.
HIPAA generally applies to PHI in all forms, but the Security Rule applies specifically to electronic PHI (ePHI). And as telehealth becomes a new normal and the administrative workforce continues to work remotely, ePHI’s presence will proliferate making compliance an even more extensive task. Meaning that while telehealth offers many tangible benefits to patients and providers, it is also a double-edged sword that requires heightened attention not just now but at all times. Here are a few things to keep in mind:
By Devin Partida, technology writer and the editor-in-chief, ReHack.com.
The COVID-19 pandemic has presented the medical industry with one of its most significant challenges yet. While the virus has pushed health care systems to their breaking point, some positives have arisen from this hardship. The demand for digital health services has skyrocketed, and many of these tools will continue to improve health care after the pandemic.
Healthcare organizations have had to turn to new technology in response to the extremes of COVID-19. In doing so, the medical industry has become more resilient, safe and efficient than ever. Many of these technologies are so advantageous that they’ll become standard practice in post-COVID medicine.
Many digital health services will remain long after researchers find a way to halt the pandemic, but here are five of the most significant.
1. Remote Consultation Services
Few medical technologies have been as crucial during COVID-19 as telemedicine, specifically remote consultation. Between January and early June, telehealth adoption rose by 50% as concerns over catching the virus in hospital waiting rooms grew. In April, remote consultation accounted for almost half of all Medicare primary care visits.
Now that so many health systems support remote consultation, it won’t likely go away. These services have improved public safety and made health care more accessible. In a nation where access to health care has traditionally fallen short, that’s an indispensable resource.
People who live in rural areas of the United States are more likely than those in urban communities to die prematurely from all five of the leading causes of death, per the Center for Disease Control. Remote-based care and telehealth-based visits can help people reduce or manage these conditions. However, rural medical and dental practices must ensure constant internet connectivity.
Telehealth is an excellent resource for caregivers to monitor their patients’ chronic conditions, is an excellent way to deliver care quickly in an emergency, such as a stroke, and virtual visits offered through the technology can reduce barriers to care.
But the most obvious challenge with offering telehealth services to patients is maintaining consistent internet connectivity without encountering dropped connections caused by a single internet connection network. Traditionally, most networks use single line connectivity to maintain the entire network, but doing so can prove to be costly and harmful to practice and patient health.
However, bonded internet can eliminate these challenges while delivering a continuous internet connection, especially important to small medical and dental practices.
Bonded internet vs. standard single connection
A traditional standard, single connection internet network can likely meet the most basic business demands of medical and dental practices—however, those that require continuous, dependable, fast internet benefit from bonded internet connectivity.
In simple terms, bonded internet combines multiple connections (unlike a single connection network) to ensure stable connectivity. Bonded internet secures an always-on connection by continuously monitoring the network for the best connection. With bonded internet, all network traffic passes through an aggregator, which divides the data stream, and routes it through an individual internet connection.
What do you envision when you think of rural living? Chances are, images of pastoral fields, idyllic red barns, and even herds of dairy cows come to mind.
While such a vision is a reality for at least some of the 60 million Americans who live in rural areas — sparsely populated regions confusingly described by the U.S. Census Bureau as “not urban” — living in a rural area has its downsides when it comes to healthcare.
Lack of access to high-quality, affordable healthcare providers plagues rural America. One main reason is that hospitals located in low-population regions face significant financial struggles. According to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill, 132 rural hospitals shuttered their doors since 2010, leaving many Americans with fewer care options.
Unsurprisingly, COVID-19 has only accelerated rural hospital financial hardship, potentially making in-person office visits even more of a herculean challenge.
Technological innovations, including in-app communication and HIPAA compliance, enable telemedicine to become a must-needed lifeline for rural communities requiring medical care and guidance. In short, tech is shifting the healthcare landscape for the better.
Telemedicine, defined as the practice of using technology to deliver care at a distance, is mitigating and sometimes wholly eliminating long travel times required to visit a rural healthcare facility. Via the use of HIPAA-compatible live chats, video meetings, and phone calls, people living in sparsely populated areas receive quality care and guidance from the comfort of their homes.
Telehealth is a $2.6B industry and has grown more than 25% since 2015. The global COVID-19 pandemic has switched telehealth’s use and acceptance into overdrive, and nearly every healthcare discipline is utilizing some form of telehealth platforms as part of their clinical offerings.
As the pandemic brought life to a stand-still, industries and employees were placed into one of two categories: those who provided essential services like grocery store staff, doctors, and emergency medical personnel and those who were deemed non-essential.
Non-essential businesses were ordered to shut down all operations while government officials figured out the next best steps for the safety of its citizens. Initially, physical therapy and other non-clinical medical professions were deemed non-essential. This changed when the Department of Homeland Security, along with state governments and healthcare officials, deemed physical therapy an essential healthcare service that should continue to treat its patients.
This acknowledgment placed the physical therapy sector in an interesting predicament. On one hand, many municipalities had issued stay-at-home orders. Even with the re-categorization of physical therapy as an essential healthcare service, many patients simply feared leaving their homes and chose to postpone much-needed physical therapy appointments until the virus was contained.
This dilemma forced physical therapy practitioners to explore the telehealth platform as a way to continue treating patients and to create a much-needed revenue stream for the health of the practice.
COVID-19 Triggers Regulatory Changes
The telehealth industry was already changing dramatically due to COVID-19. To help telehealth services become more widely available, Centers for Medicare and Medicaid Services Administrator Seema Verma relaxed HIPAA restrictions that had previously limited telemedicine as a patient care option.
The deregulations included the ability of physicians to treat patients across state lines without becoming licensed in that particular state and ushered in the development of IT infrastructures that did not meet compliance or regulatory parameters established by HIPPA laws. Lastly, a rapid introduction and approval of dozens of new billing codes were issued to itemize and enable medical professionals to bill Medicare for telehealth services.
For example, Medstar Health, an integrated health system in the Washington D.C. area, went from 10 telehealth visits per week to 4,000 per day. FAIR Health reported that telehealth claims went from their March 2019 base of 0.17% of all claims to 7.57% by the end of March 2020—a 43-fold increase in the first month of the pandemic alone. In the Northeast, where COVID hit incredibly hard, telehealth visits increased 150-fold.