Electronic Health Reporter

By Varsha Rao, CEO, Nurx.

The challenges and tragedies of the past year are well-known, but amidst the hardships of 2020 some hopeful signals have emerged in healthcare. Patients and the people and systems who care for them have been forced to do things differently this year, and many of these experiments will be with us to stay. These are some trends that will strengthen and take shape in 2021.

#1 Stakeholders embrace asynchronous

Payors, providers and other industry stakeholders who may have been reluctant to engage with async models in the past have been won over in 2020. The pandemic accelerated the understanding that async can safely and efficiently care for patients at scale. Providers who waded into async out of necessity during COVID have found that it allows for less rushed, more direct communication with patients that in many cases results in better care, while increasing provider flexibility and quality of life. Payors are realizing telehealth offers smart savings compared to legacy systems. State laws are coming along too — in May Maryland changed legislation allowing for asynchronous telemedicine to be accepted, and we expect more states to modernize in this way.

#2 Decrease of PCP as gatekeeper

Today’s young adults were already less likely than those of previous generations to have a primary care provider, and this trend will grow as PCPs close practices and people grow accustomed to a la carte care. Circumstances of 2020 have led people to get care formerly channeled through a primary provider directly, in a diverse array of settings.

COVID swabs at drive-through clinics, flu shots at supermarket pharmacies, and prescription medications through telehealth, combined with increased utilization of home monitoring devices and wearables, have transformed patients (for better or worse) into their own care coordinators.

#3 Patients moving away, literally, from brick-and-mortar care 

Simultaneous with a decrease in PCPs as the first line of care, patients are on the move. With remote work allowing many professionals to live anywhere, some have chosen to move closer to family or to try out a new location. With urban centers less of a magnet during COVID closures, patients are moving to more affordable rural areas or less crowded resort communities.

All of this means a break with their existing brick and mortar healthcare systems, and makes telehealth an attractive alternative as it allows them to get care from anywhere and also maintain continuity of care when they’re unsure where they’ll move next. Great for people like me who frequently move and don’t have a regular OBGYN.

#4 Mental and behavioral health go virtual 

Mental healthcare has been an area of medicine with some of the biggest financial and logistical barriers to patient access — therapist appointments were often hard to get, hard to get to, and expensive, with insurance coverage generally limited or nonexistent. But the pandemic swiftly pulled mental and behavioral healthcare into the future, as more people needed this support at the same time as providers were forced to adopt remote care technology.

While in some cases it may be preferred by a patient or provider, it’s often not necessary for mental healthcare to be delivered in person, so we may see that remote care will be the default rather than the exception going forward. 

#5 Patients turning to telemedicine first

Until recently many patients looked to telemedicine as a stop-gap measure — a way to get a prescription when you need it quickly and your doctor doesn’t have an appointment available, but only as a one-off and not a replacement for that in-person provider relationship. But we see this order reversing, with patients looking to telemedicine first and only seeking out in-person care for conditions that absolutely require it, and this is especially true for younger adults.

A recent survey of more than 2,000 people conducted by HIMSS found that members of the Millennial and Gen Z generations “overwhelmingly” prefer, and would actually pay more for, online care. Rather than seeing telemedicine as transactional, they’re increasingly experiencing it as relational, with the expectation that they can receive not only medication, but answers and ongoing care from responsive real providers on the other end of their devices.

In many ways it’s a hard time to be a human, but it’s a truly exciting era to work in healthcare. I’m optimistic that the trends defining next year will result in more empowered patients and modes of care that are more nimble, effective, and satisfying for those who care for them.