Telehealth changes care delivery in the COVID-19 era

COVID-19 knows no boundaries, infecting people in so many countries – regardless of age, ethnicity, gender, or socioeconomic status. The medical community has had to find ways to confront the virus – how to diagnose and triage suspected cases, heal the inflicted, and find ways to safeguard the healthy. To help accomplish this, medical professionals are now embracing telehealth like never before. And, it’s easy to understand why. Telehealth allows clinicians to engage with patients at a distance – safely, efficiently, and securely.

Telehealth vs Telemedicine

Let’s start at the beginning. A frequently asked question is: what is the difference between telemedicine and telehealth. The Health Resources Services Administration defines the terms as:

Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.

Given the wide application of this technology in the medical community, “telehealth” is the appropriate term, but keep in mind most use the terms interchangeably today.

Reluctance

Telehealth has been around for decades, and as technology advancements were made, the number of applications has broadened. Rural areas of the country have accepted this technology, bringing expert care to those who would otherwise have no access. And, behavioral health professionals have incorporated telehealth with great success for some time now. Yet, telehealth didn’t have wide acceptance in the medical community for these primary reasons:

  1. Reimbursement
    CMS (Centers for Medicare & Medicaid) had recognized telehealth as reimbursable for very specific and limited services. For the most part, Insurance companies followed suit. Therefore, healthcare systems were less inclined to offer services they weren’t going to get paid for.
  2. Clinician acceptance
    Whether it was fear of trying new technology or concern over security or just the desire to see patients in person, many healthcare workers were reluctant to incorporate telehealth into their practice.
  3. Cost to implement
    To deliver remote care, providers need to make hard investments in software, aside from their current IT expenditures. In the past, this usually meant the purchase of new hardware, too. The “soft” expense is the time needed to train staff.
  4. Patient adoption concerns
    Many healthcare systems were convinced patients would not accept remote care versus in-person visits, believing the technology would be too cumbersome for many to navigate.

COVID-19 Strikes and US Healthcare Norms are Upended

As the U.S. watched in horror what was occurring in China and Asia and then Europe, the healthcare industry recognized that telehealth would be a valuable tool to fight this pandemic. By early March 2020, CMS quickly understood that the time to adopt telehealth was now, and they moved quickly. Regulation changes were occurring on almost a daily basis, as the number of cases surged. The medical community was having a difficult time, keeping up – more regulations were changed in the past two months than had occurred over the past two decades. And while the new regulations are seen as temporary, most anticipate CMS will make many of these reimbursement policies (or a similar form of them) permanent. And this was all brought about by the benefits to patients, clinicians, employers, and the general population. Let’s review the primary advantages this technology affords society.

Safety

Limiting exposure to the coronavirus has proven to be the way to control the spread of this pandemic. Virtual visits (aka eVisits) and remote patient monitoring minimize the contact of patients with one another and with healthcare providers, thereby reducing the risk of further infections.

For those in hospital isolation units, strategically placed cameras monitor the patient and devices. As a result, the number of times clinicians enter a room is sharply reduced, which decreases exposure and the use of PPE (Personal Protective Equipment) that has been in short supply.

Convenient access to care anywhere

In the convenience – and safety! – of their home, patients can connect with their Primary Care Physician (PCP) as needed. Patients can also transmit their own vitals to the PCP with user-friendly peripheral devices. These telehealth encounters could be scheduled appointments or on-demand, and all that’s required is an internet connection and a device. Cell phones – ubiquitous in today’s world – are an ideal tool to make that connection happen.

On the physician side, the PCP and specialists have access to all of the patient’s records with the proper integration of a telehealth platform. Often that information can be siloed in different platforms, and clinicians have to toggle back and forth (and deal with those pesky passwords). Telehealth affords them the ability to just stay within their EHR (Electronic Health Record) and find all relevant patient data.

Communication with ALL patients

As the American population continues to diversify, healthcare providers have the added task of finding ways to explain conditions and treatment options to limited English proficient patients, as well as to those who are deaf. The difference between healthy outcomes and dangerous mistakes is the ability to communicate. ViTel Net announced an industry first with an integration that bridges that gap by forging a live videoconference with an interpreter during the telehealth encounter.

Benefits to the workforce and employers

Employers are in the process of instituting or amplifying telehealth access for employees in the workplace, and doing so is helping the bottom line. The reasons for utilizing telehealth in the workplace are numerous, including:

  • Absenteeism – by controlling who is sick and keeping the infected employees home, the spread can be reduced, and thereby, enhance the likelihood of that business staying in operation. 
  • Convenience – all that’s needed to set up an “eClinic” is a dedicated space or room with an internet-enabled laptop or device connected to a physician services organization. The capabilities can be enhanced by incorporating peripheral devices for real-time capture of vitals, heart and lung sounds, and visual diagnostics.
  • Retention & increased satisfaction – employees appreciate the ability to immediately access care, and the resulting peace-of-mind translates to happier, more productive workers, who remain with that organization. 
  • Rapid intervention – by having this convenience, an employee may learn that his/her condition warrants further investigation. As a result, that individual will seek medical care more quickly, when timing is especially critical.

Summary

COVID-19 has had a devastating impact across the globe, bringing about changes to our way of life. A “silver lining” during this pandemic has been the acceptance and adoption of telehealth that has broadened access to healthcare. Telehealth will not go away – quite the opposite! We will see its use continue to increase, as healthcare systems and medical professionals continue to recognize its many benefits. Telehealth has fundamentally changed the way medicine is delivered – and our society is all the better for it.