The Doctor Will Zoom You Now: The Rise of Telehealth

Telehealth, also known as remotely delivered healthcare, has been provided by healthcare providers for decades, but it was used by only 11% of Americans last year. Back then, federal regulations effectively hamstrung the ability of the technology to gain traction.

As you might imagine, this all changed in 2020. Many practices and healthcare facilities had to rapidly switch gears, patching together a remote-based offering that would help them remain agile and meet the needs of their patients.

How did we adapt so quickly to the world of telehealth? The widespread implementation we have seen within health facilities across the nation was encouraged by a raft of state and federal policy reforms. In addition, health providers have also responded with their innovations to streamline remote care.

How laws have changed to meet the needs of telehealth

1. Reducing red tape
   As COVID-19 spread across the US in early March, the Office of Civil Rights (OCR) at the Department of Health and Human Services (HHS) announced that it was easing restrictions on the use of video-calling services for telehealth. This change made it possible for video services not usually used for healthcare communications, such as Skype or Zoom, to bridge the patient and provider gap in access to remote care.
   
   
2. Changes to health insurance
   Several states addressed coverage for private insurance and Medicaid by enabling 'payment equity', ensuring patients had access to telehealth. This allowed private insurers to reimburse these services at the same rate as in-person services.
   
   
3. Changes at the federal level
   Throughout the pandemic, there was bipartisan support for telehealth. Bills were introduced in the House and Senate to encourage greater access to and lift state limitations on the provision of virtual services.

How healthcare providers are adapting to meet the needs of telehealth

In addition to the rise in video consultations, the pandemic has forced healthcare providers to think outside the box and adjust their care models in response to rapidly changing circumstances.

Some technological advances include:

Asynchronous Telemedicine: This is a process by which health care professionals exchange patient medical information with another specialist, such as a radiologist. This information might include laboratory results, imaging studies, videos, and other documents. Also known as 'store-and-forward' telehealth, it offers an easy way to share data among patients, primary care professionals, and experts remotely, allowing all members involved to review the details when it is convenient for them.

At-home health monitoring: Remote patient monitoring (RPM) is a telehealth sub-category that enables patients to collect medical data and transfer it to healthcare professionals through their smartphones. RPM systems have been used to discharge patients with thermometers and finger-attaching devices that relay critical, real-time health information to clinicians, including heart rate and blood pressure.

Additional conveniences that aren't directly related to the medical side of things, but make a difference, include:

•  Being able to find a doctor by typing in information such as insurance coverage, type of doctor and neighborhood; not only will you get a list of doctors to choose from but usually information about their next available appointment date.
• Being able to view test results, including lab imaging.
• Visit summaries.
• View prescriptions and reordering medication.
• Schedule the next doctors appointment.
• Message doctors.

Although the expansion of telehealth services is no doubt encouraging, it is not consistent across the board. Indeed, depending on a particular hospital's capacities, these services can vary substantially, from simple phone calls to the most cutting-edge remote procedures.

What is in store for the future of remote healthcare? It might not surprise you that artificial intelligence is likely to be involved. Advances in machine learning could soon make it possible for 'AI engines' to take over most of the care that primary care doctors are currently providing. Under the guise of a human-like avatar, the AI engine will direct patients through a series of questions similar to those that primary care doctors and nurses pose during in-person office visits.

Will telehealth still be relevant after the pandemic?

It's a common refrain in healthcare circles that remote care may be having its moment, but healthcare is still a services industry when all is said and done. There is some truth to this - few are prepared to argue that video visits will fully replace in-person healthcare. This is particularly true when it comes to Alzheimer's and dementia patients.

Telehealth usage has also dropped in line with the fall in COVID-19 cases this past summer. Telemedicine visits accounted for only 21 percent of overall medical appointments by mid-July, down from 69 percent at the pandemic's initial height in April.

But some states don't see the technology as a flash in the pan. Colorado and New Hampshire have already passed bills permanently integrating all or parts of their governors' telehealth emergency orders into state law. These two states might be ahead of the game - A study from the Department of Health and Human Services (HHS) recently found that while telehealth usage fell from its peak in March/April, demand continues to grow at rates higher than ever before:

"The stable and sustained use of telehealth after in-person primary care visits started to resume in mid-April suggests there may be continued demand for telehealth in Medicare, even after the pandemic ends." 

So while we may not see virtual appointments replace in-person care anytime soon, it's clear that the technology will become a viable alternative in a post-pandemic world. This is borne out in a study by Doctor.com, which found that 83% of patients are still likely to use telemedicine once this is all over.

Now patients are able to see their doctor while wearing pajamas, it seems unlikely they will want to go back.