By Joe HarpazContributor
Telehealth. It’s no longer just a nice-to-have, but instead a must-have for patients and healthcare professionals alike during these uncertain times the COVID-19 pandemic has brought about. While we all wish that it hadn’t taken a pandemic to propel telehealth forward, for better or for worse, it has. The spotlight is now on telehealth in a big way, and for good reason.
Based on a survey by Sage Growth Partner (SGP) and Black Book Market Research, 25% of consumer respondents had used telehealth prior to the current COVID-19 pandemic. Fifty-nine percent reported they are more likely to use telehealth services now than previously, and 33% would even leave their current physician for a provider who offered telehealth access.
According to a report by Global Market Insights, the telemedicine market is set to be valued at $175.5B by 2026. These numbers certainly indicate the need for telehealth now and in the future.
Lisa Mazur, partner at McDermott Will & Emery specializing in the digital healthcare space, stated, “Telehealth was already experiencing significant momentum and growth prior to this public health emergency, and its continued trajectory has been solidified by the vital role it is playing in care delivery today.”
Here are five reasons why I believe telehealth is here to stay.
1. Telehealth Adoption And Readiness To Embrace Technology
With a significant portion of the U.S. under stay at home orders to help flatten the curve, people still need their physicians, and access to telehealth can help make this possible. As with all technology, there are limitations, but telemedicine has a significant role to play not only in screening for COVID-19 symptoms, but for keeping up with routine needs and follow-ups. It’s even being used to continue to see and treat cancer patients.
Many patients and healthcare professionals alike are embracing telehealth tech. Laurie Fashakin, a board certified physician assistant at Derrow Dermatology Associates, shared:
“Our patients have been responsive and open to the telehealth option. What’s nice about telehealth is we can see all our acne and isotretinoin patients. It’s important when treating chronic conditions such as acne, psoriasis, and atopic dermatitis that patients continue to have access to us and their medications. Virtual visits make this possible during this crazy time.”
One medical specialty that has seen a telehealth surge is behavioral health. In a recent survey, nearly half (45%) of respondents said that their mental health is being impacted by the coronavirus pandemic, and the use of virtual visits for mental health needs has hit record highs. The current situation has drawn attention to the value of access to telemental health for both existing patients as well as an influx of new ones.
Meaghan Stewart, a licensed mental health counselor in Florida, shared:
“In addition to the exacerbated anxiety people are feeling, I’ve observed an uptick in relapse and domestic violence as well as a rising number of clients asking for psychiatrist referrals for the first time. Initially my clients and even I were resistant to telemental health (which was new to me), but within weeks the training wheels have come off, and I am treating clients efficiently and effectively.”
Plus, an announcement from the Federal Communications Commission (FCC) has established a $200M COVID-19 Telehealth Program to help eligible healthcare providers continue to treat patients with the help of telehealth tech. This should help to make the technology more accessible to patients who might otherwise be unable to access telehealth services.
2. Lowered Regulatory Barriers (At Least For Now) In a matter of a few short weeks, regulatory changes that would likely have taken years to pass were resolved virtually overnight. These regulatory changes have, at least temporarily, reduced or eliminated barriers that previously existed in an effort to encourage both providers and patients to opt for telehealth over in-person visits when appropriate. This is not only to mitigate the risk of spreading COVID-19, but to curb the use of personal protective equipment (PPE) that needs to be saved for medical staff on the front lines and of course to continue to provide patients care from the safety of their homes, even if medical practices are closed. From the first COVID-19 diagnosis in the U.S. on January 21, to Congress passing the first coronavirus relief legislation on March 6, to the CARES Act being signed on March 27, there has been a seismic shift in the regulatory landscape. Under the CARES Act, there are many provisions that will help practices, including one that specifically encourages the use of telehealth. Regulatory changes have, at least temporarily, reduced or eliminated barriers that previously For example, Medicare regulations historically restricted the availability of telemedicine to patients who resided in rural areas, and such services could only be provided by a physician located in an institutional setting. Under the current waivers, telehealth services can be provided to patients at any location, including their homes, and physicians can now use their residence as the location for treatment. Telehealth across state lines, however, is still open for debate. Likewise, telehealth services could previously only be provided to “established” patients of a physician, meaning patients that had been in their office for a visit within the past three years. The current waivers permit physicians to treat new and current patients using telemedicine. Another important item of note is the loosening of HIPAA privacy standards for telehealth platforms to allow the use of standard video conferencing apps. Specifically, the Office of Civil Rights (OCR) has stated that during the current public health emergency, it will not use its enforcement discretion against providers who use applications such as FaceTime, Zoom, or Skype, which would generally not comply with the HIPAA Security Rules, to provide telehealth services. This is as long as the use of these and similar applications is in good faith. This selective non-enforcement position gives providers the flexibility to treat their patients remotely using commonly available video-chatting technology without fear of penalties. Healthcare providers should take caution, however, as they may still be responsible in the event of a data breach. And because this change is temporary, it means that non-HIPAA compliant solutions may not be a viable long-term solution. What about prescribing controlled substances via telehealth? This wasn’t up for consideration until a few weeks ago, but the Drug Enforcement Administration (DEA) recently loosened certain requirements and will permit physicians to prescribe controlled substances based on a telemedicine visit during the pandemic. What if a patient needs a knee brace or crutches? As long as the need is deemed non-urgent, such equipment can now be shipped to the patient without their physical signature. A follow-up telehealth visit can be held for a fitting session until the patient can be assessed in person. COVID-19 or not, patients have health needs that need to be met and telehealth is helping while maintaining social distancing. 3. Improved Financial Impact And Reimbursements Prior to COVID-19, physicians were generally not paid for telehealth visits at the same level as they would typically be compensated for in-office visits. This left little incentive for physicians to adopt telehealth broadly. Prior to the pandemic, Medicare reimbursement for telehealth services was only available for a limited patient population and in a limited set of circumstances. In those limited cases in which telehealth services were covered by Medicare, reimbursement for telehealth services was lower than for in-person visits, and oftentimes physicians were not compensated at all. As a result of the public health emergency and because many physician offices are closed, Medicare has waived virtually all of these restrictions and has expanded coverage, meaning that telehealth services can be provided to a much wider range of patients. This is good news for both patients and physicians. For physicians, telehealth can provide a source of income during a very challenging time while equipping their practice for virtual care in the future. Additionally, Medicare and, in many cases, Medicaid and some other payers, are reimbursing at the same rates for both virtual and in-office visits. Some commercial payers are following suit, reimbursing for telehealth services that would previously have been non-covered services. To make telehealth an even more appealing option for patients, Cigna, along with some other insurance providers, is waiving costs associated with COVID-19 as well as telehealth through at least May 31. These changes have turned telehealth into a financially sound option for practices that want to stay open and provide ongoing care for their patients throughout the current public health emergency. “Patients and providers are leaning on telehealth more now than ever before – and this trend will undoubtedly continue post-public health emergency now that more patients and healthcare providers are comfortable using it and payers are able to see its full potential to reduce (rather than increase) medical spending,” shared Mazur. 4. Video Telehealth Is Great But It Could (And Will) Be Even Better There are inherent limits of video-only telehealth technology, but when you combine medicine with technology, the possibilities are endless and big investments are being made in telehealth. For example, TytoCare just received $50M to invest in its telehealth-connected stethoscope, infrared thermometer and otoscope, among others. The combination of telehealth-connected devices and the consumer’s ability to access them conveniently will help extend the quality of care that could be provided and help telehealth visits rival in-person ones. For example, one publication recently opined that digital health and telehealth combined will help the field of cardiology become more automated. Just as smartphones and televisions continue to evolve, so will the technology that powers telehealth. 5G is poised to help improve access to such technology as well. Expect a lot of innovation coming in this area; it’ll be interesting to see if regulations can keep up with the potential. 5. Untapped Potential: Looking Towards The Future Of Telehealth For now, telehealth is playing a big role during the COVID-19 crisis. Adoption by both patients and healthcare professionals will help lay the groundwork to secure its place in the future of the care continuum. Just as the idea of robotic-assisted surgeries seemed to be a bit too futuristic not that long ago, they’re here to stay. Turning a blind eye to the value of telehealth is turning down untapped potential for the immediate and long-term future of healthcare. While no one truly knows what the post-pandemic world will look like, it’s evident that telehealth technology will continue to evolve and become a permanent part of our daily lives. I’ve heard from some in the healthcare space that they predict that 20-30% of routine visits will become virtual ones. Aided by technology, we’ll become even more plugged into our own health. Two of the biggest (and often competing) tech giants Apple and Google announced their joint effort to launch contact-tracing via Bluetooth. While it’s not a fool-proof solution, nor as invasive as the technology that is being used in China, there are still concerns over privacy and data exploitation. But the effort does have the potential to help track and identify those who may have come in contact with someone infected with COVID-19 and can help predict pockets of outbreaks before they get out of hand. Until there is a vaccine developed, it’s likely that all of us will continue to proceed with caution. We will continue to opt for services that mitigate risk and reduce unnecessary interactions. Lastly, and most importantly, the rules of the road are complex and are changing at a pace like never before. By the time you read this article, it is likely things have already changed. Medical providers seeking to leverage telehealth in their practice should ensure they are fully up to speed on the applicable regulations and compliance requirements. Given the complexities, it's advisable that medical providers consult with their legal counsel and advisors. And individuals should ensure they are well informed on insurance coverage and direct costs associated with any virtual visits. It is quite clear the ever-evolving power of telehealth will be one of those solutions that become part of our new normal.