PART 1: TELEHEALTH… THE FUTURE IS NEAR

The outlook for telehealth at beginning of 2020 was good with adoption trending in a positive direction.  A survey of American College of Physicians (ACP) showed increased usage over the prior year suggesting continued steady expansion in 2020.  The vast majority of ACP members surveyed were interested in learning more about telehealth technology as well as its effective and safe use in practice.  Technology penetration in three provider-focus telemedicine areas showed the strongest potential: electronic e-consults (42%), asynchronous evaluations (39%), and synchronous virtual care (33%).  The expected short-term opportunity in adoption was video visit technology where it was already deployed.  Implementation of the three patient-focus digital telehealth areas were less pervasive:   Remote Care Management (28%), Remote Patient Monitoring (24%), and Patient Wearables (6%).  The expected short-term opportunity was increasing availability of these technologies within healthcare practices.  In general, the barriers to adoption to date has largely been financial and structural concerns, not a lack of interest amongst providers.   

This blog details how the COVID-19 public health emergency forced the healthcare ecosystem to address many of these roadblocks to remote care. It is the first in a three-part series exploring the evolution of telehealth and remote care in the post-COVID landscape. 

Telehealth:  Rise of COVID-19 

When the COVID-19 pandemic hit the US in early March 2020, the technology implementation of telehealth exploded overnight. As a lead indicator, submitted claims for telehealth services jumped 83 times nationally in April 2020 over April 2019.  The Office for Civil Rights set the stage for this growth by relaxing HIPAA requirements around the use of the commercial video conferencing solutions such as Zoom and Skype.  State regulators were pushed to maintain a pool of remote providers by allowing temporary licensing of healthcare professionals across state lines.  FDA recently released as a series of medical device guidance documents to increase availability of critical healthcare equipment and address the need for social distancing and remote care. FCC allocated $200 million  to provide immediate support for funding healthcare providers telecommunication services.  Most critically, CMS set the precedent for telehealth reimbursement during the public health emergency and the private payers followed suit.  The ramp–up of the infrastructure for practices and health networks in many instances took between 48 and 72 hours and leveraged makeshift staging areas.  In some cases, parking lots were used for distributing laptops outfitted with camera to individual healthcare providers, who were equally motivated to continue working.  Even reluctant patients found themselves welcoming the telehealth visits and the feedback has generally been positive.  Telehealth was demonstrated as a serious alternative to in–person care for many treatment scenarios.  In the keynote address at the American Telemedicine Association (ATA) 2020 conference, Dr. Joseph Kvedar proclaimed “Telehealth is now a household word.”  

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