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VIEWPOINT: Telehealth in the pandemic era

By Laura Miller


Laura Miller

There is a well-known proverb: “Necessity is the mother of invention.” What started as a niche market for concierge and special-case patients, the telehealth industry has become a behemoth virtually overnight — with projections reaching $559.52 billion by 2027, according to Fortune Business Insights — entirely because of the COVID-19 pandemic. How could something that was once rarely, if ever, considered in most health-care settings become one of the industry standards?

 As with most things in modern society, it boils down to cost and compensation. Prior to the pandemic, telehealth had a flawed reimbursement model. Health-care insurers laid out very strict and specific criteria that had to be met to get telehealth services reimbursed — and if the reimbursement was somehow approved, the rates often did not compare to an in-office visit. Moreover, many health-care providers had legitimate concerns about determining whether a visit could be done virtually or should be done in person. Given that adequately configured (and secure) telehealth systems have associated IT costs for setup and maintenance, most health-care organizations felt it was a lost cause to put these in place because the overhead was so high and the likelihood of health-care providers getting paid for their time was so low.

 Then the COVID-19 pandemic happened. As lifestyles and patient needs shifted dramatically, so did regulations and attitudes toward telehealth. Suddenly, something that was deemed too costly and challenging to implement became the primary way — in many cases the only way — to provide effective patient care in a safe manner for all parties involved. Insurers realized that telehealth was going to be a standard for the foreseeable future and have, temporarily, updated their reimbursement model to provide fairer compensation. Providers embraced the new way of connecting with their patients virtually. Many have found that virtual visits are great for checking in with patients on everyday issues, and even better for regularly checking in with patients with chronic conditions requiring frequent monitoring. Telehealth has given providers the ability to continue care while still prioritizing in-person visits for patients who need it. Patients found that they could still get the care they required, even amid a pandemic. When surveyed, some patients even noted that having the visit from the comfort of their home alleviated the usual stress associated with “having to go to the doctor.” This suggests telehealth may have brought about more patients getting the care they would not have previously received.

 While telehealth has been one of the few positive outcomes of the COVID-19 pandemic, it is still evolving and has challenges ahead. Many of these challenges have to do with reconciling how things have been done in the past versus how they should be done going forward. Insurers are currently providing fairer compensation, but it is temporary due to the emergent nature of a global pandemic. Providers are now seeing more patients in the office but still offering telehealth services while they are able. Providers are offering the same level of care and doing the same amount of work for a telehealth visit that they would do for an in-person visit. Patients are more engaged than ever, and this trend will only continue as technological ability increases with each new generation. Many patients are now going to wonder why they must come into an office to review lab results or a quick consultation when a virtual visit makes more sense. Prior to the pandemic, many insurers would require a patient to have an in-person visit with a provider for that provider to be compensated because that is how payer contracts have been set up in the past. It is wasteful to continue doing something that has been proven inefficient. Patients deserve the opportunity to build a healthy relationship with their doctors. Health-care providers should be able to receive equitable payment for their time, virtual or otherwise, without the fear of having to work overtime to meet insurer standards — and risk burnout. Health care is at a crossroads. Many current models of care are outdated and need to be modernized, so they make sense for everyone.

 With all the technological advancements in the last decade, the health-care industry is poised to meet these challenges head-on. Telehealth is becoming more accessible and improving with each passing day. It has also led to the innovation and development of new tools, like remote patient monitoring, which has become a hot topic in recent months. So, the next logical step is full — and seamless — integration with electronic health records (EHR) software. A streamlined workflow that enables accurate visit documentation while allowing for quick and reliable communication with a patient is paramount. It can greatly improve patient and provider satisfaction because everyone benefits when things are done — and done well. On the flip side, inefficient, poorly implemented workflows can cause issues with charting, quality reporting, business analytics, and revenue.

 Telehealth is our new normal. The pandemic has forced our hands and made many of us in health care change our perception of what health care is and what it should be. Gone are the days of patients sitting in waiting rooms, secretly hoping what the person has that is coughing next to them is not contagious, and they do not catch it. Gone are days of driving 45 minutes each way to see a specialist for six minutes after waiting an extra hour because the schedule is running behind. Health care cannot and should not go back to the way things were. Providers and patients have seen that there are better ways to do things now. We, as health-care professionals, must roll up our sleeves and get to work on hashing out the finer details of how to make the progress we have made permanent, while still leaving room for future growth and improvement. This is our moment to take health care into the future.                        

 Laura Miller is the founder, owner, and CEO of TempDev, a health-care IT consulting and technology firm. Contact her