Telehealth providers should move beyond teleconferencing

Concepts like telehealth and digital health have been popular for years but arguably haven’t driven substantial change. While health care costs in the U.S. increased by one-third from 2010 to 2018, life expectancy held steady. Some argue the rate of health care innovation has slowed in recent decades.

COVID-19, however, has already driven one of the largest health care reassessments in years. But it is still too early to tell if the crisis will drive overarching transformation or isolated shifts in areas such as telehealth.

Much of the recent surge in the U.S. relates to a relaxation of Health Insurance Portability and Accountability Act privacy restrictions concerning popular video chat software. “In essence, the main thing telehealth has done is replace an in-person visit with a video visit,” said Bill Betten, president of the consultancy Betten Systems Solutions. “The real issue is how to use telehealth to include more remote monitoring of patients.”

Factors Driving Remote Care

Basic telehealth capabilities have existed for decades, but only recently has the technology become pervasive. As hospital administrators across the U.S. braced for an influx of coronavirus cases, “virtual and remote care took off,” said Ralph Gonzales, MD, chief innovation officer of UCSF Health in a webinar. By mid-April, telehealth interactions constituted nearly 30% of ambulatory care visits in the U.S. Until recently, fewer than 10% of U.S. adults had a telehealth visit, according to a Rand Corp. senior policy researcher quoted in the Washington Post.

One of the chief barriers for telehealth providers has been the lack of comprehensive financial support from the federal government and insurers. The situation is steadily improving. “Before, Medicare was not paying for telehealth visits. They are now,” Gonzales said. And next year, the agency plans to expand telehealth access for seniors.

Though telehealth coverage has expanded throughout the U.S. amidst coronavirus stay-at-home orders, it is not yet clear the degree to which private insurers will cover telehealth in the long term.

Telemedicine does have potential cost benefits, however, which can be more than 30% less in the home than a hospital, according to the Commonwealth Fund. A Johns Hopkins study also found that the mean length of stay was shorter by one-third in a study involving elderly patients.

Infection Dynamics Could Accelerate Virtual Care  

The high toll of the novel coronavirus in traditional medical environments could drive telehealth adoption. Before the coronavirus crisis struck, the prevalence of hospital-acquired infections drove remote care for vulnerable patients. And while short-term shortages in protective equipment played a role in the disease spread among health care workers, hopes are fading that the coronavirus will soon disappear.

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