More than a year and a half after the first positive COVID-19 case was diagnosed in the United States, industries across the nation are still grappling with operating in a post-pandemic world. Many businesses came up with temporary measures to ensure they could continue operating according to the “new normal”, but few anticipated that social distancing, masking up and working from home would be part of our daily lives in the latter half of 2021.
But what exactly does this new normal look like? For many industries, switching to remote work, decentralizing operations and virtualizing processes was as easy as sending their employees home with laptops and replacing in-person meetings with Zoom or Skype calls. But, as many reading this will appreciate, it’s not quite as simple for healthcare operators. Medical care has always been an intimately personal practice. Doctors must understand their patients on a deep level to address their needs meaningfully, and it’s often the subtle, non-verbal cues that lead to a more holistic appreciation of those needs.
Telehealth, like any other disruptive technology, presents us with a choice: do we shrink away from the changes in our industry and risk obsolescence? Or do we meet this unprecedented challenge head-on and create a more inclusive, responsive, safer industry for the future?
A Crash Course in Telehealth History
Before the pandemic, telehealth consultations were only undertaken in specific situations, typically for patients living in remote areas where in-person medical appointments were difficult or impossible. Even in these cases, patients would typically still need to travel to an originating site such as an RNC or a Skilled Nursing Facility.
The uptake of telehealth consultations since the beginning of 2020 is unquestionable, due partly to the fact that the historic barriers to remote healthcare were dropped when the pandemic hit our shores. But the most significant data for us as medical professionals is that the number of patients opting for telehealth consultations has remained high.
The CDC recorded a 154% increase in telehealth visits during the last week of March 2020 compared to the same period in 2019, which coincides with the peak of the first wave of the coronavirus in the US. In April 2020, nearly half of all US Medicare primary care consultations were conducted remotely, compared to just 0.1% pre-pandemic. Subsequent analyses by McKinsey & Company show that telehealth use is 38X higher in 2021 than pre-COVID levels.
These statistics are compelling, but it would be a mistake to see the rise of virtual healthcare as a purely COVID-driven phenomenon. The Journal of Internet Medical Research points out that telehealth has been practiced to some degree for decades, and surveys carried out in collaboration with the Employee Benefit Research Institute in 2017 demonstrated that, particularly among millennials, there was already a significant movement towards virtual healthcare long before the pandemic.
Similarly, a 2018 study by Chiron Health showed that people over 40 years old were equally open to the idea of telehealth consultations. When we take into account the intensifying shortage of physicians in the United States, as well as the fact that older generations are much more likely to require ongoing, intensive medical care, these statistics aren’t in the least surprising.
From the vantage point of 2021, the COVID-19 pandemic starts to look less like a dramatic shift in patient behavior, and more like the final tipping point for an inevitable and fundamental change in our industry.
Healthcare Virtualization and Remote Patient Monitoring
In the throes of the most severe health crisis our world has seen for a century, it’s understandably difficult to see the emergence of telehealth as a threat rather than an opportunity. The technology we enjoy today connects us in ways we wouldn’t have imagined a few decades ago. Internet- or Bluetooth-connected monitoring devices give doctors real-time, around-the-clock information about their patients, and they’re portable and user-friendly enough for patients to take home.
Here’s an excellent example from a blog by Lance Owens, CMIO of Metro Health:
“On Nov. 30, in the wake of the pandemic’s second U.S. wave, Metro Health – University of Michigan Health – launched a 24/7 home-monitoring program for ambulatory COVID-19 patients at our 208-bed hospital in Wyoming, Mich. By discharging certain patients to recover at home, where they are most comfortable and heal best, we have been able to keep more beds available and limit exposure and workload for staff. In the first month of operation, 33 patients enrolled, saving more than 300 hospital stays. When an attending physician clears an ambulatory COVID-19 patient for home recovery, we equip the patient with an internet-connected tablet and Bluetooth-synched peripherals: thermometer, blood pressure cuff, pulse oximeter, and scale. We teach them how to use the equipment and we send them home.”
In a tangible sense, telehealth has the potential not just to replace, but enhance healthcare offerings throughout the industry while relieving pressure on healthcare facilities and allowing them to admit patients who require critical or direct supervision. As Dhrumil Shah, CMIO at Compass Medical puts it:
“By virtualizing care and delivering innovations at home, we are building bridges which no health system can build physically.”
How Does Telehealth Affect Patients?
By and large, the consumer response to telehealth has been favorable. 40% of millennials, who constitute the largest portion of the US workforce, said that a telemedicine offering was “extremely or very important”. In Accenture’s 2020 Digital Health Consumer Survey, 54% of respondents reported reduced costs, 49% said telehealth was more accommodating to their schedules, and 45% said their health problems were diagnosed more quickly.
Telehealth benefits for patients:
Data shows that telehealth consultations are making medical consultations more convenient for patients by eliminating the need to travel to appointments, and by eliminating geographical restrictions. Telehealth consultations also don’t require patients to book time off work for a medical appointment.
Ease of Access
Patients in remote areas who may not have had access to medical specialists are able to seek treatment from the best, rather than the closest healthcare provider.
Comprehensive diagnosis and treatment data
Smart medical devices provide around-the-clock access to patient data, which means it’s easy for doctors to provide updates and post-consultative care to patients in the comfort of their own homes. It also means doctors have better insight into the patient’s health, so they can provide the best care possible at any stage of treatment.
A survey by the IRVHA suggests that nearly three-quarters of patients (71%) are afraid of visiting a doctor’s office due to COVID-19. Virtual consultations give patients the peace of mind that they’re not exposing themselves to further risk by consulting their doctor.
How Does Telehealth Affect Healthcare Professionals?
Primary care physicians and specialists have a lot to gain from offering telehealth consultations:
Lower risk of sickness
One of the most significant challenges of the COVID-19 pandemic has been the threat frontline workers face of contracting the disease. Telehealth consultations help medical professionals avoid repeated exposure to contagious, potentially serious illnesses.
Increased Reach to Patients
Offering an effective telehealth option extends the reach of medical service providers by enabling them to engage with patients that may not have been able to access their facility for any reason.
Eliminating the need for patients to travel to a consultation means doctors are less likely to wait for patients delayed in traffic, and even shortens the average length of a consultation. Studies by the Medical Group Management Association show that the average duration of an in-person visit can be almost 10X longer than telehealth consultation. In practice, this means an increase in the number of patients healthcare practitioners will be able to serve in a day. Research by the Children’s Hospital and Medical Center in Omaha demonstrated that offering telehealth consultations reduced patient no-shows by up to 50%.
Operating virtually reduces many of the overheads that come with running a brick-and-mortar practice. According to research by the RAND Corporation, the average cost of a telehealth visit is just $79 – nearly half the average cost of an in-person appointment at $146.
Deloitte forecasts a 5% increase in telehealth consultations in 2021, compared to a 1% increase in 2019. McKinsey & Co estimates that as much as $250 billion in current US healthcare spend could be shifted to virtual technologies. Medical providers who aren’t willing to take this trend seriously could find themselves on the wrong side of history.
Where to from here?
One thing is abundantly clear from the surveys, analyses and projections published by major healthcare bodies: telehealth isn’t a passing trend. It’s here to stay. The responsibility of healthcare professionals now is to make sure that patients opting for remote consultation and care are served equally to those who prefer in-person visits. Further, it’s the obligation of healthcare service providers to ensure that we’re using whatever technology is available to us to enhance our offerings, eliminate inefficiency, and uplift the health of the American public.