Telemedicine reduces healthcare workloads and increases access
The world is staggering under the crushing and immediate economic and healthcare pressures caused by the emergence of the novel coronavirus. While the current pandemic will eventually come to an end, others could rise over time. But it is the changes in how healthcare is delivered that will stay with us and change the known medical universe forever.
"What is happening right now is the future of medicine," says Rich Bird, healthcare and life sciences strategist at Hewlett Packard Enterprise. "In the long term, healthcare will dramatically improve as a result."
Here's a look at the early formation of healthcare without boundaries.
How the change started
The respiratory disease called COVID-19 is caused by the novel coronavirus. It spreads rapidly and advances to life-threatening levels, in some cases, in a matter of hours. Within months, the virus permeated every country in the world and overwhelmed medical resources everywhere.
In country after country, medical staff have succumbed to extreme fatigue and to the virus itself, with critically ill patients overflowing into makeshift hospitals. The availability of certain medical resources—from masks to ventilators—were quickly limited as the number of infected people rose rapidly. Researchers are crossing disciplines and borders in collaboration and desperation to find a treatment, a cure, or a vaccine, as the death toll ticks ever higher.
The focus on solving one of the gravest threats to humanity is intense, urgent, and unwavering. And that unfortunately means there is little time, energy, or resources left to deal with other medical problems that are also unrelenting and often just as urgent.
To provide care for millions of people caught in this unprecedented healthcare squeeze, telemedicine has been promoted from a novel nice-to-have feature to a full-bore must-have set of tools.
Telemedicine proves crucial
Telemedicine has proved to be so crucial during the pandemic that the Federal Communications Commission rapidly developed and approved a $200 million program to fund telehealth services and devices for medical providers. Hospitals and healthcare providers can qualify for up to $1 million under the program, which is part of the historic $2 trillion CARES Act, which aims to offset the economic blow from COVID-19.
"As we've seen through the COVID-19 emergency, which is straining our healthcare system, being able to consult a provider without having to go in person is enormously valuable when resources are scarce and the virus is so contagious," says Nicholas Lalla, co-founder and managing director of Tulsa Innovation Labs, which is the tech-led economic development arm of the George Kaiser Family Foundation, a $4 billion charity in Tulsa, Oklahoma.
"The COVID-19 emergency has thrown into relief the importance of healthcare access. We must marshal science and technology to change healthcare delivery and reach underserved populations—rural communities and the urban poor alike," Lalla says. "One ill person can impact an entire community or city."
Many telemedicine apps are compliant with HIPAA and other laws. However, government regulations, insurance company restrictions, and the policies of medical governing bodies are routinely being eased or outright suspended to broaden the scope of telemedicine as a vital alternative in this time of crisis.
"We are e-prescribing medications, and our patients are meeting with their doctors, groups, and therapists on a virtual HIPAA-compliant app," explains Stephen Loyd, MD, chief medical officer at JourneyPure, a drug and alcohol addiction treatment provider. "The app is similar to FaceTime, but it connects patients to a life coach who is available 24/7 via secure messaging. The app also helps patients manage a healthy lifestyle by reminding them to take medications, journal, and get enough sleep."
Since routine, chronic, and acute non-COVID-19 related medical conditions require a variety of diagnostic tools and treatment options, telemedicine is rapidly expanding to adopt and accommodate them all.
For example, Orit Markowitz, MD, director of pigmented lesions and skin cancer at Mount Sinai hospital, specializes in noninvasive skin cancer detection and treatment. She is using a virtual skin cancer exam in the wake of COVID-19 to treat her patients remotely.
New tools are used for routine skin exams and to facilitate home skin cancer screening. One example is a dermatoscope tool for smartphones that acts as a microscope to enable a doctor to virtually evaluate any spots on the skin that concern patients.
A second example is a tape stripping pigmented lesion assay test for melanoma. It involves an adhesive patch that sticks to a mole like tape and is peeled off to collect skin cells, which are then mailed to a lab. Within 72 hours, the doctor can inform the patient of the presence or absence of the most aggressive form of skin cancer.
"This all became possible because of the earlier movement of digitalizing medical records and images," says HPE's Bird. "Everything was already in place."
Telemedicine as the cornerstone for future healthcare
Telemedicine is gaining more than just a toehold in medicine. It is steadily becoming the norm for a wide array of ailments and treatments—even in some disciplines you wouldn't necessarily expect.
"Traditionally, physical therapy [PT] has always relied on in-person interactions and hands-on care, which has put the profession in a really tough spot with the COVID-19 pandemic," says Todd Norwood, PT, DPT, director of clinical services at Physera, a virtual telehealth company.
"As a profession, I think PTs are asking themselves some hard questions about managing risk for themselves and for patients in the current environment," Norwood adds. "Telehealth PT provides a safe and effective way for patients to continue with their care in the current situation. There is already strong, peer-reviewed evidence that telehealth PT is effective for a range of conditions. Ultimately, we need to find ways to enable more patients to access the care they need."
"After the pandemic subsides, it's not likely that patients or providers will want to give up the convenience, improved access, and safety from infectious diseases that telemedicine delivers, especially since the bottlenecks caused by government regulations and medical polices are now opening up," says Bird.
Indeed, the new FCC COVID-19 Telehealth Program formally adopted a long-term connected-care study, which appears to indicate an interest in keeping the telemedicine momentum going.
Insurance providers are also embracing telemedicine—partly as a matter of necessity and partly because of changes in regulations.
While state laws vary, some states, such as Texas, have passed legislation requiring health insurance companies to cover telemedicine visits, according to Kay Van Wey, a medical malpractice attorney and personal injury specialist at Van Wey, Presby & Williams. Further, she says, many states have enacted special COVID-19 measures requiring health insurers and HMOs to compensate health professionals for telemedicine visits the same as for in-office visits.
Insurance will need to adapt
"Large insurance companies such as UnitedHealth Group Optum and many Blue Cross Blue Shield association members such as Anthem have implemented temporary relief for co-payment or co-insurance for telehealth-delivered services, which makes getting care even more affordable for people," says Tom Nix, CEO at Ria Health, an app-based program for alcohol addiction.
"Our contracts with some of the largest insurance companies have created a spike since the 'shelter in place' began. We have experienced a 50 percent increase with in-network members who need a telehealth treatment option. This relief from co-payments is an excellent incentive for people to seek treatment now," Nix adds.
In several states, such as Georgia, telemedicine practices are springing up seemingly everywhere. Access to healthcare providers is now being offered online and via phone apps through pharmacies, traditional healthcare providers, urgent care providers, and insurance companies. It likely won't be long before the market heats up as all these telemedicine providers and brands compete for market share. But it's still early, and there is plenty of room for growth in telemedicine.
"In any case, no one is interested in going back after this," says Bird. "Can you imagine waiting hours in a doctor's office for something you can do in minutes using telemedicine? Most people don't want that, and others have trouble getting to a doctor's office at all. There's no solid argument for returning to the old healthcare model, and patients are well aware of that."
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This article/content was written by the individual writer identified and does not necessarily reflect the view of Hewlett Packard Enterprise Company.