Opportunities and Challenges for Telemedicine in the U.S. During and After the COVID-19 Emergency


The 17th of March, 2020, may be regarded as the day the telemedicine revolution finally started. The rapid adoption of telemedicine and telehealth by Coronavirus/COVID will result in major changes in how healthcare services are delivered, spawning new healthcare marketing possibilities. In the interest of public safety, the federal government eased payment and HIPAA limits earlier this month, removing two massive and long-standing impediments to telemedicine adoption. Many private health insurance policies followed suit. These developments pave the way for exciting new approaches to serve patients better today and in the future to strengthen, expand, and maintain medical practices, medical offices, hospitals, and healthcare networks. 

Before COVID-19 accelerated the adoption of this convenient, efficient, and successful delivery approach, telehealth had been transforming healthcare for years. Providers and patients who are still hesitant to use telehealth may be unaware of its numerous workflow and benefits. 

Telemedicine benefits both patients and healthcare practitioners. By conversing via telehealth, neither the care provider nor the patient is inconvenienced by the need to travel. The patient receives the necessary healthcare at a lower cost. The potential given by telehealth to swiftly and conveniently visit several patients per day would result in higher income for the provider. Telehealth use in medical practices is growing faster than expected, thanks largely to the American College of Physicians (ACP), which has encouraged doctors to engage with patients remotely for years.

Telemedicine Opportunities And Problems Inside And Beyond Pandemic

The COVID-19 epidemic is unlike any other in history. The prevalence of worldwide travel, the virus’s ease of transmission, and symptom diversity have resulted in an unparalleled rate of spread. The requirement for physical separation has also accelerated the global use of telehealth solutions.

Telehealth is a method of delivering and managing health care in which individuals (often in partnership with family members) manage elements of their treatment with remote support from medical specialists. To augment electronically mediated treatment, direct communications are employed. Individuals might live in their own homes or care facilities. Digital data gathering and selective data interchange improve regional, national, and global monitoring. Telehealth also facilitates epidemiological research, which can affect future healthcare delivery.

The urge to embrace telehealth solutions to promote self-management has been increasing, owing partly to the growing number of patients with chronic conditions who are living to old age due to the rapid speed of medical innovation. This achievement, however, has produced a rising difficulty for healthcare systems, with more complicated treatment requirements resulting in higher expenditures. Nonetheless, before the COVID-19 epidemic, progress was modest.

The epidemic has compelled individuals and healthcare systems to reconsider what is attainable and desired and to adapt care models to the quickly changing environment. Telephone and video consultations have become more popular in several nations. Patients have been sent home with gadgets such as pulse oximeters and self-management guidelines to reduce the strain on healthcare systems. Some hospitals have implemented robots and tablet computers to allow for physical separation while monitoring and talking with patients.

However, telehealth is more than simply technology; it also necessitates changes in working processes and data curation. Previous impediments to telehealth included the requirement to modify work practices. One of the primary reasons telehealth solutions were utilized during the pandemic was to allow work without physical presence at the workplace to safeguard patients and healthcare personnel.

Telehealth has the potential to improve patient safety and results. Nonetheless, telehealth concerns are associated, such as worsening the digital divide, poor software engineering, and security breaches. Future telehealth systems must be safe, dependable, and adaptable enough to meet the needs of regulatory, professional, and healthcare organizations. All of these platforms should be updated regularly.

To reap the long-term advantages of telehealth, organizations must work together to discover what works best, where, when, why, and how. Governments must help the health technology industry create and test breakthrough telehealth solutions that are both safe and agile. The industry must collaborate with professionals and patients to ensure digital inclusion, data security, and solutions that are intuitive, adaptable, and personalized to users’ requirements. This customization will aid in overcoming opposition to modifying established work practices. Although the burden of care on patients and their families must be acknowledged, new information and competencies may empower physicians, patients, and caregivers. Telehealth can accelerate health literacy in the same way as COVID-19 has promoted computer literacy.

Concerns About Telemedicine and How to Address Them

Telemedicine is expected to rise at a 16.8 percent annual rate between 2017 and 2023. Because of its low costs and simple access to healthcare services, it is already utilized by more than half of all hospitals in the United States and by about one million Americans.

While there are several advantages to telemedicine, there are also legitimate concerns. The good news is that you can overcome these anxieties by making a strategy. Here are seven telemedicine problems to consider and practical solutions for dealing with them.

1. Reimbursement

Receiving reimbursement for telemedicine services may be difficult for physicians and other healthcare practitioners. Medicare, for example, provides limited coverage for telemedicine payments.

Services covered by the Medicare Chronic Management Program, such as services for individuals with two or more chronic health problems, may be reimbursed. To be eligible for compensation, these conditions must last at least one year or until death.

The Centers for Medicare and Medicaid Treatments (CMS) recommends coverage for 2019 and beyond, including enhanced preventative treatments and virtual check-ins. Furthermore, private insurance companies may not pay for telemedicine therapy in most cases.

It aids in establishing a reimbursement strategy that uses technology to track expenditure for reimbursement claims to overcome reimbursement hurdles. You may utilize software to track these expenses for you, allowing you to precisely document receipts required by payers while remaining current on insurance’s approved payments.

2. Inadequate Integration

If your EHR system does not communicate with the platform you use to deliver telemedicine services, you will most likely complicate your workflow records. You can record your established process and guarantee your patients’ e-visits are correctly documented and updated for future visits by using a platform that interfaces with your EHR.

3. Inadequate Data for Care Continuity

Inadequate platform integration might potentially disrupt the continuity of care. Suppose a patient receives telemedicine from one provider but switches to another for his next e-visit. In that case, the second physician may not have all the information she needs to diagnose the patient’s illness. The ideal method is to enquire about prior telemedicine services provided to your patient, including those established at hospitals and with other medical institutions.

4. Service Understanding

If your patients are unaware of your telemedicine services, they will not use them. With nearly 96 percent of major businesses expecting to provide telemedicine services to their employees, it’s a squandered opportunity if your patients are unaware that you provide these services. That is why organizing your launch through content marketing and social media marketing to spread the news is critical. Email newsletters, social networking sites, and your blog, if you have one, are all options.

5. Patients’ Lack of Technical Knowledge

When patients do not understand how to use telemedicine services, use and accessibility suffer. Before starting your telemedicine services, do a patient poll and ask which devices they would be most comfortable using to access your telemedicine services. It is also critical to teach your personnel how to use your telemedicine equipment to assist patients who seek assistance.

6. Costly Technology

When the cost of equipment and services to deliver treatment is added, telemedicine charges can be a source of worry for physicians, hospitals, and medical practices. You may be able to save money by choosing bundled services or those that charge a flat rate, but bear in mind that as the usage of telemedicine grows, so will technology costs and service costs. Telemedicine services are also assisting patients in lowering their expenditures for in-person visits and ER trips, with the latter possibly saving up to 25% on ER staff costs.

7. Concerns about privacy

Telemedicine services are handy, but they can potentially introduce security and privacy concerns when accessing patient data through the Internet. The privacy and security regulations of HIPAA require that information obtained through a telemedicine service be encrypted and your network connections. Furthermore, while communicating with patients, you must ensure that you communicate with them through a secure connection. You must get the agreement of your patients before recording and storing video calls.

The Challenges and Opportunities of Telemedicine

Is telemedicine a less expensive option for costly emergency room and urgent-care visits? Or will it result in increased use rather than decreased expenditure trends? Telemedicine’s promise resides in its ability to become a meaningful care delivery alternative or practice extension for managing patients with chronic medical conditions and mental health co-morbidities, particularly seniors.

Several elements will determine telemedicine’s future as an innovative alternative care delivery strategy that benefits all stakeholders.

1. Margin

One source of worry is the margin. Is it a downhill race? Will market forces cause the monthly member/employee fee to payers and employers to disappear? Can you earn a good living charging $40 for a text or video consultation and another $100 for a house call? How much is left after running costs, marketing to and gaining each patient as a client, and, most crucially, paying the clinician?

We’re not far from the time when good providers will refuse to conduct telemedicine for much less. Significant cost savings on patient acquisition will be required, or providers would need to hire paid clinicians to do the work to make the stand-alone telehealth model feasible.

2. Utilization

Another source of worry is how patients use telemedicine. Many of the patients who currently use telemedicine services are not very ill. They report headaches, fevers, sore throats, earaches, runny noses, and rashes for themselves or their children. Treating patients via computer, tablet, or smartphone is unquestionably more convenient than a pricey trip to the ER or urgent care. It keeps them away from the other sick individuals waiting there.

However, the significant system-wide savings will not be realized until telemedicine visits effectively replace visits that would otherwise have occurred at these more expensive sites. If you can corner an analyst, they will most likely tell you that, in principle, telehealth will lower expenses, but we are still waiting for statistics to show that it does not result in increased use.

3. Misdiagnosis

In addition, telemedicine may increase expenses in other ways. If a patient’s symptoms continue or cannot be correctly identified, a virtual doctor would most likely advise them to visit an emergency room or urgent care facility.

Telemedicine may sometimes result in unneeded medications. A telemedicine consultation is frequently followed by a prescription for an antibiotic to address a patient’s symptoms. Is that antibiotic truly required? Or will it result in more antibiotic-resistant forms of bacteria, causing more people to become ill? These concerns are valid, but I believe that telemedicine has the potential to become a critical component of our healthcare delivery system architecture, as well as a powerful lever for bending the cost curve and making our system easier to navigate.

The Opportunities

1. Providing Direct Care

Telemedicine can attain its full potential when it is available as a covered benefit in a health plan. Plans can educate and incentivize subscribers to use telemedicine or home visits for primary care. The plans can use physicians’ expertise or experience to assist patients in obtaining or navigating additional treatment as needed. Some more foresighted employer-sponsored and individual programs are exhibiting positive indicators that this is beginning to happen. For various reasons, the providers should preferably be in-network health systems and physicians rather than virtualizes who are not linked with a local provider or health system.

2. Following Up on Discharged Patients

Another promising method is for health systems to use telemedicine skills to supplement their regular health services. Telemedicine, for example, might be used to check on or monitor patients after discharge to decrease needless hospital readmissions.

3. Behavioral Health Issues

Telemedicine can potentially improve the delivery of several parts of mental health treatments. This is a clinical area where telemedicine can significantly impact clinical and the economy. Unaddressed mental health difficulties can aggravate an underlying chronic health problem (known as comorbidities), resulting in high-cost emergency room visits, hospitalizations, readmissions, and lost productivity at work.

Behavioral health telemedicine consultations that lessen these cases can result in significant system savings. Telemedicine availability decreases or eliminates any perceived stigma associated with in-person interactions with physicians and can promote the consistency of quality and compliance with behavioral health treatment programs.

4. Chronic Disease Treatment

Most significantly, telemedicine is a potent medium for chronically sick patients. These are the people who use the most expensive medical services, and they aren’t the ones who use today’s telemedicine applications or “Instagram” their kale and quinoa lunches. These people drive cost trends for the whole health system and are the primary focus of those at financial risk for their treatment.

Telemedicine services, for example, that provide a multidisciplinary team of caregivers to a payer’s sickest enrollees, have the potential to generate significant savings. Other strategies include remote monitoring of treatment plans, drug regimen compliance, and digital health coaching or concierge-like services for patients with chronic diseases.

There are some compelling examples of this happening, but it won’t become widespread until the patient’s current care team is financially motivated to embrace telehealth, either due to the shift to value-based payments or, more realistically, if they can receive traditional fee-for-service reimbursement.

Key Takeaways

Despite the technological and logistical hurdles of remotely linking patients to their health care providers, studies show that telehealth delivers significant benefits for persons with disabilities, particularly those in rural locations. Telehealth programs, at their finest, enable patients to get healthcare services when they need them, swiftly and safely.

Immunocompromised and infectious patients can obtain care while posing less danger to themselves and healthcare professionals. Remote patient monitoring allows healthcare organizations to decrease interactions between infected patients and others, safeguarding staff and patients. However, the technology must be easily available and tailored to the patient’s demands. This is crucial both during the COVID-19 epidemic and for future care delivery. States and health institutions must collaborate with persons with disabilities and their advocates to identify possible accessibility issues while introducing telehealth. The objective should be to make telehealth available and useful to everyone.

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