The Pulse

The Rise of Telemedicine Post COVID in the US

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A robust healthcare system is the backbone of any economy. But the inability to access this system at the appropriate time can lead to panic. In the wake of the Covid-19 pandemic, this issue was very evident in countries across the globe. Due to movement restrictions and social distancing norms, people were unable to visit hospitals for in-person consultations. Similarly, the fear of contracting Covid-19 from a hospital is preventing patients from an in-person visit.

According to a recent study, more than 61% of respondents feared that going to a hospital is risky during the pandemic. Medical practitioners believe that a lack of options for consultation can lead to a public health crisis. It is true in the case of people with lifestyle diseases. At this juncture, telemedicine is emerging as a powerful alternative for healthcare access. In this blog, read about the upcoming trends in telemedicine in the U.S

Covid-19 and the Healthcare System in the U.S

In early 2020, the unprecedented rise of Covid-19 -19 cases put immense pressure on hospitals and clinics across the country. Shortage of critical medicines and hospital beds created a health emergency in almost all states. The peak period of coronavirus infections saw a spike in the ICU bed occupancy. Most healthcare workers had to go through high-stress levels at the workplace. As a result, non-Covid patients were increasingly finding it difficult to access the healthcare system. Even for Covid-related treatment, direct consultation with doctors was not easy.

Some relevant statistics about the impact of Covid-19 on the US healthcare system are,

  • According to a survey, around 49% of healthcare workers suffered burnout due to work stress.
  • The number of in-person hospital visits for ambulatory care dropped to 60% during the pandemic.
  • The data from the Department of Health and Human Services show more than 100% ICU bed occupancy in 113 hospital service regions.

In the context of this highly-stressed system, telemedicine is emerging as an effective method for primary healthcare systems. In the United States, the data from various surveys observe a positive trend in telemedicine consultations during the pandemic. With the advent of new technologies, telemedicine is poised to be the ‘new normal’ in primary medical consultations and diagnostics.

Telemedicine- The Future of Healthcare System

Telemedicine is a bye product of the union of technology and healthcare. In this, the efficient use of technology facilitates remote screening, diagnosis, and consultation for various diseases. With advanced communication technologies, a medical practitioner can interact with patients in a very effective way. In popular media, telemedicine and telehealth are often used interchangeably. However, telemedicine is a subset of telehealth. Telehealth is a broad term that includes technologies for both clinical and non-clinical activities. There are two modes of telemedicine technologies. They are,

  • Synchronous telemedicine: In synchronous telemedicine, the doctor conducts a live consultation. Here, there is always two-way communication between the patient and the doctor.
  • Asynchronous telemedicine: In the asynchronous method, a patient’s health parameters are recorded and transmitted to the medical practitioner. Later, the doctor reverts after an analysis. It is not a real-time interaction.

For mild ailments, telemedicine is an excellent option to avoid a hospital/clinical visit. In a way, it supports both patients and health workers to adhering to Covid-19 appropriate behavior. Similarly, it reduces the stress on the healthcare systems and workers.

Till the end of 2019, the adoption of telemedicine was very slow. The rise of telephonic consultations during theCovid-19 lockdown gave a new lease of life to it. Nowadays, a set of innovative medical technologies are taking telemedicine experience to a whole new level.

Global Trends in Telemedicine

Across the globe, telemedicine is evolving fast. From the mode of a mere telephonic consultation, it has become more interactive and accurate. With the Covid-19 -19 related restrictions, there has been a dip in in-person clinical consultations across the globe. For the telemedicine industry, this provided a much-needed boost. Going by expert opinion, the global telemedicine market size is around 55.9 billion USD by the end of 2020. In the future, it is expected to grow at a CAGR of 22.4% by 2028. Within the industry, teleradiology is a fast-growing segment.

The increased adoption of telemedicine is highly beneficial for multiple categories of patients amidst the Covid-19 spread. The most common applications of telemedicine are,

Basic consultation and follow up

The most popular application of telemedicine is a basic video consultation. In this, a patient interacts with the doctor using any video chatting medium. This works effectively for regular patients mostly looking for follow-up advice regarding medication. During the pandemic, video consultations for mental health issues registered an unprecedented rise. According to a WHO study, more than 70% of countries switched to telemedicine mode for providing mental health consultations.

Rehabilitation therapy

Telemedicine is useful in remote guidance for rehabilitation therapy. Physiotherapists and rehabilitation therapists are providing a live demonstration of physical movements for patients. It is also helpful in ensuring that patients are complying with the prescribed activity routine.

Consultation for lifestyle diseases

Patients with lifestyle diseases suffered the most during the outpatient restrictions at hospitals. The pandemic was a key factor that disrupted their routine medical checkups. For many such patients, telemedicine consultations are a real boon. In this case, people use wearable devices or portable monitoring equipment for recording key parameters. Based on these parameters, the doctor provides necessary guidance during online consultations.

The Rise of Telemedicine in the U.S

The United States is the undisputed leader in the telemedicine industry. Being an early adopter, the country is far ahead of other countries in integrating technology in healthcare. But mass adoption of telemedicine techniques gained popularity only after the Covid-19 pandemic. During the pandemic, there was an increase in medical appointment cancellations across the US. Due to the fear of infection through contact, most people skipped an in-person visit. Similarly, lack of transportation facilities also is a major reason for fewer hospital visits.

As per the official data from the Centers for Disease Control and Prevention, nearly 41% of patients in the U.S delayed/avoided medical care visits for the fear of Covid-19 infection in 2020. On the other hand, the number of telemedicine consultations is rising exponentially. During the first wave of coronavirus, online consultations registered a growth of 154% in comparison with the same period in 2019. Some key statistics that depict the popularity of telemedicine in the U.S are given below,

  • 11% increase in live video consultation in 2020 in comparison with the previous year
  • High adoption of telemedicine consultation among the age groups 18-49
  • 77% were fully satisfied with the remote consultation they received
  • A total of 5.4 billion USD investment in digital health startups in the first half of 2020.

Going by these trends, the telemedicine sector is here to stay even after the pandemic. For primary consultations, most people now prefer a telemedicine session.

Factors Enabling the Adoption of Telemedicine

The telemedicine adoption rate is at its peak due to the coronavirus pandemic. In the US, the trends are clearly in favor of a tectonic shift in the healthcare sector. Health care centers are collaborating with digital health startups for transforming their system. It is going to be beneficial for both patients and healthcare workers. Apart from the coronavirus crisis, numerous other factors contributed to the growth of telemedicine. The factors enabling the adoption of telemedicine are,

  • Changing healthcare Scenario

Covid-19 drastically changed the healthcare sector. Outpatient visits are witnessing an all-time dip owing to multiple reasons. An already stressed medical infrastructure is unable to cater to a large section of the population. Restrictions as a part of Covid-19 appropriate behavior is a key factor in changing the mode of health care access. Due to the fear of infection, most people prefer remote consultation to an in-person visit. Unavailability of consultation slots and closure of local clinics are also major reasons for the rise of telemedicine. In the U.S, healthcare is still a costly affair. Many patients are now moving towards telemedicine due to low-cost availability.

  • Favorable policy scenario

In the past, telemedicine faced multiple hurdles from the policy regime in the country. There were growing concerns regarding patient privacy and data management. Moreover, teleconsultation is not suitable for treating all types of ailments. Similarly, complete reliance on remote consultation can lead to shortfalls in proper diagnosis. After facing a healthcare crisis during the Covid-19 pandemic, the government is more receptive to telemedicine consultations. As per the recent trends, there is a significant increase in reimbursements by medical insurers for remote medical care.

  • Technology and innovation

Telemedicine is possible only because of the improvement in technology. More and more companies are getting into the telemedicine industry. Beyond live-video consultations, the next phase of telemedicine will use virtual reality and artificial intelligence for a better experience. On the demand side, the wearable devices market is also driving the widespread acceptance of telemedicine. Similarly, health and well-being mobile applications are also becoming popular. Together, these technological advancements create a conducive environment for the growth of telemedicine in the U.S.

  • Internet penetration

Internet is the backbone of telemedicine and telehealth. It facilitates all aspects of telemedicine- both on the demand and supply side. Without a proper internet infrastructure, the seamless integration of telemedicine technologies is not possible. A good quality internet connection is crucial for live interaction, data collection, monitoring, and analysis. The increase in the number of broadband connections is an enabler for telemedicine adoption. The internet charges have also come down, making it affordable for most of the population. In the future, the 5G technology is going to revolutionize the sector.

  • Training and awareness among healthcare workers

Social acceptance for telemedicine among the healthcare community is also necessary for making it popular. During the Covid-19 lockdown, many clinics adopted online consultation. Numerous medical associations and hospitals are organizing special training for their staff in telemedicine techniques. Due to these activities, there is a considerable increase in awareness and acceptance among hospital staff. Manpower constraints and the risk of infection are driving more institutions into adopting telemedicine.

Challenges and Way Forward

There is indeed an increase in social acceptance for telemedicine among a large section of the population. The government also now recognizes the need for pushing telemedicine as a much-needed step in health care reforms. Still, there are numerous challenges in the implementation of healthcare technologies. The main barriers in telemedicine adoption are,

  • Privacy concerns

Teleconsultation is a process that involves data exchange through an electronic medium. The use of audio-visual components also makes it vulnerable to security risks. Even with high-security systems, there is always a concern about hacking and malware attacks. Any such mishap can expose the sensitive personal data of millions of patients. While using live video consultation, it is crucial to ensure the use of HIPAA (Health Insurance Portability and Accountability Act) compliant software applications. But most applications available in the market are yet to comply with HIPAA privacy clauses. All these factors can compromise user privacy.

  • Regulatory environment

The regulatory environment is still evolving in the case of accommodating telemedicine. Regulators have to carefully balance health care reforms and citizens’ interests. The emergence of numerous digital healthcare startups also poses a big challenge to regulators. For telemedicine, the regulatory environment spans multiple aspects. Medicare policies, state-specific regulations, privacy laws, etc are all part of this puzzle. Moving forward, more clarity is inevitable for facilitating telemedicine adoption.

  • Urban-rural disparity

Like any healthcare facility, telemedicine also needs to address the issue of equity. When it comes to broadband penetration and bandwidths, there is a huge urban-rural disparity in the country. This can pose a big challenge to telemedicine services in rural areas. Without a stable internet connection, real-time consultations are difficult. Similarly, a lack of secure connection can become a big security threat. Concerted efforts for mitigating these barriers are essential for the advancement of telemedicine in the U.S.

Conclusion

Health care systems are undergoing a massive transformation. The impacts of Covid-19 are shaping the new trends in the health sector. The increased adoption of telemedicine is a direct result of this impact. It is a win-win situation for both patients and health experts. For a complete transformation, the sector needs to address some critical challenges. Similarly, the government needs to facilitate a conducive policy and regulatory environment. With the rise of numerous digital health startups, we can expect that there will be equitable access to telemedicine for the entire population soon.

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