Did Telehealth Evolve Due to COVID-19?

Amid Covid-19, group socialization and physical (brick and mortar) business operations have been buried in oblivion. The global world is still adapting to the new order, especially corporations and healthcare centers. However, certain services have not felt the need to drastically diversify/transform their operations, namely telehealth services currently booming in business with remote patient monitoring and improving patient experience. They are laying the foundation for ensuring healthcare and wellness from home.

In the United States of America, The Office for the Advancement of Telehealth has encouraged telehealth models such as long-distance healthcare and health-related advice and education to be administered in patient-practitioner relationships, with funds allocated for rural areas to access and afford telehealth platforms. The telehealth industry was expanding before Covid-19 and with a market size of $2 billion due to stakeholder companies such as Teladoc Inc. and Carenet Healthcare Services Market Share.

The Coronavirus pandemic has rapidly paved the way for virtual care visits to exceed one billion annually, catapulting us into the largest patient-practitioner exchange. This spike was specifically illustrated when Partners Healthcare provided 1,500 virtual visits in February. By April, the value rose to more than 250,000 and is still transcending by the second. In a revolutionary about-face, the United States government and the insurance industry actively promote telemedicine by making it more available, accessible, affordable, and adaptable to the new world, hence eradicating the long-standing barriers to reimbursement for medical care.

Sonia Singh, a Chicago-based healthcare consultant, the Vice President of Healthcare Consumerism at AVIA, recently said, “One of my favorite stories is a health system that described doing 100,000 virtual visits last month. When we asked how, compared to prior months, they replied, ‘we’ve done 12.’ We said, ‘You mean 12,000?’ And they said, ‘No, 12.'”

The health care landscape of virtual care and remote patient monitoring has leaped into the future, and it is creating a monumental shift in operations when a slump has hit the healthcare industry. More importantly, telehealth services have reformed the status of remote patient monitoring.

How remote patient monitoring has grown during COVID-19

Even robust and resilient medicare systems face a shortage of medical practitioners, personal protective equipment, hospital beds, and mechanical ventilators in intensive care units. Remote Patient Monitoring (RPM) resolves this problem. RPM is the employment of digital technology to track a patient’s vital signs in outpatient environments like their homes, revolutionizing the healthcare industry by reshaping the quality of medical care and expanding the healthcare financial billing operations. Many remote patient monitoring companies offer advanced RPM systems designed with medical alert systems, device-agnostic, smart, and secure responses, with a GPS for active older adults who may be susceptible to falls or wandering. The RPM system is an artificial intelligence-powered health intelligence platform, with medical and biometric sensors, IoT home sensors, and 24/7 monitoring of patients.

New policies have been introduced to promote non-invasive monitoring devices by The Food and Drug Administration (FDA). These policies have profoundly affected the measuring of patients’ respiratory rate (RR), which is poorly recorded in the status quo, despite its relevance due to the pandemic. Current COVID-19 guidelines suggest measuring resting respiratory rate to enlighten triage decisions, diagnosis, prognosis, and as criteria for ICU admission, to identify patient deterioration due to the virus.

While RPM has been harnessed to grapple with the coronavirus, acute illnesses, and chronic diseases, RPM tools have even been mobilized to monitor the coronavirus outbreak by providing geographical data and statistics on the spread of the pandemic, such as a collection of temperature reading data from digital thermometers across the country. RPM has enabled a national health map to be plotted, providing information about the potential location of clusters of the virus.

Chronic disease management and the coronavirus

As per the International Journal of Technology Assessment in Healthcare, the research aims were two-fold: first, to systematically theoretically review the cost-effectiveness of telehealth at home for chronic diseases, and second to develop a mechanism of the economic evaluation of home telehealth projects for patients with chronic illnesses. With 22 studies and 4,871 patients on telehealth from the home of chronic illnesses from 1998 till 2008, the results highlighted how telehealth was found to be financially effective for the healthcare system and insurance providers and cost-effective for patients suffering from a chronic disease. However, its impact from a societal perspective remains uncertain, especially with older adults. Nevertheless, increasing apprehensions about ensuring quality chronic disease management and healthcare access loomed on primary care providers across the country in March 2020. Meanwhile, patients suffering from chronic diseases had no other option but to rely on telehealth and remote patient monitoring.

An April 2020 report from Evidation portrayed that approximately 50 percent of patients with a chronic illness are perturbed about visiting their healthcare provider’s office for a non-coronavirus healthcare need. Ten percent of those respondents said they were so worried; they would forego medical care for the chronic disease altogether. This spelled out a potentially catastrophic healthcare landscape. A dilemma of whether patients should continue to forego their chronic disease management physical check-ins vs. visiting their medical practitioners with the potential risk of contracting the virus in the hospital. Thus, although uncomfortable with the idea, older adults had to resort to RPM in an acute medicare crisis. These perpetuated further problems. Many older adults in the chronic disease population lacked the technological ability to have a video conference via a smartphone or a computer. Moreover, even when older adult patients have an adult child or a grandchild who could assist them in setting up the telehealth and telemedicine, social distancing protocols are making that an arduous task at hand.

However, through RPM, chronic disease management is possible. More than half of chronic pain patients have reported remote care visits via either video or phone, text, or email devices. Patients with arrhythmia and depression also reported higher-than-average remote care access. The Journal of Medical Internet Research has also published a research paper on how remote patient monitoring has impacted significant behavior change in people, which will further reduce the substantial global increase in chronic diseases. RPM can commence lifestyle changes for people that can prevent, delay, and reduce the plausibility of contracting several chronic diseases when employed timely. Thus, with older adults at home, RPMs can transform patient behavior. LocateMotion’s device-agnostic platform ensures healthcare and wellness by enabling the devices to monitor and provide affordable, accessible, and timely services and preventative care to patients with chronic disease.

The Telehealth Landscape post-COVID-19

The most immediate question that currently poses to the healthcare industry is what does the future hold?

The medical industry, governments, and the insurance industry have to re-evaluate healthcare facilities worldwide and the virtual interface between the practitioner and the patient. While workspaces have to continue to be flexible and adaptable, traditional and rural clinic spaces and older adults either lack the financial resources to adapt to the new normal or are too reluctant to do so. Ergonomic workstations need to be developed for more extended periods for useful technology, security, and preparations for 24/7 operations with high-quality audio-visual equipment. To counter social isolation, telehealth workers are required to have access to fitness rooms, engaging social spaces, and locations with a connection to nature via balconies, rooftops, or windows.

With the telehealth platform being a quarter trillion dollar future, the industry can diversify into different models. As an alternative to physical urgent care visits and after-hour consultations, on-demand virtual urgent care and virtual office visits for primary care, behavioral health, and specialty care for virtual cardiac rehabilitation can be conducted. Moreover, through tech-enabled home medication administration and device-agnostic systems, patients can receive injectable drugs at home, monitor symptoms, and provide resources for self-administration of telemedicine. Furthermore, telecommunications infrastructure must be permanently available, affordable, and accessible to all people, regardless of age, economic status, or geographical location, as we enter into a virtual world.

Service uniformity and payment parity for telemedicine care need to be ensured for patients while allowing audio-only calls for telemedicine visits to assist patients who do not have access to live-video technology. However, this new world may result in potential trade-offs. Patients may incur privacy issues and more inferior quality of care compared to in-person visits. Depending on insurance companies, some patients may have the opportunity to engage in telemedicine visits and see their healthcare providers from specific telemedicine vendors. This could forge discrepancies in access and continuity of care to patients. Additionally, government expenditure may significantly increase in expanding coverage of telemedicine. Keeping all stakeholders, the costs and benefits of telehealth in consideration, lawmakers, consumers, and providers are the key to deciding how telehealth is the future or not.