Telehealth and the “new normal”
By Pamela J. Gallagher
At the beginning of the COVID-19 pandemic, many healthcare professionals were making predictions about telehealth’s effectiveness and the possibility of its post-pandemic adoption (including me). Nearly a year after the rapid rise in telehealth usage brought on by the virus, we are starting to get a clearer picture of telehealth’s role in the healthcare landscape as we inch closer to post-pandemic life.
Increased access
Telehealth will likely be a major player in addressing health equity issues that have plagued our communities in recent decades. According to a report by the National Rural Health Association, more than 70 community hospitals closed between 2010 and 2016 and hundreds more are now in danger of closing. The decline of rural hospitals requires that patients in these communities drive long distances and take large amounts of time away from work and family to access in-person medical care. Telehealth may become the primary means of healthcare access for rural communities.
Transportation is often a roadblock to receiving care, not only in terms of distance, but also affordability. Impoverished communities, those who cannot afford a car, or who live in cities without viable public transit have difficulties maintaining their health because of the challenges of making it to an appointment with their physician. Though there are other social determinants of health at play as I will discuss below, telehealth creates an opportunity for those with limited transportation options to receive regular medical care.
In the dangerous conditions brought on by the recent nationwide freezing temperatures and winter weather, we saw another facet of the importance of increased access to care by digital means. Telehealth presents the opportunity for patients to receive care no matter the weather or road conditions during the winter months and cold-and-flu season.
Beyond transportation-related issues, telehealth has proved to be a solution to the rising need for behavioral health services. Research conducted prior to the pandemic indicated a shortage in mental and behavioral health professionals to address the growing need. 80% of rural counties do not have access to a psychiatrist compared to 27% of metropolitan counties. Psychiatrists who specialize in pediatrics are scarce, with 15 million youth in need of mental health services, but only 8,300 psychiatrists qualified to deliver it, according to Anosha Zanjani, et al.
Telehealth makes it possible for these underserved populations to receive the care they need even if they aren’t in close proximity to a behavioral health professional. Furthermore, a 2020 survey from digital behavioral health company Tridiuum found that “81% of behavioral health providers began using telehealth for the first time in the last six months due to the COVID-19 pandemic.” With such a high percentage of providers currently using this technology, data will be readily available to measure the effectiveness of digitally delivering behavioral health services to allow providers to expand services post-pandemic.
Lower costs
Over the past year, telehealth technology has proven that it can lower costs for patients and physicians alike. For doctors that embrace telehealth, smaller office spaces and lower overhead, combined with the ability to increase patient flow, would benefit their bottom line. Patients save on transportation costs and cost of care, with the lower, up-front pricing of telehealth appointments offered by websites like MDLive.
Additionally, insurance companies like UnitedHealth, Anthem, and Humana are taking measures to encourage the use of telehealth appointments, even including a ‘click here’ link that directs their insured clients to physicians of the insurer’s recommendation. If individual providers don’t participate, many of their patients may be provided services through insurers or providers that focus on telehealth only. With the convenience and lower costs to insured patients, it may be difficult to ‘get the patients back’ for in-person visits.
Technology should not be adopted simply because it has a lower cost. Patient well-being must remain at the forefront. But lower cost combined with increased access and convenience made possible by a year of the rapid rise of telehealth services is promising for post-pandemic delivery of care.
Even with the expansion and adoption of telehealth that we’ve seen across the healthcare industry, questions remain. A few, among many others, include:
How will digital appointments impact the essential element of trust built through the doctor-patient relationship?
Though telehealth can address issues in transportation inequity, what can be done about others problems, such as access to private space, a computer, or secure, reliable WiFi to conduct appointments?
How will providers and hospitals determine the pricing structure of telehealth services?
COVID-19 has escalated changes to the way we care for patients. We talk about “getting back to normal,” though we all know that the healthcare industry has always been ever-changing and will certainly look different than it did pre-pandemic. We get to redefine what normal will be, and I believe that the experiences of the past year have shown us that the “new normal” should include embracing telehealth to increase access to and lower the cost of care for our communities.
Resources:
How telemedicine is transforming treatment in rural communities, Becker’s Health IT
How is Telehealth Changing the Doctor-Patient Relationship?, OrthoLive
Telemental Health and the COVID-19 Behavior Health Crisis, Anosha Zanjani, Brian Giebink, Kathleen Woods, and Kimberly McMurray
UnitedHealth Group’s Optum, Change Healthcare to combine in $13.5B deal, MedCity News
Telehealth and COVID-19, Anthem
Humana policy guidance for telehealth, Humana
Telemedicine and the Doctor/Patient Relationship, Protásio Lemos da Luz