Beyond the bubble: What will telemedicine be like after COVID-19?

Since COVID-19 made self-isolation and quarantine necessary, telemedicine and telehealth have experienced a surge in popularity. Experts debate the extent to which it will remain an integral part of the health care landscape after the COVID-19 crisis.

Telemedicine before COVID-19

Telemedicine was conceived as a way to provide health care to people in remote or low-income regions. Medical Futurist’s “One Minute Challenge: Telemedicine” video from November 2018 explains how telemedicine became commonplace in the country of Rwanda, allowing rural communities to access medical care from the faraway capital city. In addition, Inuit populations in the Arctic are able to quickly and easily access health care through their own smartphones.

However, before COVID-19 made it a necessity, telemedicine adoption was low. A December 2017 study found that 82% of consumers did not use telehealth services. The main barriers were the lack of proper infrastructure to support telehealth, lack of awareness and concerns about reliability/effectiveness.

Telemedicine during COVID-19

As one might expect, the use of telehealth and telemedicine has seen a huge increase over the past couple months. In New York, telehealth visits have skyrocketed 312%. Telemedicine company Teladoc Health saw its visit volume increase by 50% during the week ended March 13 and its stock price increase by almost 43% during the week starting March 16. Even the CDC and WHO have begun recommending telemedicine as a health care alternative.

Telehealth and telemedicine are a great fit for the current situation for obvious reasons. It eliminates the need for person-to-person contact between clinicians and patients, lessening the chance of spreading or contracting COVID-19. Some companies are even planning to release at-home COVID-19 testing kits, further reducing the amount of contact patients have with providers.

Many practices have raced to ramp up their telemedicine services at a time when the pandemic is already stressing patients and providers. Health care and tech companies have stepped up with an array of solutions to fill this gap. For example, AllWays Health Partners has partnered with Microsoft Teams to create AllWays on Teams, a free virtual visit platform that takes minutes to implement. This service is free for participating providers and, during the state of emergency, it’s available for all patients, not just AllWays Health Partners members. For more information about AllWays on Teams or to sign up, visit the resource page on our website.

Will telehealth stay mainstream in the future?

Some are concerned that we’re in the midst of a “telemedicine bubble,” and that this bubble will burst once the pandemic subsides and other areas of life return to normal. Changes made to regulations during the state of emergency are potentially paving the way for telemedicine’s continued use. The Centers for Medicare & Medicaid Services (CMS), which had previously limited the ability of providers to be paid for telemedicine services, increased its coverage of these services, causing many private insurers to follow suit. In addition, both state and federal governments are relaxing the requirement that physicians have a separate license for each state in which they practice.

Philadelphia-based Jefferson Health President and CEO Stephen Klasko, MD believes that the nature of health care has been permanently altered by COVID-19. “If you are a provider and think you're going to go back to your business model solely being based on hospital revenue and not relevant to people who want care at home, I think you will be out of business. I think we were always wondering what the big disruption would be that got us to join the consumer revolution, and I think this is it.” He offers five insights on the future of health care delivery:

1. There will be more partnerships between health systems and payers as telehealth accelerates

“The COVID-19 crisis will accelerate a disruption in how healthcare is delivered, paid for and perceived that would have happened anyway, albeit more slowly,” said Dr. Klasko. Health systems are shifting away from the “sick care” model and focusing on keeping patients out of the hospital when possible. In order to facilitate this change, health systems will have to align with payers to provide better care to patients at a lower cost.

2. The combination of increased data gathering, and artificial intelligence will make the society more resilient to disease spread

Experts are concerned that there will be another global public health crisis after COVID-19 ends, based on the appearance of MERS, Ebola, and Zika virus all within the last decade. However, if the health system continues to support telemedicine, technology can evolve further and help prevent disease spread. “Think about how the pandemic would have been handled differently if we had continuous data coming in from patients through their wearables and other sources as it related to temperature, respiratory rate, etc.,” said Dr. Klasko. “Or if 3D-printers were as ubiquitous as cell phones.”

3. How hospitals handle data today will make or break patient trust in the future

Data has shown that consumers trust local hospitals and providers more than big tech or big pharma, but giving patients easy and secure information transfer will increase trust. Patients will want to ensure that their information is kept safe and won’t be used against them. Allowing patients a part in owning their own data is a big part of that. Hospitals which prove that they can properly handle patient data will have their patients’ trust even after the pandemic ends.

4. Technology can close the gap between the “haves” and “have nots” but it must be applied strategically

As previously mentioned, telemedicine has great potential to give lower-income patients access to good health care. More than that, however, Dr. Klasko believes that telemedicine can help providers specifically address the social detriments of health. For example, “It will be unthinkable a few years from now that a pregnant patient that needs to be monitored a few times a week will have to come into a hospital full of sick people to do it,” said Dr. Klasko. “We know that the underserved population has a higher maternal and perinatal mortality partly because they cannot afford to take off from work, park the car, etc. Bringing pregnancy care into the home can be a game changer.”

5. The most prized skills in physicians will be empathy, communication and self-awareness in the digital age

Though medical schools tend to emphasize technical skill, memorization, and the ability to make quick decisions, those aren’t the only traits necessary to be a good physician. In fact, as telemedicine advances, these skills will become less important. Things like empathy and good communication are things that can’t be effectively taught in a classroom.

After the COVID-19 state of emergency, experts will be faced with the question of how to prevent a similar crisis in the future. Telemedicine has great potential for flattening the curve during pandemics. Beyond this, it has potential for increasing access and quality of care in general. Now that so many patients and providers have tried telehealth technology, it's hard to imagine that they won't be won over by the convenience.