Look around you. In restaurants, on public transit, and in our own homes, we connect daily with our friends, family, and co-workers through technology.
FaceTime, Zoom, and Skype allow us to “virtually be there” for big moments or daily routines, if we choose to. Recently, I used technology to solve a plumbing crisis in our home without paying the weekend rate for a plumber.
While our society has become quite comfortable conducting all sorts of interactions via technology, telehealth has met some resistance early on. However, the 2020 pandemic ushered in the widespread adoption. Now, it has become practically a life necessity.
The evolution of telehealth is a welcomed and long anticipated help for many Americans, especially in rural areas. As with all highly regulated industries, changes begin at the top—Capitol Hill.
As the pandemic swept the nation, delivering proper healthcare to those who needed it became even more important. Policy barriers that have been slowly addressed took centerstage due to the public health emergency. CMS (Center for Medicaid Services) oversees state and federal health insurance exchanges and is a major influencer on the types of services that can be approved and paid for by all types of insurance programs.
During the public health crisis, CMS took accelerated action to remove barriers to telehealth for everything from routine checkups to prescriptions medications, even emergency medicine. This movement has made accessible much needed services to underserved areas and available to high-risk population ensuring less potential exposure to COVID-19.
With barriers like geography and transportation, and especially access to high demand specialists, telemedicine is delivering important care that may be lifesaving for some people. My parents, who live in a rural town, have been dealing with some ongoing health issues that required them to drive an hour over mountain passes, often in inclement weather, to receive care. There have been some occasions where in person visits are necessary. Yet, other times it was simply follow-up or check-in.
RP-VITA is a collaboration between InTouch Health and iRobot Corp using state of the art telecommunications and AutoDrive technology in a telemedicine device. As it moves through the hallways at a hospital it gives the appearance that a physician is making his rounds, however, the units are not entirely autonomous.
They often require a normal level of assistance by a medical professional, such as a nurse or medical assistant, to bring this electronic doctor into the examination room to observe the patient. The physician can control the unit remotely but will need another pair of hands present to administer tests using the onboard instruments or other equipment in the room. The remote physician can be seen and heard on the monitor and will receive the data from the tests being run on the patient.
The attending physician may be elsewhere in the hospital or in a completely different location. RP-VITA can save time and money by essentially allowing specialists to be in multiple locations without the travel time. These units are not only being used for medical applications but also tele-psychiatry assisting adults and children with mental health and behavioral health issues.
As we look to reduce the costs of healthcare, preventative medicine is key. Utilization of telehealth has greatly increased throughout 2020 from 13,000 Medicare beneficiaries weekly to 1.7 million during the last week in April. The increase in utilization provides greater opportunity for early intervention and treatment which directly influences healthcare costs.
There are still some barriers and bumps to workout. Some regions lack reliable internet connections often referred to as the digital divide. The digital divide has impacted many others besides healthcare including education, employment, and access to other basic needs.
No technology platform is 100 percent secure which leads to concerns about patient privacy and data security. Some practices limit their liability and risk by only providing telehealth services through specialized technological platforms, but this comes with its own accessibility issues – not to mention a learning curve. Federal, state, and local governments have been struggling with how to address the divide but have no widespread solutions currently.
As a teleservice, accessing care from a primary care provider across state lines should not be a problem, right? State laws may vary on this and are still being addressed to bring alignment nationwide. A close family member is dealing with this barrier as they would like to relocate to another state but are reluctant to leave their mental healthcare provider and start over with someone new. If this matter can be resolved, it would provide more flexibility for patients and continuity of care for the long term.
Prescription for Screen Time or Me Time?
While the pandemic has accelerated the rates of utilization of telehealth services, it is unclear whether those rates will maintain post pandemic. Even if the rates settle somewhere in the middle, it is a service that is and will have a positive impact on our congested healthcare system.