Is Telehealth Here to Stay? Yes, But Only if We Stick the Landing
After two years of lockdowns, panics, and gallons of hand sanitizer, we seem to be entering a post-COVID world. Governments are relaxing vaccine mandates and minimizing masks mandates, while markets are returning to normal. We’ve all learned more about the Greek alphabet then we did in high school. Bill Maher accurately assessed the pulse of the nation when he concluded, we’re “over COVID.”
A hyper-connected species is going to communicate diseases across our increasingly tiny world, and we can’t stay locked indoors all the time – but we can learn valuable take-aways from COVID.
One of the best lessons we can learn is the value of telehealth. As patients and healers confronted the realities of the pandemic, many practices joined the telehealth movement while those already onboard ramped up their services. Before 2020, the use of telehealth had been low, mostly because byzantine state and federal laws prohibited health care providers from delivering virtual care to most patients.
In the face of a worldwide pandemic, the federal government eased restrictions for telehealth and the market exploded. The federal government correctly chose to bypass antiqued HIPAA regulation (originally created in 1996) in exchange for the “good faith principle” which allowed doctor and patients the opportunity to use the best technology without fear of reprisal.
With fewer restrictions, providers could get reimbursed, patients could stay at home, everyone could socially distance, and care was delivered.
One news outlet went so far as to pronounce that telehealth is here to stay, but there’s a big “if” connected to that. It’ll only be here to stay if we reduce restrictions permanently. Medical professionals from physicians to nurses to therapists are encouraging the powers that be to make these changes permanent for the sake of patient care.
Connecting patients and providers via technology is nothing new. A Lancet article from 1879 discussed the then-revolutionary idea of using telephone calls to reduce unnecessary office visits.
Telehealth in 2022 means more than just talking on the phone or over a webcam. It includes remote-patient monitoring, which includes the transmission of personal health data such as vital signs, weight, blood pressure, blood sugar, blood oxygen levels, heart rate, and electrocardiograms. It includes “store-and-forward” transmission of digital medical details such as pre-recorded video or images (X-rays, MRIs, etc.). These are especially useful for consultations with specialists who can review medical information after it’s been collected, so patients can access specialty care without the need for adjusting schedules or lengthy travel.
A world with smart watches like the apple watch that include activity tracking, EKG, and blood oxygen levels – gov’t regulation is painfully stuck in the past.
In a response to the pandemic, the government allowed temporary reimbursement for many services under federal programs. Many private insurers followed suit, going so far as to waive copays for telemedicine visits for any reason. Many states also relaxed their rules to make telehealth more accessible, such as the requirement that a patient must be in a medical facility to obtain an evaluation. Removing these and other obstacles curtailed the delay of care, patient deterioration, and in many cases even death.
Going forward, there are a variety of things that state governments and other organizations can do to make this progress permanent.
One, support telehealth access across state lines. Letting patients, including Medicare recipients, access providers outside their community is critical if their home lacks certain providers or if they simply want to keep a doctor they trust. This could also flatten the level of care, as the wealthy can take time off to travel for treatment that others cannot. Many rural states have smaller populations than many large cities – the best way for them to provide robust access to a diverse panel of specialists is by using out of state physicians.
Two, allow all types of medical professionals to utilize telehealth, effectively eliminating artificial barriers and bottlenecks to affordable, specialized care. If retail giants like Amazon aren’t limited by state boarders for household goods, what value is there in limiting accessibility and affordability for medical care?
Three, don’t limit treatment by requiring an in-person visit before telehealth is available. Some states legislated this requirement pre-pandemic – an obstacle planned to reduce the use of tele-visits. If anything, it would be more logical for a patient to meet with a provider over telehealth to determine if in-person treatment is necessary. As a physician, I definitely know the value of an in-person exam for a lot of care, nonetheless, a significant amount of care can be quickly and effectively initiated with the proper use of technology.
These and other solutions can provide for a healthier long-term future.
Of course, telehealth visits can’t and shouldn’t replace all in-person medical appointments. Virtual visits that supplement traditional care can save patients time while helping to keep them safe. Providers likewise can cut down on their risk of exposure to communicable diseases while easing the pressure on overburdened systems. If we stick the landing, history will show that the coronavirus was when 21st Century medical protocols finally caught up with 21st Century medical technology.
Dr. Josh Umbehr, M.D. is a Family Medicine Specialist in Wichita, KS.
