COVID-19 and Shift Towards Telemedicine

Healthful Vitality | 03/08/2021 | By Dr. Gunjan Chauhan | COVID-19 and Shift Towards Telemedicine

The outbreak of the current pandemic as a result of the coronavirus disease 2019 (COVID-19) has led to significant modifications in delivering medical care. Moreover, it has rapidly restructured the healthcare system. The most significant change due to the pandemic is expanding and accelerated use of telehealth and telemedicine services among rural and urban populations (1). This new, evolved mode of delivery, known as telemedicine, provides increased accessibility and high-quality healthcare services irrespective of an individual’s location.

Amid the current pandemic, the implementation of telemedicine aims to provide cost-effective and quality care to patients. The Centers for Medicare and Medicaid Services (CMS) has explained that telemedicine is a service that seeks to improve the health and medical conditions of the patient by using real-time interactive communication involving patient and physician at different locations, unlike face-to-face interaction (2).

Clinical Applications of Telemedicine

Currently, telemedicine is not just a method of providing virtual care. But it is a way where each individual’s mental, physical, and social well-being is taken into account. No one expected that healthcare could be accessed digitally, but due to COVID-19, telemedicine has shifted how health systems work. Telemedicine has made it easier for patients and doctors to provide treatment for all ailments. In addition, it helps to exchange medical data and information in real time. This data exchange provides accessibility to rural populations. And it also saves patients time as they do not have to wait for their appointments (3).

What are the critical impact of COVID-19 and shift towards telemedicine

There are four critical approaches to delivering quality care to the patient:

1. Communication via telephone – It involves verbal interaction between the patient and medical professional through telephonic conversation.
2. Real time Interactive Medicine – Through this approach, the patient and clinician communicate in real-time while maintaining HIPAA compliance.
3. Remote Patient Monitoring – Caregivers who are located remotely can access the relevant data of the patient residing at home by using mobile medical data (e.g. Measurement of blood pressure, blood sugar level).
4. Store and Forward – In this method, the patient can share his medical records with the physician and accordingly a treatment approach can be planned.

Telemedicine during COVID-19

Due to the pandemic, much research has focused on evaluating the effects of telemedicine compared to traditional patient encounters that generally happened before the pandemic. Telemedicine has shown during the time of crisis that this technology can enhance approachability and improve the level of care. And simultaneously ensure that social distancing is followed. Therefore, the safety of the physician and patient is not compromised. Additionally, with the surge in novel technology, it has become much easier for clinicians to obtain any relevant record that will help in a patient’s treatment.

Even though the use of telemedicine existed before the pandemic, the situation and demand post-pandemic are pretty different (2). A recent report showed that telemedicine use was 11% in 2019, which has increased to 46% (4). This presents that the pandemic has brought a significant shift in the use of technology in the healthcare sectors, making it accessible to most U.S citizens (4).

After COVID-19, there has been an increase in the use of Current Procedural Terminology codes (i.e., the codes that are used by health-care providers to bill for health services) that covers telehealth services (5). The Centers for Medicare & Medicaid Services (CMS) have added around 80 new telehealth service codes to ensure Medicare reimbursement. It has also expanded telehealth services to all its established and new patients. Previously, it was required by the physicians to perform an in-person visit before scheduling a telehealth service so that a patient-clinician relationship is established. With the arrival of COVID-19, the CMS has eliminated this restriction so that all patients under the traditional medicare plan can easily access telehealth consultations (6).

COVID-19 and shift towards telemedicine: Advantages of telemedicine

Telemedicine proved to be beneficial to the patients as well as the healthcare providers. It has made it easy for patients to attain access to healthcare services. Due to digital advancement, even in rural areas, the delivery of medical care has become very convenient. Most people who cannot schedule and attend their follow-up appointments, such as the elderly, disabled, or those who do not have access to proper modes of transportation, can easily opt for this virtual modality of care (7). Healthcare providers can also monitor the patients in their home environment. Telemedicine can help physicians create a new source of revenue and promote their finances post-pandemic (8).

Telemedicine has become integral to healthcare systems as it provides safety, convenience, and adequate health support in these demanding times. Here are the key characteristics that make it an effective tool for patients and clinicians:

1. An accessible patient care approach

During this pandemic, there has been a huge demand to perform COVID-19 related tests and other routine check–ups. The clinicians can provide proper service and access large number of patients through the method of virtual care. It will save both patients’ and physicians’ time. Depending on the severity of the condition, an in-person appointment can be scheduled if at all required.

2. Provides safety to the health care professional and patient

A research at Health Policy Research Center at Massachusetts General Hospital’s mentioned that most of the medical personnel feel that telemedicine is safe and an essential tool in this risky time. Through this, not only doctors and their families are protected from the transmission but even the patients can get help from any medical specialist in a secured way.

3. Provides support and care to the patient in great need

People located in remote locations generally face a shortage of medical professionals, telemedicine will serve as an important tool to empower them with a foundation where their health is also considered a priority. Additionally, low risk patients can be provided adequate care and treatment at home.

4. Rapid exchange of Information

Digital advances in healthcare has allowed fast and easy exchange of patient’s medical history, imaging reports and other medical information between the doctor and patient. This will also allow regular tracking of patient’s health status.

5. Allows convenient access to the elderly

It is evident that the harsh impact of this pandemic is seen largely among the elderly population. Therefore, they are provided adequate care, support and timely diagnosis via telemedicine, without being exposed to hospital’s environment.

6. It is a cost-effective and time saving method

Due to virtual monitoring, remote analysis and storage of data electronically, both physicians and patients are able to save money as well as time. Patients do not have to travel to distant location to consult a doctor.

Future directions: Embracing virtual care

Before COVID-19, there needed to be well-designed guidelines, policies, and reimbursement regulations that ensured the healthcare system’s financial, structural, and employment stability in the USA. However, with the arrival of the pandemic, it has become evident that there is a strong need to plan and design various legislative policies that are not only beneficial to the physicians, but also provide quality care services to the patients who resides in remote and less approachable areas (9).

A balanced approach that ensures the formation of a high-quality health system is the need of the hour. Therefore, should plan a provider-patient partnership involving the insurance firms and the critical stakeholders in a healthcare organization to bridge the gap in the healthcare system.

The federal government should make solid legislative policies that provide transparent details to the providers and the payers regarding the costs, quality, and access to individual care services. Healthcare reform should keep the entire financial planning of this sector as simple as possible. The present system, which involves deductions, subsidies, premiums, taxes, tax exemptions, and out-of-pocket payments, should be replaced with a simple financial system. The numerous options of public and private health insurance programs should be replaced with a single universal program that covers an individual throughout his lifetime (6).

To conclude the discussion on COVID-19 and the shift towards telemedicine, digital care will be integral to post-pandemic. And a standardized approach to assess the quality metrics will ensure that patients are always given the best care.

References

1. Noel K, Messina C, HouW, Schoenfeld E, Kelly G. Tele-Transitions of Care (TTOC). BMC FamPract.2020;21(1):27.
2. Telemedicine: centers for Medicare and Medicaid services; Available: https://www. medicaid. gov/ medicaid/ benefits/ telemedicine/ index. Html
3. Mehrotra A, Chernew M, Linetsky D, Hatch H, Cutler D. The impact of the COVID-19 pandemic on outpatient visits: a rebound emerges. New York: Commonwealth Fund, May 19, 2020
4. Bestsennyy O, Gilbert G, Harris A, and Rost J, “Telehealth: A quarter-trillion-dollar post-COVID-19 reality?” May 2020, McKinsey.com.
5. Lonergan PE,Washington SL III, Branagan L, et al. Rapid utilization of telehealth in a comprehensive cancer center as a response to COVID-19. Health Informatics. Published online April 15, 2020.
6. State Telehealth Laws and Reimbursement Policies Report. Center for Connected Health Policy. Published 2020. Accessed April 12, 2020.
7. Wilson et al. Reimbursements for telehealth services are likely to be lower than non-telehealth services in the United States, Journal of Telemedicine and Telecare, June 3, 2016.
8. Kichloo A, et al. Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA Fam Med Com Health 2020;8:e000530
9. Henry BW, Block DE, Ciesla JR,McGowan BA, Vozenilek JA. Clinician behaviors in telehealth care delivery. Adv Health Sci Educ Theory Pract. 2017;22 (4):869-888

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