Telehealth Trends in 2022

The concept of telehealth has been around since the telephone was invented – when folks called up the local doctor for a quick consult or asked him to come around to the house. Today, telehealth is more than just talking. It consists of video chats via apps, webcams, smartphones, and video conferencing software. Very simply, telehealth utilizes communication technology to offer healthcare services to patients without requiring an onsite physical exam.

The combination of the COVID-19 pandemic and innovations in health information technology have pivoted telehealth into the mainstream. And now, thanks to new government regulations and updated rules for commercial insurers, telemedicine services are receiving equitable reimbursement rates. This promotes a win-win for all – willing providers, grateful patients, and insurance companies that benefit from improved engagement and better health outcomes that help keep medical costs down.

Particularly during the dark days of COVID-19, hospitals were able to send patients home and effectively manage their care remotely. Given the necessity and immediacy of facilities having to embrace technology to manage capacity and patient care, telehealth underwent a trial by fire – and proved successful. 

Before the pandemic, less than 40 percent of hospitals and health systems were using or planning to use telehealth. Today, 53 percent have incorporated telehealth into their service delivery, and telehealth has catapulted to one of the top three focus areas for the healthcare industry. Patients have been exceptionally responsive to the telehealth transition, both during lockdowns and ever since. As of July 2021, utilization had stabilized at 38 times higher than pre-pandemic levels. According to research by McKinsey & Company, more than three out of four patients say they’re interested in using telehealth – particularly for refilling medications, reviewing test results, or receiving follow-up education.

The following are some of the promising benefits and developments in the telehealth field:

• It has effectively bridged gaps in the areas of rural health and access to specialized care.
• Wearables, remote diagnostics, and monitoring help keep the home-bound more engaged with their physicians for a higher quality of care.
• Researchers are currently exploring the potential for telehealth interventions to treat chronic pain, depression, anxiety, and other chronic conditions.
• High telehealth participation and outcomes in the mental health and urgent care fields make it likely these specialties will shift permanently to a predominantly virtual model.
• The Veterans Administration has experienced positive outcomes via a tele-stroke program, which provides virtual access to neurologists in hospitals.
• The VA also has a neurology and pain program that provides chronic-pain management via telehealth, as well as tele-GRACE – which extends telehealth reach to geriatric home and community-based care management.

Hospitals have launched a home model, in which connected health technology and sensors are paired with clinical staff to offer high-acuity services in the home. This accommodates patients’ preference to stay at home while freeing up high-demand beds in facilities.

Telehealth offers the potential for better use of healthcare provider time, especially in the wake of potential healthcare worker shortages in the future.

One of the biggest challenges for telehealth is patient access, particularly in areas that have poor cell service or internet connections. The new infrastructure bill recently passed by Congress is designed to improve broadband access to the internet in rural areas. However, it still remains for households to have smartphones, tablets, or computers to be able to participate in virtual video conferencing with a health professional. 

Chronic Condition Management

Today, about 40 percent of Americans suffer from a chronic condition, such as kidney disease, heart disease, cancer, lung disease, Alzheimer’s, diabetes, and stroke side effects. These patients can best manage their conditions through positive lifestyle choices, preventative care, treatment plan and medication compliance. However, it is difficult to maintain this level of self-care without routine physician interaction. This is an area in which telehealth can have a great impact – enabling regular check-ins and encouragement by provider staff without time-consuming office visits. Moreover, frequent consultations can help detect small problems early on before they become a bigger health issue.

Mental Health Care

Nearly one in four Americans suffers from a mental illness or substance use disorder – conditions which have worsened and become more prevalent since the pandemic began. In fact, lockdowns and social distancing guidelines disrupted many treatment programs for mental health services as support groups, community clinics, and private practices closed. Telehealth video conferencing proved to be a shining beacon for mental health care; in many cases proving to be more effective than in-person treatment.

For example:

• Lack of transportation was no longer an issue.
• The time it takes to travel to and from a treatment center was eliminated.
• In-home sessions eliminated the need for childcare.
• In-home sessions enabled those who struggle with physical disabilities.
• Some patients spoke more openly from the comfort of home as opposed to a facility, particularly those who experience anxiety.
• The distance of a phone or screen can offer a heightened sense of security during remote therapy sessions.
• This distance makes it easier for patients to admit to experiencing a substance use relapse – whereas previously they may have simply skipped the appointment.
• Because the pandemic brought with it additional stress factors, many patients recognized quickly that they needed help, when otherwise they may have resisted it.

As many therapists, counselors, and doctors quickly turned to teletherapy and telepsychiatry to support their patients, it became a widely accepted form of treatment. Also, because it less time-consuming to connect virtually with patients, the medium gives America’s shortage of specialists a way to connect with more patients – even those out of the local area.

Reimbursements

It is widely recognized that the key to the pandemic’s adoption was better funding for telehealth via reimbursement rates on par with in-person physician consultations. However, when the US is no longer under a health emergency status, these rates may dissipate – a change that many feel would be a mistake. Congress or the CMS will need to pass legislation and/or change rules to ensure today’s rates remain in force.

Before the health crisis, insurers balked at paying equal rates for audio-only visits. There is currently a four-digit “virtual check-in” billing code for phone conversations lasting 11 to 20 minutes. On one hand, if telehealth payments are reduced, so will the service. This would be unfortunate for many patients who benefit – the elderly, full-time workers, and people who live in rural areas where they have to drive an hour or longer to see a doctor.

On the other hand, insurers worry that permanent telehealth payment parity may lead to additional problems, such as unnecessary follow-up calls, or drawing out a five-minute call into the 11- to 20-minute range or encouraging telehealth when in-person visits would be more appropriate.

Cost Savings

New analysis from Willis Towers Watson finds that insurers recognize the role telehealth can play to help contain or lower healthcare costs. Examples include (1) use as a navigation tool to guide patients to the right care sources; (2) more patients seem willing to seek out care, whereas they were previously hesitant due to time constraints; (3) more frequent engagement with physicians may improve medication compliance and lifestyle behaviors.

In 2019, the telehealth market was valued at $42 billion. Industry experts now predict that by 2027, the market will grow to more than $397 billion. However, it is not without challenges. After all, patients want their telehealth experience to be seamless and integrated; nobody wants to have to juggle multiple apps, websites, and patient portals based on which provider they see. It’s important for electronic health records to be integrated for sharing among providers and with access during telehealth calls or video conferencing – especially if several providers participate in the same call for enhanced care coordination.

Furthermore, data from remote monitoring and wearable devices should also be integrated with electronic health records (EHR) and secure telehealth platforms, which will allow care teams to intervene at the first sign of trouble.

Over the next five years, health IT companies plan to invest heavily in remote patient monitoring and “hospital at home” type experiences. Note, however, that these research and development costs are expensive, and they do not expect all efforts to pan out. In fact, some are likely to require the same level of infrastructure and clinical support as in-patient care practices. Therefore, new innovations that survive must not only be effective from a health outcomes perspective, but also be cost-effective to implement.

Indeed, many industry stakeholders, particularly those in the health IT field, see telehealth and remote patient monitoring as a key component of care delivery moving forward. However, the future strength of the telehealth market lies with reimbursement levels. If they remain as robust as during the pandemic, the industry is poised to thrive. After all, many patients prefer the telehealth experience.

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