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Hurricane Katrina was responsible for the most recent increase in interest in Telehealth, but it took the COVID-19 global pandemic to demonstrate the potential for long term change by reimagining how healthcare will function in today’s society. Telehealth is best defined as a visit between a patient and health care provider via telephone, smartphone, computer or tablet. ‘Telemedicine’ and ‘Telehealth’ are often used interchangeably but in fact ‘telehealth’ is a broader term encompassing services like in-home monitoring or teleradiology (where CT scans or MRIs can be read by radiologists often located vast distances from the patient and primary physician.) Video visits have become by necessity, a new normal in healthcare in the wake of the world-wide coronavirus outbreak. These visits are proving vital to maintaining the health and safety of physicians, nurses and other healthcare professionals as well as patients, families and the community as a whole. These live, interactive visits have become an excellent solution for following the Centers for Disease Control and Prevention’s (CDC) directives to stay home and call before going to a medical facility. Many hospitals direct calls to a 24/7 nursing service that gives advice and makes referrals. This centralized system allows front-line staff to probe deeper and make more accurate determinations for treatment. It is interesting to note that in a recent survey 84% of respondents said they were more likely to select a healthcare provider that offered telehealth services.

TELEMEDICINE TRIAGE

This is the system of screening patients remotely. The communications are via phone or App to centralized call centers or care providers where they are advised as to their next step. These systems offer enormous benefits in terms of safety, time management and allocation of resources including staff and supplies. It also offers increased access to help and advice to those with transportation, location or mobility issues. Virtual visits also offer the ability to remotely identify symptoms that patients may not be aware of or unable to self-diagnose/describe. Examples of this could be cases of lesions associated with skin cancer or recognizing the important early warning signs for heart attack or stroke.

ENLARGE THE TOOLBOX

A new light has been shined on remote patient monitoring for situations that are potentially contagious or infectious, high risk populations and chronic illness management. This portable system offers a data rich continuous monitoring platform for physicians, patients and their caregivers. The use of remote patient monitoring is being used by staff to monitor several rooms at once, reducing the amount of physical contact needed and freeing up doctors and nurses from climbing in and out of PPE’s. This has the potential to redefine workloads while still replicating many  in-person services and lowering the burden on stressed out family and caregivers.

DRIVING THE FUTURE OF TELEHEALTH

The Federal and State governments will have a large say in the discussion of the future of telehealth in the vast and complicated world of American healthcare. Federal and State regulations that provided barriers to telemedicine implementation were quickly removed in order to speed access to care while maintaining best possible protection scenarios for medical staff, facilities and patients. Success with telemedicine in the wake of COVID-19 means this is unlikely to change. Insurance providers also have a significant piece of this pie. Telehealth medical coverage is likely to slide back once this crisis is deemed over however the Centers for Medicare/Medicaid did expand coverage enabling more providers the use of telemedicine. The Medicare Emergency Rule is compensating physicians for video visits at the same rate as in-person visits. Prior to COVID-19 many physicians were reluctant to offer telemedicine options because insurers either refused to compensate them or did so at a lower rate. Access to broadband internet services will also play a significant role in the use and success of telehealth. Currently 21 million Americans still lack access to broadband internet, primarily in remote or rural areas.  The COVID-19 pandemic caused the federal Health and Human Services Department to open its money drawer to fund telemedicine projects. The FCC has also funded its own 100 million Telehealth expansion program to increase broadband expansion to rural areas of the county. These government responses are important first steps.

POST PANDEMIC

It is hard to say what the post pandemic reality will look like in healthcare or anything else for that matter. Changes in technology capabilities can occur almost overnight so how best to harness it? Will in-person visits be reduced to emergencies only? Most likely not but many people are now accustomed to using telehealth services as their first point of contact. People who have had the experience of telemedicine and have developed a level of ease and familiarity with it. Most will wish to continue its use. As hospitals and healthcare professionals adjust to this ‘new normal’ the questions remain: How will telemedicine impact workflow, patient flow, staffing and other resource allocation? Can it or will it actually improve quality of care? Can we become smarter, safer, more resilient, agile and engaged?

Contact us at NHS Solutions with your ideas and opinions. We have Interim Nurse Leaders on the front lines and invite your input as heathcare continues to innovate and adapt.