What is telemedicine? And how can it help.

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While some form of telemedicine has been available as a form of healthcare delivery since the 1960s, for the first few decades, there were some barriers to adoption. Initially, the equipment used for telemedicine was specialized and expensive, so outside of the government, education institutions, and hospitals, the average person didn’t have access. With the information and technology explosion brought on by the internet in the 1990s, it became much easier for patients to utilize some technologies to connect with their doctors. The introduction of the iPhone in 2007, coupled with the simultaneous, rapid expansion of broadband internet, were the missing pieces that shattered any remaining technological obstacles.

With all of the technical components that allow anyone to take advantage of telemedicine now commonplace, the question is, have patients embraced this healthcare option. Over the last few years, there have been various studies, surveys and polls conducted looking to determine how patients feel about telemedicine. A JD Power survey conducted late last year found that just shy of 10% of Americans had used telemedicine, with 40% reporting that their health system or insurance provider doesn’t offer telemedicine services, and 35% stating they are unaware if they even have that option. About 50% of respondents thought that the quality of care via telemedicine would be lower than an in-person office visit.

Needless to say, while medical institutions may be regularly utilizing various forms of telemedicine, the public hasn’t exactly been lining up to take advantage. Sadly, even with numerous studies pointing to the efficiency and benefits of telemedicine, insurance companies have been slow to voluntarily add telemedicine to their list of covered services.

Enter COVID-19

The introduction of the sars-cov-2 virus to the US (not to mention the rest of the world), had a major impact on how healthcare is being delivered. By the end of March, shelter-in-place orders were being implemented, and healthcare practitioners’ offices were being ordered closed. These unprecedented closures created a perfect storm of patients still needing care and doctors still needing to be able to see patients and keep their practices operating. As a result, the use of telemedicine visits exploded, practically overnight.

Doctors offices that didn’t offer telemedicine services prior to COVID-19 are now offering them in an effort to keep their practices operating. More insurance companies are now offering to cover telemedicine visits, some temporarily with zero copays. Third-party telemedicine companies are seeing huge surges in utilization and startups in the space are raising millions of dollars in a matter of weeks. Government reimbursement policies (which are usually painstakingly slow to change) for telemedicine visits are also changing. 

At the end of March, the Centers for Medicare and Medicaid Services (CMS) released temporary changes due to COVID-19, that allowed for more than 80 additional services, such as physical therapy, psychological testing, intensive care services, and custodial care services to be covered under telemedicine visits. They also removed some of the frequency limitations of some services to allow for more frequent telemedicine visits. Prior to these changes, Medicare had strict restrictions on the use of telemedicine, limiting it to specific locations and circumstances. Once these changes were announced, members took advantage and use skyrocketed. Almost 1.3 million members used telemedicine services the week of April 13th, compared to just 11,000 the first week of March (an 11,718% increase).

Realizing The Benefits

Over the past couple months, with the sudden change in how healthcare had to be delivered, patients and doctors have been forced into embracing this alternative option. Fortunately, even with potential downsides such as user error and privacy and security concerns, many patients are recognizing the laundry list of benefits this form of communication with their doctor provides, which include:

  • It’s more cost effective.
  • Patients experience shorter wait times.
  • It’s more convenient.
  • It removes geographic barriers and the impact of local clinician shortages to increase access to care.
  • It has been shown to improve the quality of care.
  • Higher efficiency and lower expenses reduce healthcare costs.
  • Flexibility and real-time, anytime access, improves patient engagement.

Temporary or Permanent Changes?

Unfortunately, like a lot of the US healthcare system, when it comes to changing how telemedicine is utilized, covered, and paid for by insurance companies is complicated. There are regulatory barriers, reimbursement issues, and improvements in training that need to be ironed out before there can be a widespread, permanent adoption. Hopefully, with the recent surge in use, there will be more and more discussions around how telemedicine can be more broadly used to help patients, doctors, and the healthcare system in general. In the meantime, there are innovative, alternative options currently available that include telemedicine services as part of the overall coverage solution

While telemedicine isn’t a viable replacement for all in-person office visits, it definitely should have a permanent place in treatment options. We hope that as the frenzy surrounding COVID-19 subsides, we continue to see forward progress and more patients, doctors, hospitals, specialists, and payees embracing the benefits of this alternative path to healthcare.