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Telemedicine: The COVID-19 necessity is here to stay

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By Steve Allen, Director, Clinical Systems Segment, Health and Life Sciences, Intel

The diffusion of innovation is typically a slow and laborious process, as users weigh the benefits of adopting a new technology against the costs of change. That is, until a crisis occurs. It is often these inflection points in history that accelerate change. Telemedicine has been ready for prime time for years, but its widespread adoption has been slow, constrained by regulatory barriers, consumer habits, and providers who struggle to incorporate the technology into their existing workflow.

Over the years, these challenges led many to question whether telemedicine would ever fulfill its potential to become the standard of care. This skepticism was quashed in record time in response to the fight against COVID-19. During this time, the technology has become not only a critical defense against the virus worldwide but also a proven asset in improving care overall. In France for example the use of telemedicine jumped by 40% after the government issued a new law to waive existing restrictions.

In the US, once thought to be most useful in areas with a shortage of specialty care providers, telehealth is now enabling widespread screening and diagnosis of COVID-19 without the risk of personal contact. It is also enabling patients with less severe symptoms to receive care from their homes. Telehealth has also enabled the continuity of care for patients with chronic illnesses by allowing them to connect with their care providers without having to go to a clinic or hospital and risk exposure.

Nearly three-quarters of respondents to a Sykes survey said they’d consider using telehealth for remote virus screening, and two-thirds said COVID-19 has increased their willingness to try virtual care. Officials at the Cleveland Clinic predicted they would have 60,000 telehealth visits before the end of March, compared to 3,400 visits in an average month before COVID-19. Additionally, many patients who have tried telehealth services throughout the pandemic have been satisfied enough to consider scheduling another appointment in the future.

For care providers, the benefits of telehealth are unparalleled. COVID-19 is straining the capacity of hospitals. By engaging with patients virtually, hospitals can limit overburdening the onsite staff and reduce the risk of spreading the virus. Telehealth also reduces the number of times healthcare professionals must don personal protective equipment, thus conserving limited supplies and simultaneously reducing the risk of infection to themselves and other providers. Telehealth can also unburden office-based providers as patients are not coming to appointments in person. These providers have been able to help their patients virtually rather than leaving them with no place to be seen for routine care.

This crisis moment has finally allowed the telemedicine genie out of the bottle. We must start now to ensure that telemedicine continues to be the standard of care for patients nationwide.

One factor that has enabled this rapid shift to telemedicine is the temporary relaxation of key regulatory barriers. Recent emergency relief legislation, including the most recent CARES Act, has provided the Department of Health and Human Services with the regulatory flexibility to improve access to telehealth, including the removal of telehealth patient and provider location requirements, adding new Medicare reimbursement codes, clarifying that smartphones can be used for telehealth visits, allowing for the use of platforms like FaceTime and Skype and allowing the waiver of co-pays.

As we look to the use of telemedicine post-pandemic, we know that robust privacy and security guardrails will be critical to continued widespread use. Thankfully, as telehealth use expands, the technology that powers it is continually improving, building in privacy from the ground up, including evolving to improve quality and accessibility to patients’ health records. New tools allow for the remote monitoring of patients’ vital signs, and new observations such as skin temperature and heart rate can be assessed using vision computing to highlight potential concerns.

Without permanent changes to regulatory barriers, which currently have been waived only temporarily, many of the applications valued today could be meaningless tomorrow. If barriers such as site and pre-existing relationship requirements and reimbursement limits are reinstated the benefits of telehealth would be lost. We cannot afford to revert to restrictions on telemedicine. A return to the previous constraints would be a major setback to the state of care and would be met by consternation from healthcare professionals, payors, and patients. We must lift these restrictions permanently, while implementing appropriate privacy and security guardrails, to truly leverage the benefits of telemedicine for the future.

Telemedicine and its benefits are here to stay. With telehealth’s ability to improve the experience, access, and speed of providing care, healthcare teams can concentrate on higher priority cases where face-to-face attention is needed to save lives. We have the opportunity now to drive much-needed regulatory changes, and we must do so quickly to ensure a better future.
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