Even before COVID-19, healthcare in the United States was in a state of transformation. The list of causes is a familiar one: advancements in technology, evolving patient habits, never-ending changes to regulations and reimbursements. Months into the pandemic — though still far from over — experts are now putting together a picture of what these healthcare industry changes might mean in the long term.
Perhaps predictably, the social distancing and stay-at-home orders put in place during COVID-19’s early stages have led to an increased use of remote and virtual care technologies. And with other changes in play, like the temporary bans on non-essential services and the spotty availability of personal protective equipment (PPE), most healthcare providers have been forced to pursue technology-driven solutions as a substitute for hands-on care whenever possible.
The immediate upshot is that the day-to-day life of most healthcare providers, and patients, has changed, and sometimes dramatically. But are these temporary changes, or permanent features? Is it too early to tell? Let’s explore four aspects of COVID-19-related healthcare industry changes that are likely to become the “new normal” in healthcare, and what you should know about them.
Change #1: The Accelerating Adoption of Telehealth.
Though it’s technically been around for decades, the adoption of telehealth — i.e., technology-driven care delivery — has been much more visible within the U.S. healthcare industry in recent years. Thanks to its perceived success in lowering the cost of care for providers, patient and payers alike, the benefits of telehealth (also commonly called telemedicine) have been evident for some time.
Yet its more widespread use has been consistently prevented over the past decade. At the heart of this obstruction are state laws that restrict cross-border care. Also impactful is the reluctance of the Centers for Medicare and Medicaid Services (CMS) — America’s largest healthcare insurer — to expand reimbursement for these services.
But in recent years, amid increasing calls from patients and politicians for expansion, those barriers have begun breaking down. This is largely due to the push toward value-based care, which has underpinned a series of new reimbursement guidelines from the CMS. COVID-19 has accelerated this trend sharply, in many cases forcing a transition to remote care for which many facilities weren’t yet quite ready.
According to a report from The Wall Street Journal, about 85% of urgent care clinics were providing some form of telehealth in May 2020, compared to 29%, less than a year ago. And a recent article published at USA Today showed that the number of Americans who use telehealth rose by more than 20% between December 2019 and May 2020, a direct result of the coronavirus pandemic.
The USA Today authors speculate that this increased usage may finally “stick”, i.e., force the wider industry adoption that’s been delayed for so long.
A few weeks after their story was published, with COVID-19 infections again on the rise, the widespread use of telehealth is taking on a feeling of permanence. As the report notes, CMS Director Seema Verma has said she “can’t imagine going back.”
“There will be a wave of ongoing adoption and increased acceptance, even as the pandemic begins to wind down,” agreed long-time Mayo Clinic chief and current OptumHealth CEO Dr. Wyatt Decker: “I think the shift is permanent.”
Change #2: The Expanded Use of Patient Monitoring.
Though telehealth technology encompasses a variety of innovations like app-based scheduling and virtual one-on-one consultations, its best-known and most widely used benefit is patient monitoring and remote management. As opposed to the direct, event-based interaction offered by virtual visits, continuous patient monitoring allows for constant access to important patient vital signs and trends.
Many facilities have already embraced these monitoring systems to some degree. Some use remote patient monitoring (RPM) to monitor patients at home and provide better opportunities for engagement and education. Within hospital and post-acute settings, contact-free continuous monitoring (CFCM) devices that track vital signs without directly interfering with the patient are more widely embraced.
Taken together, these systems provide the ability to regularly and reliably collect an enormous variety of patient data, all of which have direct impact on outcomes. From vital signs like heart and respiratory rate to more complex measurements like blood pressure, blood sugar and oxygen levels and more, CFCM and RPM give medical teams the info they need to ensure rapid intervention and top-quality care.
“Monitoring programs can also help keep people healthy, allow older and disabled individuals to live at home longer and avoid having to move into skilled nursing facilities,” notes The Center for Connected Health Policy. “RPM can also serve to reduce the number of hospitalizations, readmissions, and lengths of stay in hospitals — all of which help improve quality of life and contain costs.”
Similarly, in-facility CFCM has been an increasingly important tool for reducing incidences of sepsis and patient falls, and as a basis for rapid response. In short, the benefits offered by monitoring systems are significant — not just in terms of patient care, but for the ability of a facility or network to improve outcomes. In that sense, once implemented, they’re not likely to be rolled back.
Change #3: A Greater Role for Mobile Devices and Wearables.
A big part of the popularity of remote care is patient enthusiasm. A few decades ago, this didn’t seem to be the case, with folks uncertain and even fearful of the prospect of using technology for purposes of healthcare. This started changing long before COVID-19, with the prevalence of mHealth — literally, “mobile health” — apps like Fitbit, BlueStar®, the WebMD App, and many, many others.
In fact, as of November 2017, there were already about 320,000 mHealth apps available for download worldwide (as noted by Business Insider). But mHealth devices aren’t just smartphone apps. It’s a category that also includes step counters, wearable patches, personal digital assistants (PDAs), and other devices that are portable and/or wearable and designed to upload data to a larger network.
These don’t necessarily technically confer any specific clinical benefit. Instead, mHealth apps are used more for tracking patient data and delivering precise education than providing actual diagnostic treatment. More than anything else, they offer convenience — which is a big reason why they’ve exploded in popularity
This popularity, and its potential to boost patient engagement, has already worked its way through the healthcare industry — and beyond. Leading medical device providers now offer smartphone-compatible apps to encourage patients to engage with their therapy, for instance. What’s more, companies like Amazon, Google and Apple are now actively engaged in growing mHealth revenues.
COVID-19 is only accelerating this trend, marrying together digital data and day-to-day care in ways that aren’t likely to be reversed. The stay-at-home mandate means people are only more likely to engage with healthy goals at home, on their own time, without the mandate of a physician or care team.
Change #4: More Interest in Self-Care (and Better Tools to Achieve It).
To some extent, all the tools and technologies listed above are designed to give people the opportunity to better care for themselves, via data that’s gathered for either their direct use, or that of their physician’s. As Business Insider points out, more than a little bit of the central goal of mHealth is “keeping patients largely responsible for their own healthcare.”
In other words, the rising popularity of mHealth and at-home care is also fueling a growing tendency towards self-management among patients. A long-acknowledged milestone on the value-based care highway, self-care and its watchwords — engagement and compliance chief among them — are understood to be much more instrumental in improved outcomes than in years past.
Especially when combined with mHealth, self-management appeals to patients by making it easy and even fun to track daily progress towards their goals. But for providers, it offers even more concrete advantages. Chief among them may be its ability to let providers focus on the patients who are, at any moment, in the more immediate need of direct care.
That’s a benefit that’s particularly important with chronic care patents. Because chronic conditions are generally slow in progression and long in duration, self-management “can offer those living with chronic conditions a means to maintain or even improve their capacity to live well over the course of their lives,” wrote the authors of a self-management study published in American Journal of Public Health.
The jury’s still out on whether COVID-19 or its complications will end up on that list of chronic conditions. What’s clearer at this point is that self-management, telehealth and mHealth are, in general, enormously helpful tools for patients, providers and payors. As such, the widespread use they’re experiencing because of the pandemic is likely to become a permanent feature of healthcare delivery.
Disclosure: EarlySense provides contact-free continuous monitoring (CFCM) solutions. To learn more, please contact us here.