TELEHEALTH AND THE NEW NORMAL

By Healiant

Lately, it seems the question on everyone’s mind is, when? When will this all end? When will things go back to normal? In many ways, the real answer to this question is never. The way that healthcare is delivered is one of those ways that will likely never return to the recent view of normal. The new normal is evolving rapidly, driven by new CMS guidance and the evolving needs of providers and patients during this public health crisis.

In early March, the president and CMS expanded Medicare’s telehealth benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. The net effect is that now clinicians can provide more services to new or established beneficiaries across the country via telehealth. Prior to this announcement, Medicare paid for very little and the fee schedule was very different from the one providers used for in-office visits. Telehealth can now be billed for most clinical visit types and providers will be reimbursed under the Physician Fee Schedule at the same rates as in-person services. Medicaid and most private payers have or will be mandated to follow suit.

This new policy and payment scheme have allowed for beneficiaries across the country to have some access to their care providers and, perhaps more dramatically, for providers to continue to practice medicine, albeit remotely. The suddenness of the onset of this pandemic and the shelter-in-place directives saw very few providers, regardless of size, prepared to respond to the changes in telehealth reimbursement. While there were many technologies built to support telemedicine, they were not broadly adopted, and most practices were not prepared to respond with a real and compliant technology solution to remotely support their patient populations.

[ It is highly unlikely that this “no rules” environment will persist any longer than our current emergency lasts. ]

CMS, understanding this challenge, additionally waived the long-required HIPAA compliance rules that normally govern electronic communication of patient health information. Zoom, Skype, and GoToMeeting are now fair game for providers to deliver services to their patients. It is highly unlikely that this “no rules” environment will persist any longer than our current emergency lasts, but in the meantime, most providers have been able to stay engaged with their patients and continue to operate. It is important to note that while some services are being provided through telehealth during this crisis, many clinical practices have seen reductions of 50% or more to their visit volume and billing.

Clinical practice visit volume and billing have reduced by 50% or more.

[ Telehealth has been an essential tool—it’s now clear that virtual care will be a permanent component of how care is delivered. ]

Telehealth has been an essential tool for a sheltered population, and it is becoming increasingly clear that virtual care will be a permanent component of the way care is delivered and accessed. Telehealth is more of a concept than it is any one specific thing. And it has been described in many ways—virtual care, remote monitoring, telemedicine, telecare, to name a few. These terms all speak to the same notion—of providing healthcare remotely by means of technology.

Over the last two decades, the pace of the technology evolution to support safe and effective remote care has been staggering. The cost and access to wearable and remote monitoring hardware has redefined what is possible outside of a physician’s office or hospital. The Apple iWatch is now a Class II medical device, and we are surrounded by other connected devices capable of providing real-time remote compliant monitoring of everything from our blood glucose to our vital signs with remarkable accuracy. In many ways, it is this evolution in technology that is the catalyst for the coming of age of telehealth as a real alternative to in-person care. This new age of telehealth born out of necessity, while profound, is just beginning.

[ New innovations continue to reshape what is possible and further extend patient care outside of a brick-and-mortar setting. ]

Almost daily, there are new innovations that will continue to reshape what is possible and further extend our medical professionals’ ability to care for their patients outside of a brick-and-mortar practice setting. As these devices become more capable, more accurate, more reliable, more mobile, and more affordable, the historical notion of a medical office with traditional walls will become less relevant. Our care providers will be able to securely connect to a wide array of integrated remote tools to access more data about our medical status than is available today in most office settings in real time. These remote technologies will allow constant monitoring, trends over time, and change-in-condition alerts that will power more knowledgeable and timely interventions.

In addition to these amazing clinical tools, providers are being introduced to a broad array of online support tools. We have all seen the importance of distance online learning, and today more than ever, our clinicians and providers are utilizing online e-learning platforms to advance their knowledge and credentials. Healiant Training Solutions, one of the many online credential preparation providers, offers e-live and virtual learning to support nurses to advance their knowledge and clinical credentials from their home and at their own pace. Now and in the future, doctors and nurses will expect to be able to access knowledge and learning without the need to travel.

“For many years, e-learning has been unengaging, boring, and somewhat ineffective,” says Josh Heuchan, Managing Director of Healiant Training Solutions. “We are unconditionally committed to creating new and more engaging ways to transfer knowledge remotely, which is why we invest so much time, energy, and financial resources on our programs. Adult learners have come to expect, and now are starting to demand, more from their education and training providers.”

[ Telehealth can reduce the time and inefficiencies of aptly named waiting rooms and much of the travel for in-person care. ]

Telehealth as part of our new normal and the future hybridized healthcare delivery model has profound promise. Telemedicine can bring best practices and clinical interventions more elegantly and quickly to our rural communities. Telehealth can reduce the time and inefficiencies of aptly named waiting rooms and much of the travel required for in-person care. Telecare, when coupled with the amazing and evolving array of remote technologies, will give doctors more timely and relevant information to make the best decisions to optimize outcomes. Virtual care promises to reduce costs through earlier and lower cost interventions to more who need access. Regardless of the name we use to define this new form of care provision, we should see the amazing opportunity it presents to a worried population to have better access to care during these trying times.