Amazon, Microsoft, and the Future of Telehealth Expansion
Amazon, Microsoft, and the Future of Telehealth Expansion
Is telehealth expansion here to stay? By now, it should be clear the answer to this question is an emphatic yes.
From new, heavy-hitting entrants, to expanding use cases, to increasing acceptance from all corners, it’s now clear that many of the temporary expansions we saw during COVID-19 will be made permanent—and expanded upon.
But how? What is the future of telehealth expansion in a post-COVID environment?
New Entrants to the Telehealth Market
In February, Microsoft announced an update to its Microsoft Cloud for Healthcare platform to enable virtual visits and remote monitoring. Microsoft already had its AI scheduling bot, Azure, on the task of scheduling appointments—the new tools mark a big extension of Microsoft’s platform into telehealth.
Meanwhile, Amazon announced it is expanding its pilot program for telehealth, called Amazon Care, to all of its U.S. employees. The company grew so fast in 2020 it’s hard to pin down how many people that now includes, but according to a NY Times report, Amazon now has at least 1.2 million employees worldwide.
The dramatic expansions of both Microsoft and Amazon into telehealth is just one indication that telehealth expansion is here to stay. But it is also evidence that telehealth isn’t just for healthcare companies anymore—it’s for any company with the resources, ambition, and flexibility to try its hand.
If 2020 was the year we saw existing healthcare groups make forays into telehealth, 2021 will be a year not only of further expansion, but of new entrants, and even consolidation (as in MDLive’s announcement it is being acquired by Cigna subsidiary Evernorth).
So, how should healthcare leaders think about these new entrants?
From Point Solutions to Enterprise Solutions
The entry of large consumer brands into telehealth reflects the new public acceptance of virtual care, while the entry of enterprise B2B brands reflects the growing desire of health systems to explore enterprise telehealth solutions.
Many health systems at the beginning of 2020 already had enterprise telehealth strategies in place. Nevertheless, during the pandemic, hospitals used a lot of bandaids and ad-hoc strategies to address the unprecedented public health crisis, from using baby monitors to do remote patient monitoring, to bringing Zoom to the bedside to allow patients to connect with loved ones.
This experimentation opened everyone’s minds to the value of virtual care, especially scaling that care beyond the emergency department or the ICU. In the past, hospitals have searched for point solutions to specific problems, such as telestroke in the ED, or remote patient monitoring.
Now, a new generation of telehealth technology is proving that telehealth can scale beyond those point solutions, into a flexible, system-wide software platform that can be adapted to nearly any workflow.
This move from point solutions for specific use cases to enterprise solutions for entire health systems is indicative of how healthcare leaders are thinking about telehealth expansion.
Additional Use Cases & Expansion
In December 2020, the Centers for Medicare and Medicaid Services (CMS) announced it was making permanent a huge expansion of payments for telehealth services. The fee schedule included 60 additional telehealth services, and CMS is studying whether more services should be added in the future.
These new payment schedules serve as a kind of roadmap for new use cases, from home visits, to physical and occupational therapy, to nursing facilities. During the pandemic, health systems needed to quickly add virtual patient monitoring for COVID patients—now, health systems are looking at how to video-enable all patient rooms. And they are looking for enterprise solutions that go beyond the hospital, extending care teams system wide. Telehealth is moving beyond the emergency department and the ICU to include a health system’s clinics, its rehab facilities, long-term care facilities, primary care offices, and more.
It’s no wonder the research firm MarketsandMarkets estimated that telehealth and telemedicine would grow from $38.7 billion in 2020 to $191 billion by 2025. Meanwhile, a March 2021 McKinsey report predicted that of all the transformations in consumer behavior during the pandemic, the transition to telehealth would be among the most sticky (second only to online grocery shopping).
One of the big reasons, according to the McKinsey report, is that consumers have found real value from using telehealth, both monetary and in terms of customer experience.
That’s not surprising: telehealth technology has reached a level of flexibility and ease of use that simply didn’t exist just a few years ago. The only question for healthcare leaders at this point is: do they have the right tools in place to prepare for the future?
Interested in a flexible enterprise solution that can scale according to your system’s needs? Learn more about the Caregility platform here.Learn More
Telehealth News Roundup: A $42 Million Investment in Rural Telehealth, Bipartisan Support for Permanent Expansions, and Caregility in the News
More than 8,000 telehealth carts worldwide, capable of enabling 4 million telehealth calls annually—it’s all part of the telehealth solution that has helped hospitalized COVID patients stay in touch with their loved ones, and even remotely attend a wedding. WCBV Boston’s Channel 5 documented that and more on a recent segment about Caregility and our contract manufacturing partner, Yorktel. Watch the piece on YouTube here.
Healthcare IT News
The US Department of Agriculture is investing $42.3 million ($24 million of which is coming from last year’s CARES Act) into rural telehealth infrastructure, Healthcare IT News reports. According to a recent report from the agency’s rural policy research arm, several factors have resulted in increased COVID infection and death rates in rural areas, with telehealth being looked to as an important part of the solution. Read more here.
The questions swirling around which parts of the historic telehealth expansion will be made permanent are beginning to come into focus as the new Congress and Biden administration have signaled support for making some of the country’s temporary measures around telemedicine more permanent. HHS Secretary nominee Xavier Becerra said during his Senate confirmation hearing, “If we don’t learn from COVID how telehealth can help save lives, then we’re in trouble.” Meanwhile, MedPage Today reported the House Committee on Energy and Commerce signaled bipartisan support for making Medicare reimbursement for telehealth permanent. Read more here.
2020 was the year the country was introduced to Virtual Care 1.0, writes Alyssa Jaffee in MedCity News, with widespread adoption of video-based consultations and a healthcare system presented with a mandate to deliver virtual care at scale. 2021 will be the year Virtual Care goes 2.0, with expanded platform functionality, broadening use cases, and expanding sites of care. Read more here.Learn More
Combining the Future of Telehealth into a Virtual Care Platform
2020 brought the crucial nature of virtual care to the forefront of healthcare delivery. From mitigating the spread of the coronavirus to connecting isolated patients and providing care for non-COVID patients, we have seen validation of telehealth under the most extreme circumstances as healthcare organizations grapple with the COVID-19 pandemic. Telehealth is now a critical component of care delivery, not just a “nice-to-have.”
How Telehealth is Shaping the Future of Healthcare
As we look ahead to the future of telehealth medicine, virtual care will continue to lay the fundamental foundation needed to enable agile and effective care with the right clinician, at the right time, and in the right location for patients. Inpatient care will increasingly be imbued with virtual components that improve productivity, patient outcomes, and provider experience.
A wide range of patient engagements will employ a digital-first strategy designed to bring costs down, improve patient satisfaction, and make the entire experience more convenient for the patient and caregiver alike. Telehealth will be reinforced with a new era of predictive tools and applications that augment the information available to improve overall outcomes.
In 2021, the blending of artificial or augmented intelligence (AI), wearables, and two-way video will advance virtual patient care. The combination of these technologies into a comprehensive virtual platform will help providers improve population health and outcomes across more patients as they extend the hospital room outside of the physical facility and into patients’ homes.
First and foremost, virtual care will continue to drive efficiency in inpatient care. AI will play a tremendous role in enhancing clinical insight and enabling care for more patients, in spite of challenges related to limited staff resources. Although artificial intelligence gets the lion’s share of attention in the world of healthcare innovation, it is essential that we do not underestimate the importance of the human element in the marriage of healthcare technology and care delivery. Rather than refer to it as artificial intelligence we prefer to focus on the concept that, in reality, it is augmented information.
Investments in augmented information are equally important as a steppingstone in complementing and enhancing the existing workflows of clinicians. Nothing can replace a knowledgeable, experienced caregiver, but how much more effective can they be if we augment the information they have at their fingertips? Continuous virtual monitoring of patients, data capture through wearables, and access to predictive algorithms that can help providers anticipate conditions affecting the patient’s outcome can combine to improve care.
Hospital at Home
The acceleration of telehealth and virtual care to address how to provide services to patients unable to visit their doctors during the pandemic has proven virtual care is not only viable but often the preferred option. As a result, hospitals are looking for ways to extend the healthcare engagement experience into the patient home. While this has largely been pursued out of necessity in order to reach patients isolating at home during the ongoing COVID-19 pandemic, it is also fueled by evolving patient expectations around easier access to care.
Virtual care models represent the modern-day equivalent of the home visit or house call of the past. Technology platforms and an array of connected devices will become permanent fixtures in our homes, as common as connected thermostats or doorbells. These virtual care solutions offer a cost-effective means for reducing some of the overhead commonly associated with hospital stays, as well as increased convenience and comfort for patients. Home-based care has the added advantage of minimizing exposure to infected patients by the healthcare staff.
Wearables in Healthcare
The proliferation of Internet of Things (IoT) devices and wearables as a growing trend will have an impact on virtual care an telehealth in coming years. Wearables such as smart watches, fitness trackers, biosensors, ECGs, and blood pressure monitors represent some of the first home-health devices to approach ubiquity. Remote technologies that consistently measure and monitor patient vitals can accelerate provider insight into patient risk factors.
By proactively alerting care providers to warning signs, clinicians are able to intervene earlier to prevent adverse or catastrophic events—again offering patients the right care at the right time. These interactive devices can also encourage patients to make better health decisions in real-time. The rise of these “digital medicine cabinet” technologies will unearth previously untapped avenues for healthcare providers to advance the shift from responsive or reactive care to more proactive and preventive medical interventions. Management of access to and the security of these devices will be paramount.
What is the Future of Telehealth?
Each of these components have had varied success to date in individual use cases, but the real power and benefit will come from combining them into a comprehensive virtual care platform. Over the course of the past year, utilization of telehealth has clearly reached incredible levels and has established a new normal which is anticipated to remain even after the pandemic is over. Now is the time to optimize these technologies and prepare for growth.
Not only has virtual care helped us deal more effectively with the pandemic, but we have been given a glimpse of what the future of telehealth and telemedicine can be. The digital revolution in healthcare has begun and leveraging two-way video, wearables, and augmented information will enable us to create a better patient experience, improve outcomes, and be more prepared for the next challenge that might come.
The benefits of virtual care have been on full display in 2020 and as we move into 2021 and beyond it is clear that there is no limit to the ways telehealth can positively impact the overall experience and outcomes across the entire healthcare continuum.
Want to learn more? Check out our post on Augmented Intelligence in Telehealth.
This post was originally published on Population HealthLearn More
Telehealth News Roundup: Improving Equity and Diversity Through Telehealth, Hybrid Telehealth Systems, and the Coming Telehealth Evolution
Telehealth is here to stay. As we continue to watch it taking hold and further shaking up the industry, here is our monthly roundup of today’s important healthcare topics and trends in telehealth. This month, we look at how telehealth helps improve equity and diversity in healthcare, what a hybrid healthcare system looks like, and how the industry must evolve to meet patient and industry needs.
COVID-19 has led to a widespread shuttering of traditional primary care offices, not to mention increased burnout and more emphasis on the role that technology plays in helping provide care. But can telehealth really replace primary care as a first line of defense? Read more here.
Critics are beginning to cast doubts on telehealth to build patient-provider relationships, provide holistic care, and reduce care costs. Hill Ferguson, CEO of Doctor on Demand, argues however that telehealth has proved the opposite – that if telehealth is able to evolve, it will reduce costs, streamline care, and help build clinician networks to grow clinician diversity. Read more here.
Healthcare IT News
Several telehealth organizations have come together to form the Telehealth Equity Coalition, which will advocate for greater equity in access to virtual care. While telehealth has helped alleviate some stark disparities in the healthcare industry, it has also made others worse, revealing the role that housing, transportation, and internet access have on someone’s ability to receive care. Read more here.
Hybrid healthcare systems are quickly becoming the future model of healthcare as hospitals continue to help fight the COVID-19 pandemic while still providing general care; Vanderbilt University’s Medical Center transitioned 50% of its volume to telehealth almost overnight. In addition to hybrid systems, hospitals are leveraging the power of smart devices to enhance telehealth visits and increase the value that telehealth can provide for patients. Read more here.
The rising adoption of telehealth has made healthcare more accessible and inclusive of women, the LGBT community and communities of color. Compared to traditional healthcare systems, telehealth has made it easier for these communities to get access to care, receive specialized treatment, and encourage those who normally don’t seek out treatment to get the help they need. Read more here.Learn More
Augmented Intelligence in Telehealth Holds Promise for Health Systems
If 2020 was the year that health systems embraced telehealth out of necessity and then discovered its many benefits, what might 2021 and beyond hold?
For health systems looking to further improve the cost savings and other advantages of telehealth, the new horizon is augmented intelligence: or, the use of artificial intelligence (AI) tools, such as machine learning, to assist and augment the capabilities of medical teams.
These tools can help with both routine administrative tasks and higher-level work, such as diagnosis, treatment, and patient monitoring.
Below we look at just a few of the helpful augmented intelligence tools that already exist in telehealth, preview potential future applications of augmented intelligence, and advise health systems on how best to take advantage of this new era in medical innovation.
Examples of augmented intelligence tools in telehealth and remote patient monitoring devices
The last few years have brought to market many remote patient monitoring devices that utilize augmented intelligence, enabling both hospital care staff and physicians to focus on other tasks while knowing that their patients are being continuously evaluated.
For example, EarlySense offers a sensor that is placed under a patient’s mattress and tracks multiple data points, including heart and respiratory rates. The sensor uses AI to analyze this continuous data stream and to detect early signs of deterioration, which the care team can then correct.
Similarly, Myia collects data from at-home patients with chronic conditions and uses machine learning to surface patients needing a clinical intervention.
Somatix offers the SafeBeing system, which is a remote patient monitoring device that relies on a wearable that uses AI to monitor gestures and passively collect biofeedback data. Somatix’s cloud-based system analyzes this data in real time to provide insights and alerts, such as an increased fall risk, for the care team. Somatix’s system works well for nursing homes and long-term care facilities.
Other companies are using AI to develop a more holistic portrait of patients’ health. Recognizing that clinical care accounts for only a small percentage of a patient’s health, with social determinants of health and behavior being major factors contributing to wellness, Innovaccer developed an AI-driven social vulnerability index that helps health systems see a fuller picture of both individual and population health.
We have also seen this type of technology being used to help with administrative tasks throughout various AI healthcare workflows.
For example, natural language processing, augmented by AI, can be used not only to transcribe patient-provider conversations during phone or video visits, but to assess which were the most salient points of the interaction and worthy of further attention. The resulting notes inform the provider’s care plan and also remind the patient of what was discussed.
In addition, as the Advisory Board wrote last year, at Providence St. Joseph Health in Washington and other health systems, system administrators have deployed chatbots to screen patients and direct them to the right resources, thereby discouraging the so-called worried well from unnecessarily coming into hospitals.
Future possibilities for augmented intelligence in healthcare
The possible future applications of augmented intelligence or AI in healthcare workflows are limited only by our collective imagination.
A Government Accountability Office Report envisioned that dermatology video visits may one day involve augmented intelligent patient care that assesses the patient’s skin for lesions and assists dermatologists in detecting precancerous and cancerous growths.
In this Becker’s Health IT article, a technology and data specialist with the University of California, Irvine, predicts that in the future individuals will have a digital health “twin” made up of all the data about an individual’s health. This twin’s data will continually be updated, and augmented intelligence tools will reveal health trends and trajectories for the individual as well as suggest personalized steps to better health.
Here, at Caregility, we predict that combining augmented intelligence with wearables and two-way video will be a game changer for virtual care, specifically when it comes to remote patient monitoring. Each of these components has had varied success to date in individual use cases, but when they are combined into a comprehensive virtual platform, providers will see the greatest benefit in improving care and reducing costs.
Taking advantage of the augmented intelligence revolution in telehealth systems
So, how can your health system benefit from all the latest applications in augmented intelligence in telehealth and be ready when new innovations reach the market?
To build a foundation for telehealth-enabled augmented intelligence technologies, the most critical step is adopting a flexible telehealth platform, capable of integrating with third-party apps and systems. Those who don’t start planning for the coming augmented intelligence healthcare transformation now may find themselves suddenly out-smarted and out-maneuvered: not by a human competitor, but by a learning machine.
For more on trends coming in the new year and beyond, check out our latest telehealth news roundup.Learn More
Telehealth News Roundup: Winners & Losers in the ‘Sleeping Giant’ of Telehealth, Patient Demographics, Plus TelePsych’s Pitfalls and Potential
Telehealth has quickly become the new normal for healthcare as we continue to grapple with the COVID-19 pandemic. As we reflect on 2020 and look forward to 2021, here is our monthly roundup of today’s important healthcare topics and trends in telehealth, including patient perceptions of telehealth, technology’s role in helping to provide exceptional care, and how mental and behavioral health fits into virtual care systems.
Healthcare IT News
While there’s no denying the quick growth of telehealth technology vendors after the COVID-19 pandemic began, the ability of those vendors to deliver seamless, quick services varies according to a report from KLAS. While focused solutions, like Caregility and Mend, have seen high customer satisfaction, telehealth giants like Amwell have started to lose traction. Read more here.
Harvard Business Review
Telemedicine has expanded exponentially during the COVID-19 pandemic, but there are still many challenges to overcome as telehealth becomes more mainstream in healthcare systems. One large hurdle comes in its application in psychiatry, which encompass more than 40% of patient visits. Read more here.
Founded in 2017, CallOnDoc quickly rose above the competition by offering online behavioral and mental health consultations as well as expanding into remote management of chronic diseases. Forbes spoke with Rahil Saha at CallOnDoc to learn about their internal operations and how they balance convenient technology and providing exceptional care. Read more here.
Healthcare IT News
A study published in the Journal of the American Medical Association concluded that older people, women, people of color, and those with lower household incomes are less likely to use video for telehealth visits. These results point out that there is still much work to be done to ensure telehealth is accessible for all patients, regardless of social or economic background. Read more here.
According to The Harris Poll, nearly 65% of people plan to continue using telehealth after the COVID-19 pandemic ends – additionally, 83% of all respondents had never used telehealth before. The survey also noted differences in how people would want to use telehealth; most want to use telehealth to ask medical questions, review lab results and get prescription refills. Read more here.Learn More
6 Musts for Choosing a Mobile Telehealth Solution
COVID surges around the country have shown that sometimes hospitals and healthcare providers need to get a mobile telehealth solution up and running or expanded quickly — and in times like those, the best telehealth solutions are often ones which don’t include the need to bring in carts or extra telehealth equipment.
Mobile telehealth systems offer a less complex, less time consuming and less costly alternative to dedicated hardware networks for organizations aiming to develop a stronger telehealth presence and harness virtual technology to enhance the efficiency, safety and quality of care.
Besides virtual visits, mobile technology which can run on the devices on hand provides opportunities to support remote patient monitoring, bolster communication and collaboration among clinicians and specialties, replace lost revenue due to fewer in-person visits, and explore new patient-centered revenue streams such as subscription concierge services.
Following are six things for healthcare leaders to look for when evaluating an effective mobile telehealth solution.
Evaluating Telehealth Mobile Solutions
A long-term telehealth solution flexible enough to support future expansion
A mobile solution may be quicker to stand up than the alternatives, but don’t lose sight of your organization’s larger, long-term view. Consider a multi-faceted solution flexible enough to accommodate a variety of inpatient and outpatient services and which can expand as your organization’s goals, priorities and services change.
Putting technological band-aids on a variety of different problems as they arise can create the same kind of fragmentation that virtual technology is designed to prevent.
In addition, approach the evaluation and implementation of a mobile telemedicine solution with an expanded view of telehealth’s possibilities. Telehealth is more than virtual office visits in ambulatory environments. Mobile platforms can also be used in a variety of inpatient settings to support remote consults between clinicians within and across facilities. It can also facilitate safely distanced communication with patients in infectious environments and much more.
A telehealth solution that is purpose built for healthcare
Work with a telehealth solution provider who understands the complex and unique workflows, processes and procedures of a clinical environment.
When the pandemic began, many organizations scrambled to cobble together systems using a variety of platforms that were not designed specifically for healthcare. Many of these makeshift telehealth systems raised concerns about privacy and caused other glitches, not only because they were rolled out quickly, but also because they were never intended to be used in healthcare. It was like trying to fit a square peg into a round hole. Look for a telehealth platform whose developers, staff, telemedicine software and devices all have a solid grounding in how caregivers work and how healthcare organizations function.
A user-friendly interface which doesn’t require patients to download an app.
Telehealth software or mobile applications that aren’t simple won’t be used. They’ll be resented, and that resentment could end up interfering with care.
Asking patients to set up an account and fill out forms online to download an app only adds unnecessary clutter, time and frustration to a process that should be streamlined, uncomplicated and even pleasant. Ideally, you want to be able to send patients a direct link on their mobile devices that allows them to connect to their doctor or nurse with a single click. Patients, including those who are less computer savvy, may avoid an appointment altogether rather than face the hindrance of trying to make a connection.
Clinicians also appreciate, and work more effectively and efficiently with, a simple, intuitive interface with high quality video and audio that reliably connects them with their patients and colleagues in remote locations.
Clinician involvement in implementation and workflow development
It’s a fundamental truth of health information technology that any system must be designed with input from and consideration for the needs of the end users. The same holds true for the best telehealth solutions for healthcare.
In which departments will you be using the technology now and in the future? How does the technology need to be adjusted to fit the specific needs and workflows of different departments and locations? Are the telehealth devices at the patient’s bedside going to be used by patients, by staff or both? Do you want the patient to be able to call to request a video visit? How do these factors vary across units?
HIPAA-compliant security features
Though healthcare providers are not subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur in the delivery of telehealth services during the pandemic, cybercriminals have been working to take advantage of the vulnerability in the current environment, which means healthcare organizations must protect their systems and their patients from these rising threats; hence, the need for a vendor whose offerings have HIPAA-compliant cybersecurity features baked in.
A partner that is a cultural match for your organization
Is your health system more independent or do you prefer a closer, more collaborative, long-term partnership? Some organizations prefer to take a product and run with it, handling testing, implementation and training primarily on their own. Others prefer a vendor that’s joined at the hip with them and prepared to be deeply involved every step of the way.
Know your organization’s and your potential partner’s culture and expectations for the relationship in deciding whether you’re a good fit for each other. A mismatch can cause discomfort and jeopardize an implementation.
The rapid expansion of telehealth services kickstarted by the pandemic has forever changed the face of clinical care and patient expectations for how that care should be delivered. Healthcare providers would be wise to weigh the potential benefits of incorporating mobile telemedicine solutions into their larger telehealth expansion plans.
To see how Caregility in expanded telehealth for two organizations, check out our Resources page, and click “Case Studies.”Learn More
Telehealth News Roundup: Augmented Intelligence, Cybersecurity Challenges, and a Host of Other 2021 Predictions
As healthcare and its use of telehealth products and services evolves rapidly, it can be challenging to stay up to date. As experts look forward to 2021, it’s clear that new technologies will continue to play a role in how telehealth services expand and whether or not systems have the cybersecurity in place to keep patient data safe and secure. Learn more about the current happenings in telehealth in our monthly roundup.
The use of technology in healthcare during 2020 has skyrocketed, spurred mostly by the COVID-19 pandemic and the need for virtual care solutions. Looking ahead to 2021, experts say technology will continue to play a role in healthcare as 5G networks, artificial intelligence and the need for more virtual care options all expand. Read more here.
In an annual tradition, HealthIT Answers gathered healthcare leaders from around the country to make predictions for the coming year — including, this year, Caregility COO Michael Brandofino. “Combining Augmented Information (aka AI machine learning) with wearables and two-way video will be a game changer for virtual care,” Brandofino said. Read more from him and other healthcare leaders here.
Healthcare IT News
As health systems across the country have expanded their embrace of telehealth platforms, it’s clear that a one-size-fits-all approach doesn’t work. While scalability is key, healthcare providers have to think about who they’re trying to help, where those patients live, and what devices those patients use to get the care they need. Read more here.
Harvard Business Review
Even before the pandemic, Utah-based Intermountain Healthcare was ahead of the curve in employing telehealth. From 2015-2019, the health system had 830,000 patient interactions, an average of 454 per day. So far in 2020, they’ve had 1.3 million interactions, close to 4,300 per day. CEO Marc Harrison shares seven of the biggest lessons he’s learned from the shift to telehealth. Read more here.
Healthcare IT News
The latest security industry forecast from Experian warns that cybercriminals will use strategies employed during the COVID-19 crisis to try and breach more healthcare systems in 2021. Experts say that it’s critical that healthcare systems continue to strengthen cybersecurity programs all while trying to provide faster and better care for patients. Read more here.Learn More
Improving Care in Progressive Care Units Through Telehealth
As COVID-19 cases have surged this winter, hospitals across the nation have struggled to meet the needs of severely ill patients. Many facilities are facing a shortage of beds and staff members to provide adequate care. By early December, a record number of 100,000 patients were hospitalized with COVID-19, putting a fearsome strain on hospitals and staff.
Against this dire backdrop, the value of telemedicine has never been so clear. For example, the “tele-ICU” uses real-time audio, video, and electronic monitoring to connect critically ill patients to a dedicated team of intensivists and critical care nurses who are based in a remote telehealth center. The benefits of tele-ICU have been well-documented: in addition to preserving the health and safety of healthcare workers, hospitals using tele-ICU have reduced mortality rates, safely decreased the average length of stay for patients, and improved adherence to clinical best practices.
The value of telehealth isn’t confined to the ICU. Researchers have now shown that using telemedicine within hospital progressive care units (PCUs) also has a positive impact — for patients and hospitals alike.
What is a Progressive Care Unit?
Progressive Care Units (PCUs) were introduced as a way to manage hospital patients who need an intermediate level of care: more care than is provided on a general medical floor but less than in ICUs, where many patients require ventilator support and continuous invasive monitoring. Also known as “step down” or “high dependency” floors, progressive care units are often the next step for patients leaving the ICU — patients who need monitoring because they are at high risk for complications. Patients in PCUs still need a high level of skilled nursing care and surveillance but they are more stable than patients in ICUs.
The Impact of Telemedicine in the PCU
Can telemedicine be effectively used to manage the treatment of patients in progressive care units?
That’s the question a team of researchers addressed in a large-scale study of a health system in Florida. Published in Critical Care Medicine, the study was the first of its kind. “Although there are many studies about the effects of telemedicine in ICU, currently there are no studies on the effects of telemedicine in PCU settings,” the research team noted.
Using a retrospective, observational approach, the team examined primary data from patients admitted to PCUs between December 2011 and August 2016 across five hospitals in the South Florida region. Since not all PCU beds at these hospitals were equipped to use telemedicine, patients who did not receive telemedicine served as the control group. In total, the researchers examined the experience of 16,091 patients, including 8,091 admitted into telemedicine PCUs and 8,000 admitted into non-telemedicine PCUs.
What did they find? First, patients in the telemedicine PCU group were 44% more likely to survive compared with patients in the non-telemedicine PCU — even accounting for the fact that patients in the telemedicine PCU were older and had higher disease severity and risk of mortality. Second, patients in the telemedicine PCU group saw a decrease in their hospital length of stay, when compared to the control group. And finally, decreases in mortality and length of stay among patients in the telemedicine PCU group were achieved “without substantial cost incurrences” to hospitals, the study found.
Transforming PCU Care Through Telemedicine
Progressive care units are gaining traction in hospitals across the nation as a strategy for freeing up beds in ICUs for the most acutely ill patients — a chronic challenge that has only become more critical during COVID-19. The American Association of Critical-Care Nurses first recognized progressive care as a nursing specialty in 2004 and today it is one of the fastest growing nursing specialties.
The growth of PCUs will only continue, researchers predict, as a result of the country’s aging population, increasing costs of care, and shortage of intensivists. Simply put, hospitals cannot afford to admit low-risk patients to costly ICUs just for monitoring purposes.
Just as telemedicine has proved to be an effective strategy for improving — and expanding — care for patients in the ICU, it has the potential to improve care delivery in PCUs by allowing for additional remote monitoring of critically ill patients.
Whether a patient in the progressive care unit is recovering from a stroke, has started a potent drug regimen that requires monitoring, or has recently suffered a heart attack, telemedicine allows an on-site caregiver to connect with a remote expert intensivist. With access to the patient’s vitals and electronic medical record, the off-site providers can write orders, provide continuous monitoring, and answer important questions.
In the months to come, equipping more progressive care units with telemedicine capabilities could improve patient outcomes and bring sorely needed expertise to hospitals without intensivists on site 24/7, especially for rural hospitals, which are particularly vulnerable to the shortage of critical care specialists.
Learn how Caregility can provide the technological support you need to equip your step-down unit with around-the-clock monitoring of critical care patients.Learn More
Telehealth News Roundup: Growing Telehealth Acceptance, Emerging Research, and Could AI Detect Asymptomatic COVID-19?
As healthcare and its use of telehealth products and services continues to change and evolve fast and furiously, it can be difficult to stay on top of it all. Yet the pace of news, research, and innovation is accelerating, from emerging research on COVID-19 to advances in AI. There are new models for healthcare delivery to consider and exciting experiments in care delivery around the country. Here’s our monthly roundup of today’s important healthcare topics and trends in telehealth.
Nearly 70% of 1,600 healthcare providers surveyed recently by the COVID-19 Healthcare Coalition say they are motivated to use telehealth more because of the experiences they’ve had during the COVID-19 pandemic. And more than three-quarters of respondents said telehealth helped them provide quality care for their patients. Read more here.
American Telemedicine Association Partners with ORCHA to Launch Review Process in the U.S. to Ensure Patients Have Access to Safe and Effective Apps
Noting that 85% of health apps in the United States don’t meet quality thresholds, the American Telemedicine Association has announced a new partnership withORCHA(Organization for the Review of Care and Health Apps) to create a review process for the U.S. to enable healthcare providers, insurers, and employers to give patients access to safe and effective health apps. Read more here.
Dallas Business Journal
The Dallas Business Journal reports that virtual primary care could soon become more common as employers and employees adjust to a new normal, where telemedicine is the preferred place of treatment. In January and February of 2020, Humana members were scheduling a few hundred telemedicine visits per day, and by April that number had increased to over one million. COVID-19 is accelerating the shift, eliminating most consumers’ reluctance to use virtual care. Read more here.
Researchers with the Patient-Centered Outcomes Research Institute (PCORI) discuss the expansion of telehealth services during the COVID-19 pandemic, including how to best harness its capabilities and reach populations that have limited access to technology or need culturally tailored interventions. Read more here.
Artificial Intelligence Model Detects Asymptomatic COVID-19 Infections Through Cellphone-Recorded Coughs
In a paper published recently in theIEEE Journal of Engineering in Medicine and Biology, a team at MIT reports on an AI model that distinguishes asymptomatic people from healthy individuals through forced-cough recordings, which people voluntarily submitted through web browsers and devices such as cellphones and laptops. The results, the researchers say, might provide a convenient screening tool for people who may not suspect they are infected with COVID-19. Read more here.Learn More