Telehealth Enables High-Touch Care for High-Risk Patients

The merits of telemedicine programs in addressing acute emergencies, such as stroke, have been well documented. In a post-pandemic world, however, one of the most important uses of telehealth technology might be in preventative care, particularly for patients that health systems and hospitals deem “high-risk.” This article will review various definitions of high-risk patients, highlight research that connects telehealth implementation with positive outcomes, and explain how health organizations are incorporating telehealth services to achieve those benefits.

Who is a “high-risk” patient?

In the literature, there is no one definition of a high-risk patient. The phrase typically refers to people whose chronic conditions increase their likelihood of seeking hospital care. “We defined patients as high-risk if the probability of a 90-day hospitalization was 10% or greater,” wrote a group of authors in a 2019 American Journal of Managed Care article. Another group writing for The Hospitalist in 2015 defined “high-risk” as those patients who are “admitted to the hospital five or more times within one year.” Whatever the exact number, explained two physicians in a 2009 Western Journal of Emergency Medicine article, these “patients provide a challenge to emergency physicians.”

“Recent work on managing frequent users on a more individual basis through consistent outpatient services has been shown to both reduce ED [emergency department] use and improve symptoms of chronic conditions that bring the patient to the ED,” the authors suggest.

Evidence-based research shows telehealth can improve outcomes for high-risk patients

Implementing telehealth solutions is an attractive way hospitals and health systems can provide the “consistent outpatient services” the Western Journal authors recommend. In the last decade, researchers worldwide have studied the outcomes of varied telehealth programs, particularly for patients with one or more chronic conditions. These studies’ results suggest that telehealth programs can make a positive impact on the health and well-being of participants:

Telemedicine use helps reduce hospital admissions and readmissions

In 2014, nearly two dozen academic medical professionals and practitioners published research in Telemedicine and E-Health that reviewed telemedicine’s impact on the management of congestive heart failure, stroke, and chronic obstructive pulmonary disease (COPD). The authors concluded that the “preponderance of evidence” showed that telemedicine use produced several benefits, but chief among them were “reductions in service: hospital admissions/re-admissions, length of hospital stay, and emergency visits typically declined.

Telemonitoring programs support improved health indicators

A 2017 article in the Journal of Medical Internet Research evaluated the impact of a telemonitoring program in Spain’s Valencia region. The study focused on patients suffering from one or more chronic conditions, particularly diabetes, hypertension, heart failure, and COPD. The authors found that patients with one or more of these conditions had better weight, heart rate, blood pressure, and glycemic control after a year of program participation when compared with the previous year. “In addition,” they wrote, “primary care emergency and hospital emergency visits were decreased, despite the participants being a year older and a year further along in their disease evolution.”

CDC recognizes telehealth as a valuable tool to manage chronic conditions

The CDC, citing research by the Community Preventive Services Task Force (CPSTF), states that “telehealth interventions can help improve chronic disease, including … “high blood pressure, cardiovascular disease, diabetes, HIV infection, end-stage renal disease, asthma, and obesity.” In numerous studies, the CPSTF found that the implementation of various technology – including text messaging and email reminders, internet-based consultations and pre-recorded videos, and phone calls – can lead to better medication adherence, clinical outcomes, and dietary outcomes.

Telehealth in action for “high-risk” patients

What do some of these telehealth interventions look like? The Spanish telemedicine program highlighted in the study above, called ValCrònic, was implemented jointly by primary care practices and hospitals. Patients “received health education and awareness interventions tailored to their conditions through informative videos” available in a study-provided tablet, through which they also independently measured and entered their vital signs. Medical personnel then determined, based on the entries, whether to “call participants to check the values, ask them to come to the health center, go to their home, or consult a doctor.”

Here in the United States, a small but growing number of mobile integrated health and community paramedic programs have been developed to help patients with complex medication regimens – a descriptor that can be applied to many sufferers of chronic conditions. “Addressing medication complexity requires a holistic approach, which should include deploying providers, such as community paramedics, in new or expanded roles,” wrote the authors of this 2019 Health Affairs article. “Community paramedics are able to go where clinicians typically do not – into the patient’s home – where they may discover unexpected barriers and underlying factors that affect health outcomes.” The authors say the next step in enhancing these kinds of programs is integrating technology to benefit these patients, such as using videoconferencing to allow “pharmacists to video chat with patients and care team members about medications during home visits.”

“We’re redefining the house call for a whole generation that doesn’t know what a house call is,” said Carl Marci, chief medical officer for Ready, a mobile health care provider, in a 2020 MHealth Intelligence article.

Learn more about how telehealth can help you reach your high-risk patients

To reap the benefits these kinds of preventive-care programs can provide, medical practices need a technology partner they can trust. Caregility offers a variety of solutions for virtual consults to virtual observation and monitoring to help boost your “high-risk” patient services. Please contact us today for more information.

Telehealth News Roundup: Telehealth Expansion on the March

This month, it was clear telehealth expansion is on the march. The Wall Street Journal reported on the record billions which poured into the sector in the beginning of 2021, nearly doubling the amount of investment that had come even in the record months at the end of 2020. This money is being used for new product development, expanded marketing, and even lobbying efforts, as STAT News reported. Meanwhile, state, and local officials continue their embrace of telehealth, with Arizona being the latest to make permanent many temporary expansions ordered during the pandemic.

Read on for our monthly roundup of the most significant developments in telehealth:

Digital health startups are booming. Their customers are overwhelmed

Wall Street Journal

The Wall Street Journal recently documented both the enormous amount of investment that poured into digital health in Q1 of 2021 (a record $7 billion in venture capital) as well as the extreme vendor fatigue now being faced by digital and telehealth customers. “We are inundated,” the Journal quoted Meredith Touchstone of CarMax as saying. “We already have these very big portfolios of vendors. And with all this new stuff coming into the market, there’s no way to assess, literally thousands” of digital-health services now available.

Telehealth companies fuel lobbying frenzy to protect their Covid boom

STAT News

STAT News reports all the new investment capital pouring into telehealth has helped these companies launch lobbying efforts to protect expanded telehealth measures. These include allowing physicians to practice across state lines and being able to charge Medicare the same for virtual visits as in-person ones. (Gated)

Arizona expands telehealth — a “no-brainer for consumers and health care providers.”

Foundation for Economic Education

By all accounts, few expansions have enjoyed such sudden, widespread support as the dramatically increased use of telehealth during the pandemic. The Foundation for Economic Education reported that the Arizona legislature has made permanent a series of executive orders from last year, issued by Governor Doug Ducey to expand telehealth in the state. The new legislation allows asynchronous services as a method of establishing a provider-patient relationship and prescribing or dispersing prescriptions; expands the list of telemedicine providers to include any clinical provider; and incorporates audio-only visits into the definition of telemedicine, among other changes.

What is digital care’s destination? 4 predictions for 2021 and beyond

Med City News

Writing in Med City News, The Cleveland Clinic’s Frank McGillan gives four predictions for how digital healthcare will transform the market and our expectations. Hint: they’re all good for consumers, from increased personalization, to availability of more “on-demand” services.

How to Find and Work with a Telehealth Consultant

As more health systems turn toward enterprise-wide telehealth solutions, they are running up against the familiar challenges of complex technology implementations that have long been familiar to hospital and health system leaders.

The ad hoc, rapid deployments of the early pandemic aside, technology implementations can normally be an excruciatingly long and complex process. Research from the AMA showed that it takes hospitals on average 23 months from identifying a digital need to scaling a digital solution to meet that need.

That’s time most healthcare organizations don’t have in today’s environment.

As a result, many hospitals are turning to consultants to help prepare, identify a vendor, and manage implementation. Our new eBook, How a Telehealth Consultant Can Help Your Organization Prepare for, Choose, and Implement a Telehealth Solution covers this subject in depth.

In the first part of the eBook, previewed here, we suggest a process for choosing a telehealth consultant to start with.

Identifying Candidates

Like finding a good doctor or lawyer, identifying a list of potential telehealth partners begins with an ask to your personal and professional network for recommendations, especially those in the HealthIT sector. Though expanding rapidly, the telehealth universe is still small for a technology segment, and this relatively uncrowded professional community can make it somewhat easier to identify a pool of potential partners.

In addition, organizations like HIMSS and publications like HealthcareIT News, Health IT Consultant, MobiHealthNews, HealthTech, mHealth Intelligence, and Patient Engagement HIT are targets for telehealth consultants who wish to publish their thought leadership on where the industry is headed and how healthcare organizations can thrive moving into the future. On social media, LinkedIn’s Telemedicine & eHealth group, devoted to industry best practice implementations and technical advances in telehealth, is a good community to post questions and solicit recommendations.

Ultimately, you should narrow the field to three or four organizations to present to your team. Don’t overlook smaller consulting firms, which, because of their smaller size, may be more responsive and able to pivot more quickly as circumstances change.

The selection Process

Choosing a telehealth consultant begins with a conversation to assess their experience and gain a sense of the resourcefulness, flexibility, and responsiveness that they will bring to problem- solving for your organization.

Ask candidates to describe ongoing and completed projects with other clients. Expect the firm to be able to describe in detail how they approached and completed projects similar in scope to the services you have in mind for your organization.

Think twice about a firm that appears overly interested in selling you a one-size-fits-all product. They should be prepared to present a few possible options and to describe the pros and cons of each. The firm should understand the connection between the telehealth services your organization will be developing and your organization’s mission and larger strategic goals.

Expect the consultant to be able to provide a standard Statement of Work. A Statement of Work provides an extra layer of detail describing tasks that will and will not be performed and delivered, often including standard fees. This level of detail helps ensure a shared understanding of what the telehealth initiative will deliver and achieve.

Ask about the consultant’s system for responding to the inevitable glitches that arise during a rollout. For example, a consultant’s failure to promptly inform you that they are running into resistance among physicians or staff before and during a project would suggest an unwillingness to tell you what you need to hear, even if it’s uncomfortable to hear it.

Consider an organization with clinical as well as technical expertise. Firms that include team members who have clinical backgrounds in nursing and other fields as well as IT experience are more likely to have the nuanced understanding of the workflows, needs and pain points of telehealth end users. Meanwhile physicians, care team members, both of whom can be indispensable throughout a telehealth initiative, will appreciate that there is clinical experience on the implementation team.

Clinical expertise is not a given in telehealth consulting firms. As a result, these nuances may be missed by even the most technically astute telehealth professionals who do not have clinical training and have never been involved in patient care.

Thinking of hiring a telehealth consultant? Our eBook has a list of telehealth consulting groups that is a good place to start, as well as recommendations for funding sources, and a full discussion of facility challenges that a telehealth consultant can help you prepare for and address.

How telehealth can rebuild relationships — and recover revenue lost during the pandemic

The COVID-19 pandemic created a crisis for our country and our healthcare system — millions delayed or avoided care; personal spending on health services plummeted; and nearly 15 million people lost employer-based health insurance, according to a MarketWatch report from November 2020.

Thus, the past year has created two groups of patients who present both a particular risk and an opportunity for care providers seeking to recover lost revenue post-pandemic:

1. Patients who have spent the last year un-engaged with their care providers
2. Patients who lost health insurance and now have new or different options for care

In both cases, the promise of telehealth is to rebuild relationships with patients through a superior patient experience. Telehealth can help care providers by re-engaging patients who have been disconnected or unwilling to seek care over the past year, and it can also help health systems avoid losing patients who are faced with new options as a result of losing or changing their health coverage.

COVID-19 revenue loss

According to a report by Kaiser Family Foundation’s Health System Tracker, in April 2020, personal spending on health services plummeted 31.9 percent year over year. Revenue fell across every specialty and in every care setting save for virtual. The Commonwealth Fund found an even steeper 60 percent drop in visits to ambulatory services.

Though the initial drop was without precedent, volumes partially recovered following the initial lockdowns — and by then the opportunity telehealth presented had been revealed. Today, any stigma associated with its use has virtually disappeared; regulatory barriers have fallen; and reimbursement, at least for now, points toward all systems go for telehealth.

Yet more than a year of disruption has resulted in patients who are now seeking options either to catch up on care deferred or establish new relationships with a trusted group of care providers.

Reaching patients who switched insurance

Picture one of the 15 million people who lost their employer-based health insurance last year. The economy is recovering, they are getting back to work, but either at a different job with different insurance, or perhaps as a self-employed independent contractor purchasing insurance from the open market.

Either way, they are re-establishing care relationships and looking to catch up on what they may have deferred, whether that’s an annual care check-up, a consult with a specialist, or an elective surgery.

Their new insurance provider may have contracted with a telehealth platform that employs its own providers — so he or she gets a package in the mail asking them to download a telehealth app and either book an in-person appointment or a virtual care call.

This patient is a potential lost opportunity for hospitals and health systems to keep patients in their community, and on their own telehealth platform.

With more health systems seeking enterprise telehealth solutions, the opportunity is there to extend the patient experience into the home in order to build or rebuild relationships with these patients who have dropped off the radar. Doing so will help health systems recapture some or all of that deferred care from the past year.

This could include:

• Leveraging telehealth for pre-surgical or post-surgical virtual care visits
• Extending telehealth into a program to improve care for high utilizers
• Providing virtual access to specialists in small or rural communities
• Moving less acute care to a virtual setting to free up hospital capacity

There is no reason health systems need to lose these opportunities to a stand-alone telehealth company with its own specialists and brought in by the insurance provider.

Building a better patient experience

Incorporating an enterprise telehealth solution into the patient journey will not only help recapture lost revenue, it will help health systems build positive, loyal customer bases within their communities.

Post-pandemic, telehealth is no longer a novel care option struggling for acceptance. It’s an expected offering among patients with new, widespread acceptance among providers of all kinds.

Building a seamless patient experience across your entire health system won’t just help bring back patients who you may have lost during the pandemic — it’ll help make those relationships secure through the next disruption, whatever and whenever that may be.

Interested in learning more about the Caregility telehealth platform? Contact us today.

5 Steps to Move Past Ad Hoc Implementations and Address Haphazard Telehealth Deployments

In 2020, the pandemic led to a telehealth boom – but a messy one. The speed with which the pandemic shut down the country forced providers to stand up telehealth platforms by any means necessary – often without strategy or structure. One doctor quoted in an August 2020 Beckers article said, “some health systems are discovering they have 20 to 30 different telemedicine services that have permeated their physician base.”

This is an essential problem to solve for hospitals, health systems, and individual providers because although the pandemic may be waning, the telehealth tsunami is not.

Why telehealth is here to stay

Patients like telehealth

Citing a Doctor.com telehealth survey, Beckers noted that 80 percent of patients said they were likely to continue using telemedicine even if they didn’t use it before the pandemic. In a recent survey by the COVID 19 Healthcare Coalition, patients of all age groups indicated that telehealth helped them overcome challenges like transportation and exposure to disease, and that it helped them reduce costs related to their visit and time they had to take off work.

“Given this favorable, early experience with telehealth,” the authors wrote, “we anticipate that telehealth will continue to be an integral component of healthcare in the months and years to come.”

Physicians like telehealth

A February 2021 article in npj Digital Medicine reported that about one-fifth of physicians plan to use videoconferencing and telehealth tools “significantly more” than they did before the pandemic. The authors of the article expect that number to grow as a wave of “digital-native physicians” enter practice. Recent AMA surveys the article cites illustrate practitioners’ interest in integrating technology into their care approaches – in particular “augmenting virtual care with additional health technologies, including remote monitoring, digital devices, and artificial intelligence.”

The telehealth business is booming

The pandemic opened the floodgates for the industry in 2020, and Arizton Advisory & Intelligence sees no signs of that trend slowing. The company forecasts average growth of 30 percent per year through 2025, when its total value will rise to about $25 billion. “A whole industry is taking shape that will require new skills of healthcare providers and generate jobs more broadly, including customer care positions, quality assurance, sales roles, IT support, and in the engineering and design of software and hardware,” wrote Kathleen Winston, Dean of the College of Nursing at the University of Phoenix in a March 2021 Physicians Practice commentary.

Fixing telehealth’s haphazard implementation

So, what can be done to fix haphazard telehealth deployments so patients and providers can fully reap its benefits?

Improve telehealth products and process

Health systems, hospitals, and even individual practices need to conduct a baseline assessment of their telehealth situation. There’s significant concern not only about the number of videoconferencing platforms used by providers but also their security. Products like Zoom, FaceTime, and Google Meet work but the relaxed regulations that allowed their use during the pandemic likely won’t last beyond it. Other concerns include fragmented patient data, inconsistencies in record keeping, and platforms that are too complicated for average patients to use. It’s crucial for healthcare executives and IT departments to assess their current situation and implement both platform and process improvements.

Improve physician performance and patient experience

Once the technology is in place, health systems should upgrade the video, audio, and lighting equipment available for practitioners to use. Then, they need to train physicians to perform better on camera. “Healthcare agencies can’t simply give their staff Zoom accounts and hope for the best,” Winston writes in Physicians Practice. “They need to provide training on skills needed to get the most out of the new medium. Healthcare education institutions will need to review and revise their curricula to provide the necessary competencies for telehealth.”

Build out the telehealth infrastructure

The U.S. Department of Agriculture has announced an investment of more than $42 million to build and improve the infrastructure needed to bring telemedicine to underserved rural areas. Technological infrastructure upgrades – particularly increased access to broadband – headlined many U.S. governors’ annual “State of the State” addresses. According to a GovTech roundup of the speeches, broadening access to telehealth was specifically mentioned as key driver for new investment in technology infrastructure.

Enshrine telehealth-friendly regulation

One of the biggest obstacles to greater telehealth adoption is licensing restrictions that prevent providers from practicing across state lines. Revisiting those restrictions will be a priority for new Secretary of Health and Human Services Xavier Becerra, who explicitly mentioned support for telehealth expansion during his confirmation hearings. Several bills, including the bipartisan Protecting Access to Post-COVID-19 Telehealth Act of 2021, have been proposed to address barriers such as geographic and originating-site restrictions on the use of telehealth in Medicare. None, however, have passed yet.

Reimbursement parity for telehealth services

And then there’s the elephant in the room. Federal and state public health emergency declarations prompted health insurance plans to overhaul their payment policies for telehealth. But there’s no guarantee that insurers will continue to offer such payment parity once the public health emergency is over. Some states – such as Georgia and California – have set equal base rates for telehealth and in-person care. It remains to be seen whether others follow that path, and how health insurance plans will respond to that action.

Learn more how Caregility can elevate your telehealth game

It’s easy to see how health providers of all sizes might be overwhelmed by the frenzied implementation of telehealth over the past year. If your organization needs help introducing or elevating your telehealth capabilities, Caregility consultants can help.

Please contact us today for more information.

Telehealth News Roundup: New Surveys Point to Very High Patient Satisfaction

The pandemic exposed the American public to a huge number of new trends, from online shopping to remote school, and of course new and expanded access to telehealth. And while some trends we’ll be glad to see fade into history (see: remote kindergartens) others, such as telehealth, have proven extremely popular. This month, we highlight reports on patient satisfaction with telehealth, as well as the big bets from new entrants into the market.

COVID-19 Telehealth Delivery Reaps High Patient Satisfaction

mHealthIntelligence

New survey results from the COVID-19 Healthcare Coalition show that people who have used telehealth during the pandemic have had an overwhelmingly positive experience. More than 80 percent reported good visit quality, and 78 percent said they felt their health concern could be addressed via telehealth. Importantly, these findings were consistent across age, insurance type, and geographic setting.

Virtual Care Patients Report Satisfaction with Range of Benefits

CBC

In Canadian report on patient satisfaction in telehealth, researchers found that people who had a virtual care visit appreciated a range of benefits, from avoiding time spent in a waiting room, to the environmental benefits of skipping a car ride. An overwhelming number of respondents — 91 percent — said they were very satisfied with their virtual care experiences

Amazon’s healthcare push is a threat—and an opportunity—for the industry

Fast Company

An article in Fast Company argues Amazon’s big push into telehealth means other companies will have to step up their commitment to seamless, user-focused experiences (We agree! See our eBook on Ease of Use in Telehealth). In the face of the new competition, writer Eric Kinariwala says telehealth companies would do well to “pay obsessive attention to customer experience and satisfaction

Administration outlines health IT funding priorities

HealthcareITNews

The Biden administration has announced a budget plan that includes billions in funding devoted to health IT. The request includes $8.7 billion for public health data collection, $6.5 billion aimed at “driving transformational innovation in health research,” and $65 million for rural broadband connectivity, among other priorities.

How will the next generation of connected wearables impact hospital at home programs?

The rise in the demand for virtual care has come with the need for home-based patient-monitoring solutions. The next generation of wearable devices has risen to the occasion.

These wearable devices will play a crucial role in the expansion of telehealth, especially in the hospital-at-home (HaH) setting. They can play a central role in disease management at various stages, including early screening, diagnosis and post-discharge care.

The continuous data monitoring offered by wearables provides real-time data collection, increasing accuracy and timely decision making. The data captured by wearables provides physicians valuable insights that go beyond the patient’s electronic health record (EHR).

Examples of wearables and what they monitor

Wearables help HaH patients stay connected to their care team. For example:

Oxygen Saturation

Pulse oximeters for patients with chronic obstructive pulmonary disease measure continuous oxygen saturation, or SpO2. The traditional version is usually clipped on the finger or earlobe. Next generation oximeters are based on flexible sensing via organic optoelectronics that can measure SpO2 at any place on the body such as the wrist, head, chest or other areas. This makes it easier to keep on continuously.

Respiratory Rate

Respiratory rate (RR) can be a strong predictor of cardiac arrest and unplanned intensive care admission. New wearable RR monitors include motion sensors, a clip-on device for monitoring breathing, and a patch that uses piezoelectric sensor array to detect deformations thoracic and abdominal surfaces. A wearable device with these sensors can be mounted into chest belts, applied to the skin, among other methods.

Lung Sounds

Diseases can cause abnormal levels of air and fluid in the lungs. A wearable digital stethoscope patch can monitor breathing continuously without placing sensors over different parts of the body

Heart Rate and Cardiovascular Disease (CVD)

Widespread use of fitness trackers has meant that heart rate, usually with chest bands or watches, is being tracked every day, worldwide on millions of users. Another common heart monitoring wearable is the adhesive electrocardiogram (ECG) patch. The patch is small and wireless with miniaturized electronics. Easy and comfortable to use, it can monitor the electrical impulses over many days to detect arrhythmia.

Blood Pressure

Traditional in-home blood pressure kits have transformed into cuffless, unobtrusive devices such as watches, glasses, a wrist/armband, shirt, sleeping cushion, chair, smartphone, camera and flexible patch. Patients can use multiple forms to fit their lifestyle, such as a wristwatch during the day and a sleeping cushion at night.

Hip Triaxial Accelerometer

Accelerometer-based measures captured during walking have shown promise in screening for fall risk. Use of a wearable device, placed at the hip, during walking tasks can record a person’s gait during the day. Accelerometers are becoming more affordable and available in consumer devices as ubiquitous as smartphones.

Biosensors

Biosensors, usually self-adhesive patches, allow patients to move around while collecting data on their movement, heart rate, respiratory rate, and temperature. Research from Augusta University Medical Center showed that biosensors can register an 89% reduction in patient deterioration.

Challenges for wearables

Wearable health technology has the potential to transform patient care. However, there are major challenges that wearables will have to overcome before widespread adoption in the regulated health sector:

• Data Quality: To go from consumer to medical grade standard, wearable device manufacturers will need to improve significantly. For example, due to the inconsistency seen in fitness trackers in past clinical studies, physicians are still hesitant to use them to make clinical decisions.

• Data Overload: Wearables generate large volumes of data that needs to be managed and maintained. The best telehealth platforms will be able to integrate this data into EHRs to personalize treatment. This is happening on a small scale. Numerous health institutions have started to integrate device data into patient portals. Several start-ups are developing technology to enable wearable-EHR integration for health systems. And a few insurance companies are encouraging the integration of wearables.
• Interoperability: Data residing on multiple mobile devices needs to be collected and analyzed seamlessly across different wireless technology standards and eventually synced to a patient’s EHR. To do this, telehealth platforms need to host an array of different devices and apps that can work together, sharing data that ultimately improves clinical decision making.
• User Appeal for User Adherence: To encourage patients to use medical-grade wearables, they must be simple to set up and use, small, lightweight, power efficient, silent, reconfigurable, durable, easy to download and aesthetically pleasing.
• Data security and privacy protection: According to a recent Pew Research Center 2019 study on digital privacy perceptions, 81% of Americans responded that the potential risks of data that companies collect about them outweigh the benefits. To build trust, manufacturers need to prioritize adherence to Health Insurance Portability and Accountability Act (HIPAA) and the European General Data Protection Regulation (GDPR).

A HaH program supplemented by wearable devices can empower patients to take better care of themselves on their health care journey. The extra data they provide can improve clinical decision making and clinical outcomes. With the Centers for Medicare and Medicaid Services (CMS) recently approving virtual care like HaH, it is only a matter of time before wearable manufacturers make an effort to improve their devices and EHR systems across the country integrate with this potentially useful data.

To learn more about telehealth-enabled hospital at home programs, please contact us.

Amazon, Microsoft, and 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.

Telehealth News Roundup: A $42 Million Investment in Rural Telehealth, Bipartisan Support for Permanent Expansions, and Caregility in the News

Caregility on TV: WCVB Channel 5 Boston Covers Telehealth’s Importance for Patients

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.

USDA to invest $42M in telehealth infrastructure

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 seen as an important part of the solution. Read more here.

Permanent Telehealth Expansion Gains Bipartisan Support

MedPage Today

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.

Telehealth Is Ready for Its Second Dose — Call it Virtual Care 2.0

MedCity News

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.

For more information on the latest trends in telehealth, check out our resources and blog.