Telemedicine will help healthcare heal after Covid19’s reckoning

By Dave Wieneke | in | 26 Apr 2020 | 2 Comments

This post was originally published by my colleagues at PK on April 23, 2020

When crisis makes ‘business as usual’ thinking implausible, it clears the way for change. The inertia that may have kept outdated practices in place subsides as the premium for finding better ways becomes an imperative.

Most business leaders have been through economic disruption before. Though each crisis brings a different flavor of hardship, they know that the key to survival is adaptation and investment. But let’s be real, we’ve simply never seen anything like this in our lifetimes—a demand drought in which 50% of the world’s GDP is in countries which are locked down.

The pandemic has undercut the predictability of normal life. Our work, economy, personal health, and ability to enjoy life are no longer givens, and seem prone to frequent and abrupt changes. In under a month, consumer spending in the US dropped by one half, and defaults and forbearances in the US have quadrupled. This week we saw a ten-thousand-person food line in San Antonio, a reminder that the suffering of this outbreak is especially deep among the poor.

Diane Swonk, the chief economist at Grant Thorton, recently told the Chicago Council that the recovery side of the Covid19 curve would be different than anything we’ve faced before. “You can’t abruptly unfreeze a flash-frozen economy and expect it to work.” She went on to note that employment recovered just 1% a year after the Great Recession of 2008.

At some point, there will be a vaccine and this pandemic will be done. But the process of discovery, testing and global-scale manufacturing and distribution means that point is likely a year or more away. Treatments are possible sooner, but this means we will have to find ways to live that allow for economic and social circulation, even while we maintain precautions. These viral inhibitions and the mindset they bring are likely to influence habits beyond mass vaccination for coronavirus.

Those returning to work will face new heath protocols, uneasy consumers with changed sentiments and a landscape of failed businesses and social contracts in dire need of mending. This is a time already ripe for innovation, and I believe that it is from these roots that telemedicine will emerge to make healthcare better and more accessible.

Telemedicine will help healthcare heal
During the virus outbreak, hospitals used telemedicine to provide care without bringing infected patients together at their facilities. Barriers, including licensing requirements and payment disparities, were adjusted to encourage its practice. A year ago, analysts were discussing the need to change these policy constraints en masse; this is now happening with growing momentum.

Today, telehealth offers are featured on the homepages of 40% of the top-ranked hospital websites we monitor. Last year only 10% of these sites had such promotion. Further, several of these top health systems are offering fixed price tele-visits. Dignity Health is offering free telehealth appointments to screen for Covid19, and Brigham and Women’s and Texas Methodist both lead with $20 fixed price telemedicine offers.

Consumers have taken to telemedicine as well. Teleconferencing with Zoom Meetings has quickly become a part of people’s home lives. Two-thirds of patients say they are more likely to make an appointment for a virtual visit with a care provider than before the pandemic. One result of this trying time is that consumers and providers have an increased disposition for telemedicine.

As people return to work, there will be a heightened need to access telemedicine services from the workplace. Individual companies or facilities, such as We Work, may facilitate remote care interactions by providing connected health tools. The office health kit of the future might include an oxygen level meter, touchless thermometer, or consumer EKG finger pad for use in remote appointments. If people buy medical wearables for the home, there’s a good chance they may have utility at work too.

This broader use of telemedicine has the potential to reduce barriers to care for lower-income patients. Taking time away from work, traveling to providers, and seeking medication at pharmacies can make access to care disruptive and difficult. By overcoming these obstacles, diagnosis and care may begin sooner, potentially bringing faster and more beneficial outcomes.

In the Covid19 response, we’ve seen telemedicine used even within hospitals to minimize the transmission of disease. But hospitals can also use this modality to aid each other through virtual consults, second opinions or providing on-demand clinical services.

My work on the Hospital Digital Index highlights this kind of capability at Barnes Jewish Hospital in St. Louis. They offer virtual stroke consultation to a network of other hospitals and providers, which has allowed them to build a center of excellence in virtual care. Such a use is properly called disruptive, as it enables business models for hospitals to collaborate and create value in new ways.

Telemedicine will change medical practice
In 2018, I described an ambitious telemedicine initiative in China which deployed 1,000 non-staffed clinics. They used artificial intelligence, telemedicine, and onsite e-commerce to triage and treat many common ailments. While in-person care and the power of the healing touch will always have a role in medicine, these new modes of care will evolve as experience and technology support more sophisticated interactions at a distance.

One of these changes is that virtual appointments may be briefer, though more frequent, encounters. Rather than seeing a cardiology team intermittently in-person, members of a treatment team may engage in more numerous brief exchanges to gather data, educate and motivate health-oriented lifestyle changes. In Psychiatry, short but frequent meetings might not have been practical in outpatient settings before, but now these could offer now patterns for care.

Often left out of the broader narrative is the impact Covid19 will have on rural communities and their healthcare infrastructure. Already underserved, representing 60% of the shortage in general practitioners across the country, rural America will emerge from this pandemic less healthy and more in need of solutions to the widening gaps in care. It was rural populations that telemedicine was first conceived to aid. As it now finds more universal adoption, and greater innovation, rural communities will benefit as telemedicine becomes more common in all medicine.

Telemedicine itself is a neutral infrastructure. For technology to matter, it has to be applied creatively to high-value problems. Over the last month, gaps in our healthcare system have grown and gained a new resolve for progress, which is vital to our health, our quality of life, and the global economy.

I work in healthcare because its leaders have such a broad commitment to service and seeking face-based change. The coronavirus has created a global moment in which we now all share this impulse. No industry has a greater need for innovators of all kinds to extend and improve care; broad and creative use of telemedicine will continue and help healthcare heal beyond the challenges we face today.