Seldom has there been a new care modality subject to more misinformation than telehealth. As anyone who has observed the industry for a length of time understands, healthcare is notoriously change-averse.
Telehealth has a long track record of success in solving problems of access, diagnostic delays, adherence to treatment, patient satisfaction and utilization of resources, including staffing. Unfortunately, its broader adoption has been slowed by misconceptions about how it fits into the care continuum, the potential for fraud and abuse and reluctance from payers to reimburse for it.
In previous articles in this series, I wrote about how telehealth helps in managing critically ill patients and how it can ease bottlenecks in patient flow that are causing poor outcomes. There are many other advantages to explore, but I believe it is better to use this forum to dispel a handful of myths that seem to form a dark cloud over telehealth taking its rightful place in the care continuum.
Myth No. 1: Telehealth, by its very nature, is rife with opportunity for fraud and abuse.
This is a tough one. Yes, there have been a number of high-profile criminal and civil cases resulting from the two-year telehealth experiment called COVID-19. As of yet, there is nothing definitive saying that this modality is any more prone to waste and abuse than in-person care. Indeed, there is the same digital trail in the electronic medical record for a telehealth visit as there is for an office visit. We also have to note that almost all regulation was dropped during the public health emergency, which did open the door to abuse. Indeed sensible regulation is needed, but there are signs it may go too far toward over-regulation, stopping innovation in its tracks and reducing the resiliency of our healthcare system.
Myth No. 2: Telehealth is appropriate when patients have presented at a community hospital unable to provide expert emergent care, but not for management of complex conditions.
This bumps into the problem of how many people live in areas where there are not nearly enough primary care doctors, let alone specialists. Many people can’t drive two hours each way to see a physician, and wind up in the ED and/or get admitted, a huge driver of high costs. Moreover, there are numerous studies that telehealth can be deployed in a variety of settings to help reduce diagnostic error and minimize risk regardless of complexity.
Myth No. 3: As we move to a value-based payment system that demands efficiencies, we can’t afford new technologies like those associated with telehealth.
Telehealth isn’t the right thing for every patient and every visit, but it has been embraced by patients, and physicians rapidly adopted telehealth during the pandemic, appreciating the insights they get from seeing their patients where they live. At-home monitoring from wearables can flag issues that might not be measured in an office visit. And younger patients are wired for everything; they don’t want to go back to sitting in waiting rooms for 15-minute face-to-faces with doctors.
Myth No. 4: The “doc in a box” approach leaves patients being treated by doctors not licensed in their state, who can’t write prescriptions.
Again, there is some truth underlying this concern. This is why my company and others hire physicians licensed in multiple states. Under new regulations, we can remotely prescribe controlled substances, which has been of great help in medically underserved areas, with no notable uptick in diversion for illicit activities.
Myth No. 5: Telehealth actually increases rather than alleviates health inequities.
This also can be true if we are not vigilant. Many medically underserved areas also lack sufficient broadband capacity, and many people can’t afford Internet coverage or lack computers. However, most everyone has a smartphone now, so they have cell coverage. There is a ton of money from the federal infrastructure law for broadband, which should lead to a democratization of web access. And as the computer-savvy generations age, this will be less and less of an issue.
So those are just some of the myths around telehealth. I think it has worried some in the industry who fear a new way of providing care that will render investments in hospitals and large medical group clinics into costly white elephants. My answer is we have to be nimble and forward-looking, as other industries have been. This is the age of consumerism, and telehealth can be a winning strategy. Use it to build your brand, as well as delivering great care efficiently and affordably.
Corey Scurlock, MD, MBA, is CEO of Equum Medical, which delivers acute specialty care services virtually, reducing delays in needed transfers and more accurately targeting care interventions, allowing care providers to serve a larger number of patients; improve patient care; and deliver positive clinical, operational and financial results.