While telehealth usage has skyrocketed during the COVID-19 pandemic thanks to expanded insurance coverage and relaxed restrictions, the future of virtual care in the U.S. healthcare system will rely on permanent reimbursement practices and continued tech innovations.
Here, four CIOs from hospitals and health systems across the country share their predictions for what telehealth will look like at this time next year.
Question: What do you predict telehealth will look like one year from today?
Editor's note: Responses have been lightly edited for clarity and length.
Randy Davis, vice president and CIO at CGH Medical Center (Sterling, Ill.): Like so many things in our business, telehealth will be driven primarily by reimbursement realities — so follow the money. Beyond that, apps will evolve allowing physicians to use the same system as they do for their paging system today. Ease of use for both physicians and patients will evolve to the point that the only thing holding back the use of telehealth is reimbursement. Scheduling systems will evolve to make the telehealth visit "smoother." Vendors have some underlying items to address to make this a bit easier for everyone; they recognize this and will address those shortcomings. Someone will develop a “killer app” allowing for drop-in video visits at the bedside for the care team and patient-allowed family members, and iPads on bed rail mounted arms to allow for this will become common.
Evan Jackson, vice president and CIO at Middlesex Health (Middletown, Conn.): From a provider perspective, telehealth will be a much more ingrained part of how we care for patients, albeit with greater definition of the following visit types: those done through telemedicine as a preference, those which can be done either way by patient preference, and those requiring in person care. Alternative providers will continue to offer competing services — breaking continuity of care — which wiIl force traditional providers to embrace this move post pandemic. Ultimately, however, how expansive telemedicine is in a year will be heavily influenced by reimbursement practices of the insurers.
Raymond Lowe, senior vice president and CIO at AltaMed (Los Angeles): Telehealth usage is really dependent on the outcome of the November elections. One outcome will be a more robust budget for reimbursement for teleservices, so we should see a much broader and wider adoption of telehealth. The other outcome could be a repealing of the existing reimbursements, which would reduce the amount of telehealth used.
From a care delivery perspective, we should have improved workflow, adoptions and the technology should be easier to use for both providers and patients. Primary care will see video specialty care, broader adoption for behavioral health and routine care/nurse visits will become more prevalent. Quality outcomes will improve with advancements in remote patient monitoring that focus on the patient-centric home for those with chronic conditions.
Scott Waters, CIO and CTO at Overlake Hospital Medical Center (Bellevue, Wash.): I think it is an easy prediction that telehealth use will continue to increase at a significant rate. We are all seeing a steep drop in the peak usage that was occurring during the first four months of the pandemic, but even the lower levels we are seeing right now are two to three times higher volumes of virtual visits than last year.
A year from now will take two possible paths: The preferable path will see that payment parity, or something close remains in place permanently. With this stability in place the volumes will increase over the current levels exponentially. We need to have financial sustainability ensured so that we can continue to develop telehealth programs for the use cases that make sense and add the most value to our patients. If the payers ensure that reimbursements will adequately cover the expenses involved with the development and sustainment of telehealth programs, then the investment in innovation in telehealth will be an easy decision for everyone.
The other path I see possibly happening is that the payment parity currently in place is removed. This will make it a tougher sell for health systems to invest in telehealth innovation and program development. I do think that despite the barriers to reimbursement that this would bring, we will still see a healthy volume growth when we compare this year to next. All of us have been forced to become proficient in this technology, as patients, care providers, employees and parents. With our new found proficiency comes comfort, increased expectations and a shift in perspective from patients that will force health systems to have telehealth programs available to stay competitive. Healthcare has been on a consumerism journey for a while now. Reviewing, comparing and grading of providers and health systems has been in place for years. Price transparency is coming along. True virtual healthcare is becoming an expectation and it will probably be enough to fuel the continued growth and investment.