When COVID-19 began rolling out across the U.S. in early 2020, the nation’s telehealth infrastructure went into testing with fire.
It was very important for hospitals to reduce people ‘s care – not only to limit the spread of the virus, but also to ensure that hospitals did not get too much, as they did in Italy. That’s a key reason why, in March, Medicare and most private insurers sought to increase access to telehealth by relaxing restrictions, waiving taxes, and reimbursing users for a meaningful visit at the same rate as a personal visit.
Shortly after the establishment of these temporary measures, telehealth cycles came to the fore. A report from the U.S. Department of Health and Human Services, for example, found that about 43 percent of primary care visits were made via telehealth in April, compared to just 0.1 percent in February.
How did that move go? Despite having only weeks to prepare, most U.S. health care organizations have unknowingly experienced a significant increase in their significant caseload. Dr. Martin Doerfler, senior vice president of clinical strategy and development at Northwell Health, was one of thousands of health care professionals who witnessed the move.
“We went from the proverbial‘ zero to 60 ’over a few weeks, and provided good care with very high levels of patient satisfaction,” Doerfler said.
Prior to the pandemic, Northwell Health – New York’s largest hospital system – made approximately 150 telehealth visits per month between 20 and 40 physicians. But in May alone, Northwell had made about 65,000 visits with about 8,000 health care professionals across the health system.
Doerfler cited an example of a single mother whose young child had breast diseases, including respiratory problems, which made visiting in people particularly dangerous during the pandemic. The pediatrician was able to assess the baby, talk to the mother through a telehealth interpreting service, and give the family the necessary steps to keep the baby healthy. The mother was happy to avoid taking her child on public transport to visit a hospital in person and still get the care she needed.
Three hours to drive 200 miles is no different than three hours to take two trains, two buses and a cab.
Clinicians at Northwell have used telehealth to deal with the pandemic in many ways, from sending phlebotomists to old patients’ homes after a meaningful visit, to connecting new mothers with specialists. lactation through secure, encrypted telehealth channels.
“There are all sorts of examples across healthcare where this technology, and the willingness of patients and clinicians to adopt it, has allowed for the kind of cases that are usually faced face to face, “Doerfler said.
Pre-pandemic telehealth programs helped keep patients and hospital staff safe by reducing human visits. For example, the Northwell TelePsychiatry Department connects people in an emergency, who may normally go to the emergency department, with a behavioral health specialist in about 45 minutes, any time of the day or week. That’s a big improvement because emergency department staff don’t usually include psychiatrists or other specialists who help someone suffering a behavioral health crisis.
The success of telehealth during the pandemic raises the question: Why has U.S. health care not already embraced meaningful care?
What are the barriers to telehealth?
One of the biggest obstacles to the widespread adoption of telehealth is the lack of national legislation providing financial incentives for health centers to adopt it.
State laws change how professionals are paid to visit telehealth. In some states, laws require insurance providers to visit telehealth at an equal rate – at the same rate as a personal visit. But in states without equality laws, there is little incentive for healthcare organizations to invest in telehealth infrastructure and training.
Accessibility is also a major barrier. The Centers for Medicare and Medicaid Services (CMS) typically reimburses clients for telehealth visits only when patients live in “designated non-rural areas”. protection. “
But not all places are small enough in remote places. In fact, a single parent living in Brooklyn, New York, may have difficulty accessing quality health care.
“Three hours to drive 200 miles is no different than three hours to take two trains, two buses and a cab,” Doerfler said. “So access is almost certainly improved. development as more telehealth is available in the direct-to-patient setting, at home or in their office. “
Lack of internet access is also a problem. A paper published by the JAMA Network in August found that 41 percent of Medicare beneficiaries do not have a computer at home with high-speed internet access, and about the same number do not have a smartphone with an unlimited data plan .
What is the future of telehealth?
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Lawyers in all parties and health care professionals have indicated that they want to make some of the telehealth regulatory changes implemented during the pandemic permanent. That’s fundamental, because without the financial incentives to continue to expand telehealth, healthcare providers may return to the pre-distributed approach. “One issue, which is important to know, is people about health care and non – health care, that telehealth will continue to expand significantly while funding and reimbursing it, “said Michael Dowling, president and CEO of Northwell. “If the insurance companies and the government decide, ‘We don’t want to pay for telehealth going on or meaningful rounds,’ it’s going to slow down. If there is no delivery system , there’s no health care system, hospital or doctor going to keep expanding telehealth unless they get a refund for it. “But some of the country ‘s largest insurers have stopped it. omitting telehealth and copayans for some customers, even though there is no clear end in sight for the pandemic. A -term solution, Doerfler said, is that CMS must start paying for telehealth services, at parity, up and down the chain, and go beyond federal legislation that requires plans self-insured health care pay for telehealth services as they would visit in person. .Health has been proven to work for emergency care, primary care and some special care, and is clearly expanding access to behavioral health care, according to Doerfler. “Some have said that the costs of providing telehealth are lower than face-to-face care, but most of the costs are unchanged, and new ones are being added by technology requirements When the patient receives a particular service billing codes are used to define that service.If the service is not smaller, the code represents that.If the service is as likewise, the code represents that and must be paid for equally. ”Doerfler added, although telehealth cannot replace all traditional health care. services, it should be “in the toolbox” for patients and doctors. ”In today’s world, where this type of technology is used for all sorts of personal and business uses, without something as personal as your care between you and your doctor from weaving into that modern patronage doesn’t make any sense, “Doerfler said.