Incentivize innovations that make telemedicine indispensable amid COVID
With the COVID-19pandemic continuing to attack America and patients avoiding potentially infected emergency rooms and physicians’ offices, the demand for telemedicine services has surged. Federal programs, private insurers and medical professionals are embracing this innovation, and, at long last, public policies are clearing longstanding obstacles to its growth.
Health care practitioners have seen exponential growth in virtual visits since March, and online appointments are expected to top 1 billion by year’s end. Thousands of individual practitioners and more than 100 medical systems, including some of the nation’s leading health care providers, are integrating telehealth technology to connect to patients at home.
The nation’s leading payer of health care services, the Centers for Medicare & Medicaid Services (CMS), has expanded Medicare reimbursement to pay for additional online health care services. CMS is also accelerating the use of telemedicine in Medicaid, and the Children’s Health Insurance Programs. Meanwhile, Congress’ $2 trillion stimulus includes $185 million for telemedicine and allows more Medicare Advantage insurance plans to cover telehealth services.
As a former acting administrator of CMS and a former senior executive at the American Hospital Association, we both support expanding telemedicine and the broadband connections that make online consultations possible, so that all Americans can benefit. We also recognize that broadband infrastructure and access are critical to empowering patients to benefit from these advances.
Acclaimed medical researcher Eric Topol has explained that telemedicine “requires a digital infrastructure that ensures secure connections between patients and physicians.” Particularly in the rural areas where telemedicine relieves provider shortages, the nation needs to build out broadband infrastructure and pursue the goal of universal broadband adoption.
Universal broadband faces two obstacles — adoption and access. While 95 percent of Americans have access to broadband, only 73 percent actually subscribe to home broadband service. This is known as the “adoption gap.” Closing this gap will require educators, tech leaders, broadband providers, hardware manufacturers, and telemedicine advocates to help every segment of society better understand the value and opportunities that come with a high-speed internet connection.
Rural America faces an “access gap” as 22 percent of homes don’t have broadband wires at their curbs. As for closing this “availability gap,” the best approaches are “tech neutral.” Let’s encourage the best companies and technologies to compete to fill the remaining broadband gaps. We should learn from the mistakes made in earlier federal broadband initiatives that fell short of their goals and move past outmoded policies that favor legacy phone companies over their competitors.
The digital transition in healthcare must continue long after we revived the economy and cured or contained COVID-19. CMS and private insurers should recognize the importance of telemedicine by expanding the temporary policies and making them permanent.
In addition to its advantages during this pandemic, telemedicine lends itself to consulting at inconvenient times of the day, such as the middle of the night, as well as providing specialty care in locations where it is not otherwise available or where the patients don’t speak the language, know physicians or have childcare available. Telemedicine is also ideal for issues that require lengthy consultations, such as addressing mental health and substance abuse.
For telemedicine to succeed, we need to meld online and in-person services, enhancing, not eliminating, the human factor. Videoconferencing skills should be built into the training of professionals, particularly the all-important “trust factor” — how to use technology so that patients will relate to them. For instance, even if professionals from outside can’t get into hospices and nursing homes, they’ll still know how to keep patients comfortable — and make them “partners in their own care.”
To be sure, there is no substitute for in-person visits. But, by sharing information among healthcare professionals, telemedicine can cure what frustrates patients and providers — the uncoordinated nature of the system — while also allowing the human element to emerge in encounters, whether in-person or online.
As long as this crisis continues, telemedicine will prepare for in-person visits in the future by maintaining or establishing relationships between patients and providers. After this crisis has passed, telemedicine will focus on personal consultations by improving communications, coordination, and data-sharing among medical professionals and their patients. As always, providers and patients will still have to find ways to close linguistic or cultural gaps when talking about issues of health, treatment and wellness.
When done right, telemedicine allows humanity to shine through in online and in-person encounters. And expanded broadband for all our communities can be a bridge, not a barrier, between patients, providers and the modern medicine we are creating during this crisis — and that we will improve immensely post-pandemic when high-tech and high-touch will work together.
Let’s continue this progress by making the incentives for telemedicine permanent — and helping patients and professionals in every community connect with the broadband without which telemedicine wouldn’t be possible.
Leslie V. Norwalk is a strategic counsel to Epstein Becker Green, EBG Advisors, and National Health Advisors. She serves as an advisor to three private equity firms and sits on the boards of directors of Neurocrine Biosciences, Arvinas, Magellan Health, NuVasive, Providence Services Corporation, and several privately-held health care corporations. Norwalk is a former acting administrator of the Centers for Medicare & Medicaid Services (CMS). Richard Wade is a consultant at Rugby Hall Communications and senior counselor to APCO Worldwide. Wade is also a former senior executive at the American Hospital Association, with 30 years of health system experience.
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