Telemedicine’s Critical Role in the COVID-19 Crisis

Imagine you were feeling ill and could chat with your primary care doctor about your symptoms—without having to get up from your couch, without compromising the ongoing social distancing and self-quarantine mandates. This isn’t a newfangled piece of technology that may exist in the future, years from now. This currently exists—has existed in various forms for decades—and it’s called “telemedicine.” 

On March 4, the United States Senate voted for an $8.3 billion emergency spending package that would fund the U.S. response and efforts to coronavirus. The Verge reported that the bill gives the Department of Health and Human Services (HHS) “the power to suspend rules that restrict their access to remote care, or telehealth.” Outside of the U.S., HIMSS reports that telehealth ranks as one of the top eHealth trends in Europe, according to the European Annual eHealth Survey 2019. MarketWatch reported in May 2019 that the Asia Pacific telemedicine market would grow at an annual rate of 24% from 2019 to 2025.  

Telemedicine and telehealth have expanded in use across the health care spectrum, not just in hospitals and medical practices, but also by EMTs, fire and rescue crews, and the military—even before the current global pandemic. However, with rising safety and health concerns because of the rapid spread of coronavirus, more health systems are relying on telemedicine to lessen the strain on their human and physical resources, continue to provide service to all patients, and minimize unnecessary exposure to others.

What is telemedicine? How can it help during health crises?

Within the health care sector, many innovation efforts have been focused on improving the patient’s experience and satisfaction with their care. Patient portals, personal health devices, mobile applications, HIPAA-compliant text messaging notifications, and virtual doctor visits are among the resulting innovative technologies. The onset of COVID-19, or the novel coronavirus, has reinvigorated the public’s desire for telemedicine. The tech has emerged as an effective triage measure, protecting those more vulnerable to viruses from coming into contact with people who may not (yet) be presenting symptoms as well as expediting more severe cases to overworked hospitals. 

As a refresher, telemedicine is the delivery of clinical services through virtual, digital, and telecommunications-based tools. Telemedicine provides clinicians, physicians, and health care professionals with tools to provide care delivery despite physical limitations like remote location, lack of staff, or chronic care maintenance. And because telemedicine by definition is conducted through virtual (video) calls, mobile applications, and personal medical devices, it can help prevent the spread of any virus.

Benefits of utilizing telemedicine 

• Reach patients in remote locations who, without telemedicine, would have limited access to care
• Reach patients that do not want to risk their health
• Remotely monitor the health of sick patients
• Ease fears about contracting viruses or illnesses
• Enable and promote early diagnosis of viruses or illnesses
• Allow clinicians and doctors to see more patients and consolidate resources to treat sick patients
• Slow the spread of infection and virus

Telemedicine isn’t an unfamiliar concept. In one form or another, telehealth has existed since the 1950s; just last year Mercom Capital Group identified telemedicine as one of the top-funded digital health categories, “with a 55% percent increase in funding year over year.”

Throughout the current coronavirus outbreak (and beyond), telehealth can increase patients’ access to care, prevent and control the spread of infection, and provide doctors, clinicians, and physicians productive ways to maintain their own health and safety. (It must be noted that telemedicine is only the first step to receiving treatment or providing diagnoses. Virtual screenings are not, and should not, be the end of the line. Patients who need in-person testing or treatment will still need to follow up their virtual consultation and diagnosis with an in-person visit. Telemedicine simply offers a safe, professional, and more immediate way for patients to mitigate full-blown fear or paranoia.)

Telemedicine searches have increased due to  COVID-19

One notable point about the potential for telehealth is that it helps provide routine care for other conditions in addition to offsetting coronavirus fears. Patients who rightly do not want to risk their health by sitting in waiting rooms or pharmacies have turned to telemedicine and telehealth as a safer option. In turn, search results for telemedicine have surged. 

• On G2, there have been twice as many buyers looking for telemedicine software in the past 15 days. The category page traffic for telemedicine has seen a 96% increase since the beginning of March 2020, as both providers and patients look for telehealth options. 
• According to the Verge, American Well, a telehealth provider, saw an 11% uptick in the use of its services over the past few weeks.
• WIRED reports that in March 2020, Plushcare, a virtual primary care provider, saw a 30% increase [in virtual visits] compared with December’s virtual care statistics.

And these increases are for good reason: Telemedicine provides practitioners and health care professionals with an effective and expedited way to provide first-line defense. That’s the real power of telemedicine: empowering the general population with means to still reach their provider in the comfort of their own home, completely reducing the risk of compromising their routine of social distancing and quarantine.

Kinds of telehealth software available

Like any other kind of software, telemedicine isn’t just one type of tool. Telehealth can take a number of forms: 

• Live doctor-patient virtual communication/consultation via computer, smartphone, or tablet
• Telemedicine carts (mobile interactive patient care systems that integrate cameras to networks to provide patients with a remote bedside physician)
• Chatbots and/or synchronous chatting (for therapy)
• Asynchronous secure clinical communications between medical professionals and/or secure messaging between clinician and patient
• Home monitoring via consumer-facing devices
• Symptom trackers that ingest data from chatbots or other telehealth tools to analyze patient data

Telemedicine in practice

One caveat to restrictions lifted off of telehealth is that Medicare and Medicaid patients are the ones who don’t have to worry about insurance coverage. For everyone else, people must and should consult what kinds of virtual health care their health plans cover or support.

Telehealth can also positively impact the health care referral system. Because virtual care is best suited for chronic care follow-ups, remote therapy sessions, and initial assessments or consultations, referrals are a necessary follow up for those who require additional care. 

Telehealth hurdles to consider

Neither telemedicine providers nor brick-and-mortar health care providers were prepared for the current pandemic’s impact on telehealth. 

Robust telehealth network infrastructure is foundational to facilities’ ability to scale. Equally as important is staffing. CNBC reports that telemedicine providers like American Well, Doctor on Demand, and 98point6 are frantically trying to meet the increased demand for telemedicine, including through trying to hire potentially hundreds of new doctors.   

Coordination and integration between telemedicine providers and existing health systems is also key. No matter how much telemedicine can expedite and streamline patient visits, if patient documentation cannot be synced with electronic health records (EHRs), clinical communication and collaboration platforms, or referral management systems, then critical care access still stutters.

Additionally, many medical practices and facilities have been experiencing problems with this surging turn towards telemedicine; either the tool(s) crash when there’s too many people trying to virtually consult with their doctor or doctors have difficulty accessing patient files because the network is strangled. Health care providers must find a balance when it comes to triaging potential patients (after all, doctors must be able to refer virtual patients to in-person visits, and still must make diagnoses), and people should be prepared to be patient with a process that isn’t totally smooth given the current crisis. 

Finally, a long-term approach is necessary for long-term telemedicine impact. Once the Center of Disease Control (CDC) and HHS create coronavirus standards of care within the United States, action plans can be spun up, to better prepare the American public and health care industry for the next outbreak.

Companies expanding telemedicine access in response to the coronavirus

Below is a list of companies and organizations that are providing telehealth as well as innovating medical technology to better act and provide for patients during times of crisis. (Please note this list is current as of March 24, 2020.) The following solutions aren’t all strictly telehealth, but they do provide health care systems with the ability to offer remote patient management. 

• Blue Cross Blue Shield will waive prior authorizations and increase coverage for coronavirus tests, screenings, and care access. 
• Spectrum Health, a managed care health care organization, has announced its free virtual screenings for people in Michigan who are worried about possibly experiencing COVID-19 symptoms.
• Infervision, a Beijing-based medical artificial intelligence (AI) company, analyzes CT scans to help distinguish coronavirus from other respiratory infections.
• Tyto Care, provider of on-demand medical exams and telehealth visits, can be deployed quickly and at scale, “allowing physicians to remotely connect with quarantined or symptomatic patients...to perform remote medical exams” during this public health crisis.
• 98point6, provider of text-based primary care, “added coronavirus screening questions to their app in late January,” according to GeekWire.
• Bright.md, developer of telehealth systems, announced that it will provide a free coronavirus “evaluation, screening and escalation tool” to all U.S. hospitals that can provide patients with a virtual triage solution. 
• Alibaba has developed an AI system that can detect coronavirus in CT scans with “96% accuracy.”
• MicroMultiCopter, Shenzhen-based industrial UAV creator, is deploying drones to “carry medical samples...to medical clinics and hospitals” and conduct thermal imaging to determine who may be sick.
• HealthEngine, Australia’s largest patient network, has launched a coronavirus information portal on its website, provided a guided online survey for people who are experiencing troubling symptoms, and announced that they will provide their “telehealth infrastructure at no or low cost for all GP providers to serve their patients,” reports Healthcare IT News.