By Naomi Fried
Telehealth is defined as the provision of healthcare remotely by means of telecommunications technology. At the beginning of the school year, Yeshiva University announced that they were introducing telehealth services instead of onsite medical services for all students. Some questioned this decision and wondered if the quality of campus healthcare would decline due to this shift.
The development of telehealth is an advancement in the healthcare industry that makes healthcare more convenient and accessible. Whereas in the past people had to potentially travel from city to city to visit a doctor, these days we don’t even have to take the subway. Antidote Health, the telehealth company that has partnered with YU, reports that 80% of common health problems don’t require the doctor to see us in-person, and can all be resolved via video conference.
Although telehealth began as early as the late 1960s, financial, regulatory, and technological challenges made it more difficult to advance. In the past, a big challenge was the lack of technology to successfully create a large network that provides health services on electronic devices. The first significant step taken towards the advancement of telehealth in the US on a regulatory and federal level was in 2010. On March 17, 2010, President Obama proposed ‘Connecting America: The National Broadband Plan’ to assist in the proliferation and improvement of broadband networks across the United States. This plan calls for the build-out and improvement of medical networks that facilitate remote patient monitoring, electronic health records, and other technology-based health services such as telemedicine.
Among other reasons, telehealth’s popularity wasn’t overwhelming due to its lack of coverage by insurance. Insurance companies seemed to differentiate between in person and teleservices and the coverage for telehealth wasn’t as broad. During the COVID-19 pandemic, a lot of temporary changes were made, and usually health insurance will cover the same amount for in-person and teleservices.
There are four main categories of telehealth. The first is Live Video-Conferencing, which is a one-on-one conversation between the health provider and the patient. The second form of telehealth is Asynchronous Video. This is an area mainly used to get a consultation from an expert in a different geographical location. The provider receives history about the patient, will take a look at test results, and consult the patient. The third telehealth category is Remote Patient Monitoring (RPM). This is often used in senior living facilities and is essentially the collection and sending of data to the provider on a regular basis for monitoring purposes. Lastly, the fourth form of telehealth is Mobile Health. These are apps and software used to assist in monitoring and treating health conditions. A primary example of this is diabetes. Many patients have insulin pumps that pump according to the instructions sent to it by the app in which the patient can input information.
In March of 2020, telehealth’s popularity skyrocketed due to the beginning of the COVID-19 pandemic. To illustrate the increase in demand, at Oregon Health & Science University, the number of digital health visits went from 1,100 in February to almost 13,000 a month later, and a month after that all 1,200 ambulatory faculty were able to conduct virtual visits.
A global outcome from the pandemic is that low-income countries who do not have much access to healthcare in largely populated areas are able to implement digital healthcare into their systems. Now, people who previously were not able to access healthcare providers have an easier way to communicate and seek help from professionals. This system was very helpful during the pandemic but will continue to serve these countries when we return to normalcy and will aid in prevention and treatment of diseases in the greater population
The major growth in the popularity of telehealth services can be accredited to COVID-19. This doesn’t mean that telehealth’s popularity will decrease post-pandemic. A graph conducted by Trilliant Health illustrates the demand for telehealth services before, during and post pandemic.
The data clearly demonstrates that interest in telehealth has spiked in the past years, with the all-time peak being in March of 2020, when the COVID-19 pandemic shut every in-person service down. Obviously, the pandemic made it nearly impossible to access any other type of care, and therefore, one can argue that telehealth is not people’s first choice. The argument follows that the use of telehealth peaked because of the extreme circumstances. Although this is true, the graph proves that satisfaction with the service is high and therefore telehealth use is still almost 5 times more than pre-pandemic.
The accessibility of the service and expansion of preventive medicine possibilities are positive effects of telehealth. In order to make sure these improvements are maintained, legal steps are being implemented on a federal level. Congress is examining the pandemic’s temporary changes and are surveying which changes should be kept, reversed or changed. Making these legal changes is important because telehealth will remain in the healthcare system, and a good permanent law needs to be made for the healthcare providers and insurance payers. Committee Chair Sen. Lamar Alexander of the HELP (health, education, labor and pensions committee) shared his insight stating that from the many emergency policies that were changed the following should remain: Stopping the rule of “Origination site.” This rule requires the patient to be at the healthcare provider’s office so that the provider can be paid, unless the patient lives in a rural area that has considerably less access to care than urban areas.
Although the pandemic has passed, telehealth will stay with us, and steps are being taken to make sure that everyone can gain from this advanced service.