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December 16, 2020 05:00 AM

Digital pathways poised to reshape healthcare continuum in 2021

Alex Kacik
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    Modern Healthcare Illustration / Getty Images

    The COVID-19 pandemic has accelerated the use of digital tools that will better direct care, minimize administrative burden on clinicians and boost supply chain transparency, PricewaterhouseCooper's annual report found.

    "Next year is going to be the year of resilience," said Gurpreet Singh, the U.S. health services sector leader at PwC. "In order to create that resilience, there are a number of capabilities that have to be digitally enabled to drive that customer connection in a more convenient way."

    More patients connected to the healthcare system virtually than ever before during the pandemic, with virtual visits increasing more than 10,000% in some cases. While utilization is poised to decline, it will better complement in-person care, healthcare executives and employers said, noting that copayment waivers implemented during the national emergency has expanded access.

    Provider executives surveyed by PwC's Health Research Institute from August to September most frequently cited mental health and psychiatry (58%), family medicine (56%), obstetrics and gynecology(46%), and pediatrics (44%) as the specialties in which their organizations will offer virtual visits in 2021. Around two-thirds said telehealth has been most useful for follow-up appointments, although they were less convinced about its use for ongoing care management, noting that reimbursement remains a challenge.

    "We will need to pair physical therapy virtual visits with a technology that can measure range of motion. Insurance companies only want to pay for objective measurements," a physical therapist told HRI, adding that patients prefer face-to-face interaction.

    A psychiatrist wrote that while telehealth offers a valuable peek into the patient's home, the relationship feels more artificial.

    The need for mental health services is poised to increase as Americans and healthcare workers digest the pandemic. More than a third of healthcare clinical workers reported symptoms of anxiety or depression as a result of the COVID-19 pandemic, but only 12% said their employer had offered them new mental health benefits.

    Healthcare intermediaries could mitigate some of those concerns and fill gaps in care. More than two-thirds of provider executives surveyed said they plan to use more care navigators and coordinators in 2021, which can boost medication adherence and follow-up care.

    "Some providers are starting to see a reduction in indirect revenues. I think the investment in telehealth and care navigators will help create a more convenient journey for the patient as well as limit revenue leakage," Singh said.

    But PwC researchers cautioned that telehealth has the propensity to create or exacerbate care inequities, particularly for those who don't have the bandwidth or access.

    In addition to consumer-facing applications, digital tools can prove valuable for clinicians, according to the report.

    CMS relaxed several administrative requirements during the pandemic, including allowing verbal versus written electronic health record orders and easing cross-state licensure requirements for virtual visits. Insurers also scaled back prior authorization requirements.

    Seventy-three percent of provider executives said their organizations are working on automating administrative tasks like speech-to-text EHR documentation.

    More healthcare providers are also using data to forecast supply and demand when it comes to staffing and equipment, a practice that COVID-19 kicked into high gear, PwC researchers said. Nearly three-quarters of healthcare executives said they had plans to collaborate with other providers or payers as a result of the pandemic, which could aid social determinants of health endeavors, Singh said.

    "It's a more proactive approach as opposed to reactive," he said. "Whether it's evaluating a patient population, looking for potential hot spots and leveraging virtual consults or proactively making appointments or fulfilling prescriptions, it improves the clinician experience and overall care."

    Data analytics will also play a primary role in improving supply chain transparency, which was among executives' top goals going into 2021, according to the report.

    COVID-19 illustrated the danger of putting too much stock in overseas manufacturers, and providers will be looking domestically or closer to the U.S. as they diversify their supplier mix.

    But for both domestic and international components of the supply chain, healthcare companies will likely require an end-to-end view of the continuum. Advanced analytics can determine supply of raw materials and finished products to estimate shortage risks, researchers said.

    "This visibility and transparency is going to persist. We don't want to get rid of it, because people are starting to count on it; there's no going back," Erin Horvath, president of distribution services at AmerisourceBergen, told HRI.

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