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October 24, 2020 01:00 AM

Telehealth expansion has been transformational; payment changes should be made permanent

Dr. Marc Harrison
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    Dr. Marc Harrison

    Dr. Marc Harrison is president and CEO of not-for-profit Intermountain Healthcare, based in Salt Lake City.

    Telehealth became an instant necessity amid the COVID-19 pandemic. With its newfound prominence, it is catapulting American healthcare forward in ways that make care more accessible, adaptable and affordable— all to the benefit of patients.

    Yet the federal government’s approval of telehealth use and payment was only made on an emergency basis. It should become permanent, as the benefits of telehealth are profound, far-reaching and transformational. And health systems must make it as easy as possible for patients to utilize. 

    While its existence isn’t new, telehealth use had been minimized over privacy concerns and compensation issues. With the onset of COVID-19, it became an essential means of reducing infection risks for patients and care providers as well.

    On an emergency basis, the federal government wisely authorized the same payment as in-person visits. That opened the door to a new day in healthcare and quickly proved that both patients and providers would adjust to it. 

    We’ve seen those benefits firsthand at Intermountain Healthcare, where our use of telehealth visits has increased dramatically during the pandemic. From Montana to Utah to Arizona, telehealth visits skyrocketed from 7,000 in March to 63,000 in just one month and continue to average 40,000 a month. Fortunately, nearly a decade ago we launched multiple telehealth initiatives that now connect about 700 caregivers in 40 programs to providers across our 24 hospitals, 215 clinics, and multiple partner hospitals.

    The benefits for patients extend far beyond the convenience of routine virtual checkups. Telehealth-based oncology, for example, can provide pre-surgical and post-surgical assessments. At Intermountain, we’ve used the technology to evaluate a patient for a bone marrow transplant and conducted some post-transplant visits. 

    The technology also enhances care for widespread chronic conditions such as diabetes and hypertension, enabling a broad range of remote monitoring as well as “nudging” to increase patient adherence to treatment plans and medications. 

    Intermountain’s Connect Care, a consumer-focused service that accommodates telehealth visits seven days a week, has contributed to a significant decrease in unnecessary emergency department and urgent-care visits. About 60% of patients who used Connect Care said that they would have otherwise accessed care in a more expensive setting, like a hospital ED or urgent-care clinic.

    Unsurprisingly, telehealth is popular with younger patients who have grown up in the digital age. About 65% of all patients using Connect Care so far are 35 or younger. Our goal is to encourage older patients to adopt telehealth too. 

    Telehealth especially benefits rural areas. One cancer patient in rural Utah faced multiple four-hour car trips each week to receive chemotherapy. He was so discouraged by the travel on top of his illness that he decided to abandon chemotherapy. His doctors then switched to telehealth, enabling his small local hospital to administer the treatment just minutes from his home and helping him make a full recovery.

    With COVID-19 surging in many states and likely to persist into 2021, telehealth usage will remain high into the winter. Health systems can further expand their reach by making it as easy as possible for patients to use. For example, Intermountain is assisting patients through pre-visit verifications and assuring they are ready in terms of basics such as accessing the website or downloading the app, registering, and filling in their personal information. We’re also working to help assure there is adequate connectivity and bandwidth for our patients’ visits.

    The pandemic has made it clear that telehealth is here to stay and that adoption can be sustained for the future—many patients like it, public health circumstances dictate it and the government is reimbursing for it—with a strong case to make reimbursement permanent. Looking forward, health systems must broaden its access, make it simple to use, and encourage patients of all ages to embrace it when appropriate for their individual care plans. 

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