Where virtual health is headed and how it will transform care

While the healthcare industry has been challenged for the last 18 months by COVID-19, one silver lining from the pandemic is greater adoption of telemedicine. More people are using telehealth today than before 2020, accounting for 13 to 17 percent of visits across all specialties. 

Now industry leaders are strategizing how to sustain the use of telehealth going forward. 

During Modern Healthcare Custom Media’s recent Virtual Health Virtual Briefing, Claudia Douglass, Principal for PwC Health Industries, led a discussion with health system executives about where virtual health is headed and how it will transform care delivery in the future.

At Renown Health, based in northern Nevada, telehealth accounted for over 50 percent of outpatient visits at the height of the pandemic. Now it makes up just below 10 percent of outpatient appointments. 

The system’s goal is to increase telehealth use, so it accounts for 20 percent of all outpatient visits, said Mitchell Fong, director of telehealth. Renown is focusing on growing telehealth as part of its aim to provide better care and improve patient access.

“The perspective we try to bring to the (telehealth) program is really about the patients and population health – how do we address those social determinants to ensure that every patient can get the right care at the right time,” Fong said.

Similarly, at Greensboro, N.C.-based Cone Health, there was a spike in telehealth visits last year during the peak of COVID-19, but they have since dropped, said Dr. Valerie Leschber, chief medical officer at the system. 

“We are looking to (increase our telehealth visits) and putting that in our fiscal 2022 priorities,” Leschber said.

Dr. Aram Alexanian, virtual health and primary care leader at Novant Health, calls telehealth visits “refreshing.”

Alexanian is currently seeing patients both in-person and virtually. He said he enjoys video visits with his patients because they are quick and allow him to see patients in their home environment. “It brought me back to the roots of why I do this,” Alexanian said. 

Another benefit is the flexibility it offers providers, who are reporting high levels of burnout. Rather than canceling appointments for the day when sick, providers can now conduct visits in their home. Physicians who are parents also appreciate being able to work from home, Alexanian said.

Leschber added that while virtual health offers providers at Cone Health needed flexibility, the system is still evaluating ways to ensure the technology doesn’t contribute to burnout and includes clinical staff appropriately. 

“There are so many opportunities to utilize our workforce in some virtual manner we are still iterating around,” she said.

Throughout COVID-19, Renown Health implemented remote patient monitoring services out of necessity. 

Capacity and burnout are concerns for the health system and remote patient monitoring enables Renown Health to discharge COVID-19 patients home sooner. It also allows nurses and other clinicians to take a break from the in-person clinical environment and see patients virtually.

Renown Health has expanded the program to include chronic obstructive pulmonary disease patients and has seen reductions in 30-day readmissions rates as a result.

“We have been able to leverage RPM to enhance the quality, to create more access and capacity for care, and also to benefit our care team and provide opportunities where they can provide meaningful care in a different way,” Fong said.

For Novant Health, they are working on setting up a 24/7 remote patient monitoring program by the end of this year, starting with the bariatrics service line, said Amber Karol, director of digital health at Novant Health. 

In the meantime, similar to Renown, Novant has leveraged virtual health to send COVID patients home sooner. Since September, 82 COVID patients have been discharged sooner and monitored from home. 

The system also launched a pilot program that involves shipping to patients’ homes COVID tests with the intention to expand system wide. There are plans to expand the program to flu tests as well.

Karol said by delivering tests to patients’ homes, “instead of making them come to us,” it enhances patient experience and quality of services.

A major challenge for Novant Health has been sorting through licensure laws in the states it offers virtual care. Depending on the state, physicians and advanced practice providers must apply for permanent license in that state in order to provide telehealth services.

“There was a lot we had to do to make sure we were ahead of when the waivers were going to expire so we could continue to see (patients),” Karol said. 
Karol said she’s hopeful these laws will change once telehealth becomes more widely adopted.

Fong added he encourages industry stakeholders to lobby for changes that create more flexible licensure laws such as the interstate licensure compact. 

Credentialing by state Medicaid payers has been an issue as well, Fong said. Some state Medicaid programs haven’t recognized physicians who get licensed in new states to provide telehealth, impacting reimbursement.

“It is truly the patients that suffer” from current mandates, Fong said. “It’s our duty to create that network, to provide that access for every patient across America.” 

Click here to register for the Virtual Health Virtual Briefing and listen to the panel discussion. To learn more about how PwC can help your organization with virtual health and new care model needs, please visit https://www.pwc.com/us/virtualhealth or contact [email protected].