I. Introduction
The COVID-19 pandemic has drastically changed healthcare delivery, and telehealth has been an invaluable tool for delivering care to remote patients.
Consider the story of Nancy, an elderly woman living in a rural area. Before the pandemic, Nancy had to travel to her physician’s office for her routine appointments. However, with the onset of the virus, she was unable to make these trips due to her age and the risk of exposing her to the virus.
Fortunately, her physician was able to offer her virtual visits via telehealth. Nancy was relieved to be able to receive the care she needed from the safety of her own home.
This inspiring story highlights the role telehealth played in making healthcare more accessible during the pandemic.
The COVID-19 pandemic caused many disruptions to the way we lived our lives, and healthcare is no exception. To adapt to the new normal, healthcare providers turned to a new technology: telehealth.
Telehealth is a way of delivering healthcare services remotely through video conferencing, phone calls, or other forms of digital communication. This technology has allowed healthcare providers to continue providing care to their patients, even when face-to-face visits are not possible.
II. Benefits of Telehealth
Telehealth made healthcare more accessible to those who were unable to leave their homes due to the pandemic. It allowed patients to connect with doctors and healthcare professionals without having to leave the safety of their homes. Additionally, telehealth platforms provided access to clinicians in rural and remote areas who would otherwise lack access to healthcare.
It provided patients with timely access to healthcare services and allow them to receive treatment more quickly. This helped to reduce the time spent waiting in doctor’s offices or waiting for an appointment. By providing timely care, telehealth visits potentially helped to improve patient outcomes by providing quicker access to care.
Telehealth services are more cost-efficient than traditional healthcare services. By eliminating the need for travel and other in-person visits, telehealth reduced the overall cost of healthcare for both patients and healthcare providers.
III. How Telehealth is Helping During the COVID-19 Pandemic
A. Increased access to care: Telehealth made it easier than ever for people to access medical care without having to leave their homes. This was especially important for those who were at a higher risk for contracting the virus, such as seniors, pregnant women, and those with underlying health conditions. With telehealth, people could receive the medical attention they need without putting themselves at risk of exposure to the virus.
B. Reducing the spread of the virus: By allowing people to access medical care from the safety of their own homes, telehealth helped to reduce the spread of COVID-19. People were not required to travel to the doctor's office or hospital, where they could potentially come into contact with someone who has the virus. This helps to limit the number of people who are exposed to the virus, which is beneficial for both individual and public health.
C. Ensuring the safety of both patients and healthcare workers: Telehealth also provided an extra layer of safety for both healthcare workers and patients. By eliminating the need for in-person visits, telehealth helped to ensure that healthcare workers were not exposed to the virus and that patients received care without having to worry about potentially contracting the virus.
Telehealth has become increasingly popular over the last few years, especially during the COVID-19 pandemic. Despite its advantages, there are still challenges to providing healthcare via telehealth.
IV. Challenges of telehealth post COVID-19 Pandemic
Pre-COVID-19 pandemic, telehealth utilization faced various challenges. The most significant is the limited reimbursement by federal, state, and private insurance outfits. Other challenges include inadequate telemedicine parity laws, high cost or the limited availability of high-speed internet (particularly in rural areas where telehealth is most needed), state licensure laws when telehealth crosses state borders, lack of standards, lack of evaluation by a certifying organization, lack of sophistication on the part of the patient, particularly in the elderly and under-educated and finally, ethical and legal challenges.
A. Reimbursement
Telehealth has issues with reimbursement. Many insurance companies do not cover telehealth services, which can be a major hurdle for patients who are unable to pay out of pocket.
Before the pandemic telehealth visits were poorly incentivized. Medicare restricted coverage for telehealth visits to patients in a designated rural area, and patients who travel to a medical facility for telehealth care.
During the pandemic, the government through the Centers for Medicare & Medicaid Services (CMS) relaxed all restrictive regulations temporarily for telehealth deployment. These restrictions include interstate licensing issues, data confidentiality issues, and most significantly reimbursement for telehealth visits.
These waivers provided flexibility to healthcare organizations during the pandemic and ensured payment parity between telehealth visits and in-person clinical care.
As we get to the end of the pandemic and the waiver period elapses, telehealth services will begin to see a drop in its utilization.
Successes made in the adoption of this technology might be reverted if efforts are not made to properly incentives these visits.
Some steps have been taken by the CMS to this end. Once the COVID-19 pandemic ends, the Consolidated Appropriations Act of 2022 will ensure a 151-day extension period before the expiration of the waivers and gives room for a transition period.
The increased flexibility regarding where a patient receives care will be reverted to the pre-pandemic policy.
Medicare will no longer cover audio-only visits for physical health encounters.
Medicare reimbursement for mental health telehealth services will again require an in-person visit within 6 months of the initial assessment and every 12 months following.
Medicare reimbursement for telehealth visits furnished by physical therapists, occupational therapists, speech-language pathologists, and audiologists will no longer be allowed.
Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) will no longer be able to be reimbursed as distant site telehealth providers for non-mental health services.
B. Poor internet connection and lack of universal access to technology
Another significant challenge to telehealth is inadequate access to technology and a lack of reliable internet connection. Many people in rural areas or those with lower incomes may not have access to a computer or reliable internet connection, making telehealth impossible for them.
C. Concerns about patient privacy
Another challenge to telehealth is that it can be difficult to ensure patient privacy, especially if the patient is using a public internet connection. Hospitals and medical providers must take extra steps to ensure that all patient data is secure and confidential when using telehealth services.
D. Physical examination and certain procedures were impossible to perform via telemedicine
Finally, there are certain procedures and physical examinations that cannot be done via telemedicine. For example, a doctor may need to perform a physical examination or use equipment to diagnose a patient. These procedures are impossible to perform via telemedicine, which means that some patients may not be able to get the care they need.
In conclusion, telehealth has provided a much-needed avenue for patients to access care during the pandemic. However, there are still several challenges that need to be addressed if telehealth is to continue to be an effective way to provide care post-pandemic. These challenges include reimbursement, lack of universal access to technology, patient privacy, and the inability to perform certain procedures and physical examinations.
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