Why Telehealth Deserves a Permanent Place in the Healthcare Ecosystem

By Elizabeth Burstein, CEO and Co-founder, Neura Health
Twitter: @neurahealthco

COVID-19 pushed telehealth into the forefront of our healthcare ecosystem. With in-person physician appointments either ill-advised or not possible, providers and patients had to pivot from the common practice of in-person physician visits to online video visits. Payers had to follow suit, as the CMS and state medical licensing boards quickly changed reimbursement and licensing laws to allow providers to conduct visits across state lines.

Following the 32% increase in telehealth visits during the height of the pandemic, a report from McKinsey states that post-pandemic telehealth visits have stabilized to between 13% and 15% across all specialty care. Frost & Sullivan predicts that the U.S. telehealth market will experience seven-fold growth by 2025, resulting in a five-year compound annual growth rate (CAGR) of 38.2%.

As the spread of COVID-19 ceases to be viewed as a public emergency, states are revisiting their telehealth requirements. As of February, only 19 states will allow permanent or long-term interstate telemedicine. Expiration dates vary from state-to-state for those not allowing interstate telemedicine to continue.

There are compelling reasons for the continued use of telehealth. With many practices and health systems suffering from a shortage of healthcare providers, telehealth improves the economics of managing patient caseloads. It enables efficient and cost-effective communication between patients and their providers, and helps providers monitor chronic conditions without the patient having to visit an office or clinic. This is critical for patients who suffer from migraines and may encounter lights and sounds in a waiting room that can trigger an episode. Virtual appointments eliminate the tiresome hour-long – or longer – waits that patients endure as part of in-person office visits. Most importantly, telehealth has proven to deliver positive outcomes in patients’ quality of life and help reduce hospital admissions.

Telehealth dramatically minimizes the wait times to see a specialist, especially in rural areas where access to a board-certified specialist is often limited or not possible. In Vermont, for example, a state interagency review found long wait times for appointments in specialty care, particularly in endocrinology (average 113 days), neurology (average 114 days) and dermatology (average 140 days).

An on-demand telehealth care model further speeds up access, facilitating either same or next-day visits. With immediate access to a physician, an on-demand telehealth provider can get ahead of a patient’s condition worsening or the patient having to go to the emergency room or urgent care, which can be a costly option for many individuals and families. It enables patients to secure prescribed acute medications quickly, finding relief sooner from their symptoms.

Advanced technology plays a critical role in enabling doctors to efficiently see and treat patients using an on-demand care model. The technology used has moved beyond web conferencing tools such as Zoom or Skype, and includes additional tools that prevent the physician from having to ask redundant questions during the video visit while improving and accelerating a data-driven diagnosis. Prior to a telehealth appointment with a neurologist, for example, the patient can engage with an online platform that then auto-populates key information around symptoms and behaviors, such as the severity of a headache, key triggers, changes in medication or lifestyle, and what worked and what didn’t. Physicians can collect this data ahead of the visit, freeing them to focus on the patient’s personalized treatment plan during the appointment.

Telehealth is not designed to completely replace in-person care. Telehealth providers have in place protocols and internal references around specific symptoms that signal when a person needs to schedule an office visit with their physician or immediately go to the emergency room or urgent care. In neurology, physical exams are necessary when a physician needs to actually touch a patient’s head to gauge reaction and determine the severity of the pain. In-person visits are also necessary when migraines continue to worsen despite medication or bridge treatments, or when an MRI or imaging test is required.

Given the efficacy and convenience of on-demand telehealth care, we can expect more specialties to offer this type of service. We are already seeing more patients engage in first-time appointments with their providers online. Consumers are becoming more comfortable with practices, including telehealth, that were first established or became widespread during COVID-19. While younger generations may adapt to the technology more quickly, it’s also an ideal tool for older generations who may be less ambulatory.

We recognize that not all patients will initially feel comfortable with the telehealth process. Prior to the video appointment, we recommend our providers share these “tips” to enable a positive, beneficial experience for the patient and the provider.

  1. Suggest the patient come with a list of questions for the provider, and recommend that they take copious notes – an easier, less awkward practice for the patient when sitting at their kitchen table rather than in an exam room.
  2. To maintain privacy during the telehealth call, encourage the patient to secure a safe and private location.
  3. Ensure the patient understands that telehealth is an option for hybrid use with in-person care. For example, you can do the initial intake on telehealth to save time and money and then go for an in-person visit for lab work or a scan as needed. Follow up consultations can also be accomplished via telehealth.