The pandemic has changed so many of the ways we interact. One of the most drastic changes is in how we manage our health. Many of us did not see our doctors in person for years. Instead, we’ve learned to receive our care via our laptops and phones.
Telehealth proved to be more than a COVID stop-gap. It has become an additional element in our list of healthcare choices.
According to an article on the AMA website, 85% of physicians said telehealth increased the timeliness of care, 75% said telehealth allowed them to deliver high-quality care, and more than 70% were motivated to increase telehealth use.
In the wake of the pandemic, the National Institutes of Health described telemedicine as “an indispensable resource” that improves:
- Patient monitoring
- Curbing the spread of disease
- The speed of identifying illness
- Continuous care for chronic disease patients
Todd Crosslin, Snowflake’s VP of Healthcare Strategy, believes that although telehealth is important, it’s only one part of a healthcare strategy. The key is to make the right choices for your treatment. Here is what he said.
Todd Crosslin: Thoughts on Telemedicine
This is a new stage, the new normal. The trajectory of telemedicine adoption’s upward trend is unknown, but I cannot imagine it going down. Some people may not have easy access to transportation but most of us now have some type of smartphone that allows us to do video meetings. Even those who don’t can speak to their providers via audio.
I think in the end, you’re going to see that telehealth is a net positive.
But telemedicine is going to be more effective with some people than with others. Think of fitness coaching, right? Some people can watch a video screen while riding a Peloton cycle, and be motivated by that. But some people need other people in the room.
Healthcare workers
There has been a great deal of burnout with doctors and nurses dealing with COVID. But we can now examine burnout trends when the providers can transition to, say 50% remote interaction. We have the ability to gather and examine data and discover how exactly remote medicine decreases burnout.
Balancing healthcare and healing
Too often healthcare is transactional, we trade payment for diagnosis. You have these prescriptions. You have these encounters. You have these diagnostics. If you’re not a clinician, healthcare too infrequently aggregates and analyzes that and gives you valuable information. What is needed is a way to not just track our health, but analyze, understand, and provide insights on it on an ongoing basis—not just to doctors, technicians, and pharmacists—but to the other group that needs it, patients. Us.
When I’m done with the telehealth visit, I would love to get a summary of what the analytics say, according to whatever diagnostics. I think this is becoming a patient expectation. It’s the consumerization of healthcare, right? I get all this information from my Amazon app. I get it all from my Instacart and all the different consumer experiences. From my exercise app. Why can’t I get that from health care?
VaaS (vulnerabilities as a service)
A major healthcare provider, CommonSpirit Health, was hacked. They just confirmed that this week and they are not alone. In the first half of 2022, the healthcare sector in the U.S. suffered 337 breaches resulting in the exposure of over 19 million records, according to a recent report.
As patients adopt remote healthcare, there needs to be an embrace of more modern technology. There’s so much technical debt inside a lot of the providers of care that there are unfortunately a lot of gaps and vulnerabilities inside health systems today. Because where do hackers go? The path of least resistance. Given how delicate our medical information is, how precious, that path cannot run through our health.
Hackers see healthcare as a rich target. As I said, they have a lot of technical debt, and they’re sitting on a lot of on-prem old technology that is not necessarily up to date.
I met with a group of CIOs a few weeks ago, and they are just overwhelmed with all these different technical-debt tasks, and they just can’t keep up. But that is where they need to embrace the more modern technologies. I’m not just talking about, say our company and the cloud, but the whole landscape of modern, functional tech. Healthcare needs a platform that manages all of the underlying vulnerabilities as a service. That’s what you want.
Mental health: a boon for the right patients
Mental health data is so much more squishy and unstructured than, say, a hemoglobin A1C value for your diabetes.
How telemedicine affects, and can effectively treat, mental health is almost a religious discussion. I don’t think I have the background to weigh in and say which is better, in-person or by screen. But some patients are more likely to engage and provide certain information in computer-based therapy versus human-based. If you engage with them using videos they are more likely to open up than if face-to-face with a live person.
Access to therapists and psychiatrists is an issue. There is a significant back-up [to get an appointment]. So if people are able to connect to someone virtually and get care, that’s a great deal better than not getting care at all, regardless of your preference.
Profit in insurance and healthcare
One issue that cannot be ignored is income. Let’s consider insurance companies. They assist us accessing and paying for healthcare but they do so in exchange for money. So we have to ask, is telemedicine good for the bottom line?
Well, it’s a volume and price thing. If you do more volume, which telehealth allows you to do, then you could theoretically increase your revenues. But depending upon what the negotiated rate is for a visit, then you could get less, or you could get more. Reimbursement for virtual care is a hotly debated topic.
What we do know for sure right now is that, in general, health systems have struggled, but payers – insurance companies – have done really, really well in the pandemic. Why is that?
Think about all the elective surgeries. They were turned off, so think about that margin for the payers. They’re not paying out elective surgery claims. It was massive, enormous, and then it disappeared. What this means in the short-term and in the long-run for patients remains to be seen, but it is an important element of remote care.
Now think about the other way that telehealth affects income, payment, and profit. Even if you have insurance, you are still going to pay somewhere between $30 and $250 as a copay depending on the type of visit. If you make a telehealth visit, however, you will most likely pay nothing.
That reality makes it more likely that people for whom cost is the differentiator will pay attention to their health before it has become dire and they have to report to the emergency room. Emergency room visits, for the record, are not just a burden to those who must make them, at an average of $2,200, but for the rest of us, who absorb the costs for any visitors who can’t, more of whom are black than white. In other words, telehealth has the very real possibility of contributing positively to much-needed health equity.
***
With the steep increase in the use of telemedicine, healthcare has changed. We can do much more than before without the cost and trouble of transportation. This is especially valuable innovation for those who are elderly, handicapped, or for whom every penny needs to be accounted for. We can also continue healthcare even when disease or disaster strikes.
Telehealth also preserves privacy while providing us with maximum access to our own data.
The pandemic accelerated us into the global adoption of telehealth, increasing access to care for patients and increased efficiency for providers. As the need for remote healthcare evolves, its value to patients and providers will be the deciding factor.