Telehealth and COVID-19: The Key Role Tech Will Play in Healthcare’s ‘New Normal’
So much has changed in the past few months. As modern healthcare systems have scrambled to face up to the dual challenges posed by a global pandemic caused by a novel disease, communities and nations have had to adapt to restrictions on movements, business and day-to-day life on an unprecedented scale.
There has been tragedy, there has been hardship, there has been confusion and uncertainty. As awareness of how viruses spread and the measures required to prevent transmission have been discussed and communicated like never before, whole new patterns of behavior have emerged. As we start to come out the other side of what we might at least call the first phase of the pandemic, these patterns have become our new normal.
Practically every aspect of our lives has had to adapt to the threat posed by COVID-19, whether it is wearing face masks in public or observing physical distancing rules when we shop or limiting the number of people we meet up with outside our own household. Like everything else, healthcare has had to change, too. As it sits right on the frontline of tackling the disease, it is likely that the shifts in behavior seen in healthcare will run deeper and last longer.
Healthcare services are, of course, no stranger to the challenges of combating infections acquired in medical settings. But the rate of COVID-19 transmission in hospitals has triggered alarm throughout the profession and led to a lot of soul-searching about what more can be done to reduce the risks. Topics like hygiene measures, personal protective equipment (PPE) for staff and appropriate distancing of patients (in waiting areas, for example) have all featured prominently on the agenda.
But there is another topic which, from the perspective of achieving radical operational change, we should probably be hearing more about — telehealth.
What is Telehealth?
Telehealth is shorthand for the use of telecommunications technology to support the delivery of healthcare. In particular, it is usually associated with the idea of ‘remote’ medicine or using telecoms technology to move beyond the conventional model of healthcare services being delivered face-to-face.
Broadly speaking, telehealth solutions can be divided into two camps. On the one hand, what we might call patient-centered applications are designed to improve access for service users. Examples include the use of video conferencing apps to carry out patient consultations, web and mobile platforms that provide guided self-diagnosis and advice, remote pharmaceutical dispensing services and remote patient monitoring (RPM), which describes the use of wearable sensors which automatically send diagnostic information back to the healthcare provider.
In the other camp, you have technologies which are designed to help medical practitioners collaborate, make better informed decisions and overall provide a higher standard of care. These include so-called ‘store and forward’ platforms, where detailed patient information, whether in the form of scans, photos, observation notes or any other type of relevant data, are stored digitally and can be shared in real time with colleagues anywhere in the world.
The beauty of this approach is that it opens up access to specialist expertise, allowing practitioners to consult with and get an opinion from the very best in their field. There are even platforms designed specifically to support real-time collaboration in invasive treatment planning and delivery. One example is Proximie, an AR-powered video app which uses the principle of virtual presence to allow a specialist surgeon to ‘scrub in’ from afar and guide a colleague through a surgical procedure.
Benefits of Telehealth
One of the big advantages of telehealth is that it is predominantly based on readily available technology that is already commonplace. The majority of people carry smartphones and use laptops, they are used to using apps and web platforms for everything from shopping to working from home, most people have some experience using video conferencing. Telehealth simply applies this familiarity to the delivery of healthcare services. It’s low cost, effective and builds on what people already know.
For patients, telehealth expands the options available for getting medical assistance. Feeling unwell is bad enough, but the prospect of having to book an appointment to visit your clinic creates its own stresses. You might be struggling to take time off work, or to arrange childcare, or to arrange transportation. You might be away on vacation or on a business trip, but you want to speak directly to your own physician.
Remote consultations allow all of these things to happen. Not having to visit a clinic for a check-up or advice also avoids travel and transportation costs, including car parking charges. You can also guarantee complete privacy while getting medical advice on sensitive issues in the comfort of your own home. In addition to remote consultations, patients also have the option to look for ‘self-service’ advice or call a telehealth dispensary service to get the prescription they need, which both offer similar benefits.
For providers, reducing the number of people coming into clinic reduces the burden placed on services. In effect, it lays the groundwork for a new type of triage system, with only the most sick and vulnerable having to come into the clinic or hospital at all. That would allow healthcare services to focus all of their resources and efforts on critical care. And as we have seen, telehealth collaboration tools mean practitioners can share information and expertise more effectively wherever they are based, meaning patients get better access to the highest quality care, and best practice standards can be raised across the board.
Better access to advice and information in the community will also empower people to manage their own health better. This will benefit all parties, providers and insurance companies included, by reducing the need for interventions and therefore lowering costs.
Telehealth and COVID-19
So how do these benefits play out in the post-COVID landscape? One of the major challenges of healthcare providers in managing COVID-19 transmission risks is being able to maintain appropriate physical distancing between patients and staff on site. Telehealth plays directly into this.
The ‘remote triage’ system mentioned above, where patients can be effectively screened and managed at home unless there is a really pressing need for them to attend a clinic or hospital, can reduce the volume of people in a location at any one time, avoiding crowds sat in waiting areas and therefore allowing effective controls against transmission to be maintained.
This is also important in a situation where hospitals in particular are being overwhelmed by demand due to spikes in COVID-19 cases, while there are also concerns about patients with other conditions staying away because of infection fears. With telehealth systems, providers can make sure appropriate care gets to whoever needs it, without having to make initial decisions on care pathways for every patient in situ.
Remote consultations could also be used to enable screening of patients potentially showing symptoms and/or risk of COVID-19, without the need for in-person swab testing. By applying AI assessment tools to video calls, systems can be built which automatically identify risk factors and make recommendations for next steps. Not only would this help to protect staff from coming into contact with infected patients unknowingly, sophisticated remote AI assessments could also feed into track and trace systems which, in many countries, are struggling to scale up based on swab testing only. Having video or live text chat contact with their physician can also provide invaluable support to patients having to self-isolate because they suspect they have the virus, potentially reducing admissions to hospital where symptoms are being managed effectively at home.
Remote collaboration tools will also help practitioners to observe physical distancing guidelines. If we go back to the example of Proximie, there is the potential for such a platform to be used to limit the number of people who need to be in the operating room at any one time. More generally, staff working in the same hospital could use ‘store and forward’ platforms and video conferencing to compare notes on patients and discuss care plans without walking across the facility for face-to-face meetings.
All in all, telehealth technologies provide a ready-to-go solution that can help healthcare providers worldwide tackle some of the most pressing challenges associated with COVID-19 and its aftermath. Crucially, the pandemic seems to have shifted perceptions around telehealth amongst the profession and the general public alike. While studies prior to the outbreak found that just 18% of people in the US had ever used a telehealth application, a survey carried shortly after lockdown was introduced in April found that nearly half of patients living with chronic illness said they planned to use telehealth options rather than visit their clinic — double the number in a similar snapshot taken just before the crisis.
With this shift in attitudes, the time is right for healthcare service providers to embrace telehealth as a key component of the ‘new normal’.