COVID-19 turned telehealth mainstream, making a once niche means for patients to receive care into a household term.
Not only are more providers offering care virtually, more patients are requesting care remotely.[i] While not limited to outpatient care, much of the telehealth discussions arising after the onset of the COVID-19 pandemic revolve around delivering direct-to-patients on-demand at-home consultations via remote visits (e.g. urgent care visits via an app).
The acceleration of telehealth is due in part to reimbursement changes,[ii] as well as to providers adopting recommended means to keep patients out of facilities but still deliver care (i.e. social distancing).[iii]
The effectiveness of telehealth in this regard currently is so well recognized that the CDC’s COVID-19 telehealth guidelines from June 2020 state:
“Telehealth services can facilitate public health mitigation strategies during this pandemic by increasing social distancing. These services can be a safer option for [Healthcare Providers] and patients by reducing potential infectious exposures. They can reduce the strain on healthcare systems by minimizing the surge of patient demand on facilities and reduce the use of PPE by healthcare providers.”[iv]
However, as stated above, telehealth is not limited to outpatient care. Telehealth, and its associated benefits, are just as applicable to inpatient care.
Broadly speaking, inpatient healthcare providers can leverage telehealth solutions to monitor patients’ conditions.[v]
Regarding inpatient care, telehealth solutions most regularly take the form of tele-ICUs. While telehealth is gaining popularity because it can help to socially distance providers and patients, tele-ICUs are known to bring distant providers to patients (e.g. rural hospitals without intensivist and limited ICU beds).
In the two years prior to the COVID-19 pandemic, research demonstrated that tele-ICUs can help “improve patient outcomes, optimize ICU bed utilization, increase financial performance and enhance educational opportunities.”[vi] More specifically, tele-ICUs can help improve “ICU mortality and decreased LOS.”[vii]
Given its associated outcomes, it makes sense for inpatient telehealth discussions during the COVID-19 pandemic to focus on tele-ICUs. However, telehealth in the inpatient setting is far broader.
One area that of telehealth that is currently being eclipsed by the pandemic is tele-stroke.
Given that time is of the essence in treating stroke, hospitals without stroke centers can leverage tele-stroke solutions to treat patients timely and improve outcomes.[viii] Like tele-ICU, tele-stroke brings distant care up close to a patient’s bedside.
The inpatient telehealth ecosystem is fragmented: some departments have tele- enabled care, multiple solutions, and mixed level of EMR integration.
However, if the current adoption of telehealth continues on the current trajectory for both in- and outpatient care during the COVID-19 pandemic and beyond, it is not hard to imagine the future of telehealth enabled care:
- Remote visits with your primary care physician from the comfort of patients’ homes
- the virtual hospital with patients cared for by bedside nurses, and clinicians continually present virtually
- the continuum of care joined together through remote patient monitoring
- hospitals with interoperable ecosystems unifying virtual care.
Solutions for each of these examples already exist and are undergoing rapid development in the current global healthcare environment.
The current environment is a catalyst to change telehealth from a means that healthcare is sometimes delivered into just part of way providers regularly deliver care.
More specifically, the current environment is making the virtual hospital within arm’s reach, just as much as our next doctors’ appointment is in arm’s reach of our smartphones.
References
[iv] https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html
[vi] https://pubmed.ncbi.nlm.nih.gov/30817384/
[vii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027727/
[viii] https://jnis.bmj.com/content/9/4/357.long
