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Our Take

How Covid-19 will impact telehealth

10 Minute Read

The rapid embrace of telehealth in the wake of Covid-19 is simply astonishing. In less than one month, provider practices shifted from doing almost no virtual visits to doing only virtual visits. Hospitals that did hundreds of visits in all of 2019 are now doing that many every hour.

Telehealth won’t be the only way to access care in the future, but it will be a much more commonplace one. For the first time, telehealth has been tested at scale across the industry by patients, providers, and payers. Advisory Board has heard many of these health care stakeholders echo CMS administrator Seema Verma’s recent comment on telehealth’s sudden and durable importance to the industry: “There’s absolutely no going back.”

 

The pre-Covid-19 reality

Telehealth seemed to be near a tipping point for widespread adoption at the beginning of 2020—just as it seemed to be near this same tipping point at the beginning of 2019. And 2018. And each of the previous five years.

The reality of telehealth before Covid-19 was unfulfilled promise at the national level. Two out of three consumers said they were interested in telehealth services, but fewer than one in ten had ever used them. Only about one in five physicians had ever done a virtual visit. A hospital telehealth program with annual visits in the hundreds—that is, one or two telehealth visits per day—could reasonably have been described as “robust,” relative to the average hospital.

All stakeholders encountered significant obstacles to telehealth. Consumers were unaware of the availability of telehealth services from their providers. Clinicians worried that they wouldn’t be reimbursed adequately for telehealth and that telehealth might not be an appropriate way to deliver care. Payers and purchasers were afraid that telehealth would turn out to be an ineffective alternative to in-person care that would ultimately increase overall utilization and total cost of care.

 

Our take

Covid-19 has pushed the health care industry to cram years of progress on telehealth adoption into a few weeks. This “trial by fire” has overcome pre-Covid-19 obstacles of consumer use and clinician adoption, and it has set the stage for potentially transformative integration of telehealth across the care continuum.

Consumer experience with telehealth will lead to increased demand for telehealth services. Clinician familiarity with telehealth will lead to greater openness to and creativity with providing care remotely. Data on patient experience and outcomes will enhance understanding about which telehealth applications work and which don’t. Reimbursement parity will be essential to unlocking and sustaining widespread telehealth adoption.

The future of telehealth could turn out to be the future of medicine.

 

Four key implications

Covid-19 has provided a national demonstration case for telehealth that would never have been possible otherwise. Sustained and expanded adoption will depend on aligning around shared goals of generating value and transforming care delivery.

  • Implication

    Reimbursement parity is closer to reality—but it’s not a certainty

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  • Implication

    Telehealth services are now “table stakes” for providers

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  • Implication

    Widespread telehealth adoption can lead to new care pathways

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  • Implication

    Our understanding of competition before Covid-19 is inadequate

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Parting thoughts

Across most health systems, telehealth delivery is patchy at best. Making forward progress requires completing an inventory of existing services.

  • Where across your service lines could or should clinical services move to virtual channels?
  • To what extent are different practices delivering telehealth services today?
  • Across service lines and practice sites, do patients know when telehealth is available and how to access it?

First priority for providers is delivering some type of telehealth at all. But soon, they’ll be competing to provide the best services—especially as telehealth competitors can be local, national, or global.

  • Where are you tracking patient experience for virtual visits? How are you tracking patient experience?
  • Based on data collected, how will you address consumer needs and expectations?

As care moves virtual, organizations may need to rewire the connection points between new, virtual channels and existing, in-person access points.

  • Across clinical services, what are the follow-up needs and interventions that cannot be addressed through virtual interactions?
  • What kind of linkages do you need to establish to connect patients from virtual interactions to in-person visits or downstream services like labs, imaging, or referrals?

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