Written by Dr. Matt Lambert, Chief Medical Officer for HealthNxt at Tech Mahindra & The HCI Group
With the passage of Labor Day, we turn to towards the fall (unofficially) of what has been collectively, the most unsettling year of our lives (also unofficial). Change has been the only constant this year, in healthcare and otherwise, and the goal of this piece is to set the course, at least on the path to virtual health.
The rise of virtual care
The healthcare industry made an unprecedented pivot in March and April in how it adopted telemedicine, a necessity created by a pandemic and bolstered by federal reimbursement reform, and there is great speculation of what the future will look like in the last quarter of 2020 and beyond. As cases and fatalities rose In the spring, we saw as much as a 4000% increase in Telehealth visits[i] and projections that 30% of those visits, over 300 million a year, would persist.[ii] As cases moved into younger populations and hot-spotted in the south during the summer, we were warned of a virtual health bubble.[iii] As we move to Q4 2020, we at HealthNxt have some thoughts on what lies ahead.
Planning for an increase in cases & virtual care
As a clinician, I can say that the virus is more prevalent now than it has been at any time throughout this ordeal. We are seeing less hospitalizations and fatalities at present because the virus has plateaued at a relatively high level (40,000 new cases/day) in young adults with fewer comorbidities and the contagion is less virulent in the waning days of warmer weather. But as the weather grows colder, I think this greater prevalence will lead to hotspots with greater admissions and deaths than we have seen thus far.
As the Chief Medical Information Officer for HealthNxt, I can tell you that many of our current and future health system partners are planning for this contingency. The majority of these same systems view their current state of virtual health deployment as temporary and are looking for a more sustainable solution. They are starting with a “fool me twice, shame on me” approach to Covid-19. We are actively working with client partners to establish tech-enabled clinical processes to manage the anticipated surge in coronavirus cases. This work starts with leveraging HealthNxt remote patient monitoring functionality to track oxygen saturation levels for patients who test positive for the virus. Keeping these patients at home while monitoring them, in real time with blue tooth enabled devices, is the safest option for patients, providers, and the community. To manage those patients who have a change in their clinical status, our care management partners are creating escalation pathways to supervising physicians who will evaluate these patients to determine the most appropriate level of care. They will do so via a virtual visit, leveraging HealthNxt’s integrated telemedicine feature, in a workflow integrated within their electronic medical record. These clinical best practices are matched with recent payment reforms that allow both the RPM and virtual visits to be part of compensated care for this cohort.
Virtual Care is here to stay
But this is just the beginning. As the CIO of one of our health system partners called out this week, the Covid-19 response is their test case for how they will virtually manage chronic diseases post pandemic. The lessons they learn in the next few months will set the path for their digital strategy in 2021 and beyond. I think we will see this trend for most health systems around the country. Even though Ed Marx and I can’t seem to agree on what percentage of outpatient care will be delivered virtually in the future, (I say 30% and he says 40%) we at HealthNxt are thrilled to accompany the clinicians and consumers on this journey.
[i] https://www.healthcareitnews.com/news/telehealth-has-staying-power-should-benefit-lasting-regulatory-changes
[ii] https://www.credit-suisse.com/ch/en/articles/asset-management/telemedicine-beyond-covid-19-202007.html
[iii] https://www.statnews.com/2020/09/01/telehealth-visits-decline-covid19-hospitals/
Matt Lambert, MD is the Chief Medical Officer for The HCI Group and a practicing, board certified emergency medicine physician. Previously with Clinovations and the Advisory Board, he served as the CMIO for New York City Health and Hospitals, leading the Epic implementation for the nation’s largest public health system and as the Physician Program Director for the Epic implementation at the University of Washington in Seattle, WA. He has authored books on healthcare reform: Unrest Insured and Close to Change: Perspectives on Change and Healthcare for a Doctor, a Town, and a Country.