Pandemic Forces Telehealth Services to Rapidly Evolve

Telehealth communication is rapidly evolving, with its adoption by providers accelerated by the coronavirus disease 2019 (COVID-19) pandemic, according to a virtual presentation hosted by the Community Oncology Alliance (COA) 2020 Community Oncology Conference on Thursday.¹

The era of social distancing will likely leave a lasting impression on telehealth services, as health care providers (HCPs) quickly learn to incorporate it as a valuable tool and adapt to the changes in health care delivery and technology, said presenter Nick Recker, president of Path Forward, an Cincinnati, Ohio-based provider of tech solutions for health care professionals.¹

Telehealth is moving ahead so quickly that many of the challenges this method faced as recently as January 2020, such as Health Insurance Portability and Accountability Act (HIPAA) of 1996 guidelines, lack of knowledge by practices and operability uniformity, patient hesitation, payer parity, state-specific guidelines, have given way to a steep learning curve as the need for telehealth has become more critical, he said.¹

“There were a lot of obstacles in place. In the last 6 to 8 weeks, we’ve seen red tape stripped away,” Recker said¹

“By the time I’ve given this presentation, it probably will have evolved [again],” he said.¹

Prior to COVID-19, many HCPs considering offering telehealth services were looking at hardware solutions and had primary concerns about information security and patient privacy. However, there is an increasing use of cloud-based solutions for telehealth delivery, as well as “turnkey” options, such as Zoom.¹

Although bandwidth and connectivity issues as well as insufficient implementation assistance and tech support have affected patients and practices during the pandemic, system capabilities are improving, Recker said.¹

Telehealth also is moving out of offices and into providers’ homes.¹

In terms of privacy, Recker said that HCPs using telehealth to see patients should have their homes included in the practice network to use security features at a higher level than those typically used in a residence.¹

In addition, business-issued devices should be used, rather than personal devices, he said.¹

Virtual private network protection adds another layer of security, Recker said.¹

In response to the increasing acceptance of telehealth, he predicted an “explosion” of products specific to these remote services that will be similar to the patient portal boom of the 2000s.¹

Telehealth relies on high-quality audio and video, and vendors are stepping up to provide them, Recker said.¹

In addition, telehealth will incorporate more wearable devices and remote monitoring of patient conditions, he said.¹

“What we’re going to see is a boom around devices the report to smartphones,” Recker said.¹

As these devices and their diagnostics become more available to patients, questions will arise about whether to accept data directly from patients as well as other health care providers.¹

Conference speakers Steve D’Amato, BScPHARM, executive director of New England Cancer Specialists in Portland, Maine, and Anthony J. Scalzo, MD, president of Hematology-Oncology Associates of Central New York, also acknowledged challenges with telehealth during a separate session.²

Scalzo shared a provider experience with telehealth that recalled a patient visit: The visit was wrapping up with a recommendation that the patient make a habit of taking walks for exercise; however, she pointed out that she had no legs.²

“By not seeing the entire patient, and not getting that physical sense, there are things that slip through the cracks,” Scalzo said.²

In his session, Recker made a similar observation.¹

“This is a tool in the health care toolbox, it’s not going to be replacement for in-person care, he said.”¹

D’Amato and Scalzo said that many payers have recognized telehealth services during the pandemic, but providers are uncertain whether acceptance of this type of health care will continue long term.

“It’s early on in the payments,” D’Amato said.²

Both D’Amato and Scalzo said that the pandemic has shown that telehealth services can provide high quality care.²

“We’ve changed a bit in how we deliver, with the telemedicine, but I think our quality has remained the same,” Scalzo said.²

Although many providers that have adopted telehealth in recent weeks because of the COVID-19 pandemic, these services need to be addressed on a long-term basis, Recker said.¹

“We got here today because we had to react very, very quickly. We really need to start to pivot into planning mode,” Recker said.¹

“I would encourage you to find a committee to dedicate to telehealth long term. … The definition of telehealth will continue to evolve,” Recker said.¹

It is important for provider practices to solicit patient feedback and remain apprised of developments with regard to telehealth, such as coding, HIPAA laws, and reimbursement, with reliable resources that include COA, he said.¹

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REFERENCES

• Recker N. Emerging trends in telehealth and information technology. Presented at: Community Oncology Alliance 2020 Virtual Conference. April 23, 2020.
• Blau S, D’Amato S, Patton J, Rahman A, Scalzo A. Cancer versus COVID-19: what we have learned from the crisis. Presented at: Community Oncology Alliance 2020 Virtual Conference. April 23, 2020.