In a world where we are asked to stay in our homes, life is being lived online. We work virtually, we learn virtually, we stay connected to family and friends virtually, and yes, we even go to the doctor virtually.
The shift to remote healthcare is necessary in the midst of stay-at-home orders, but it has been challenging for many physicians who have had to completely rethink the way they interact with patients; it has also called for patients to take more responsibility for their own health.
However, the news is not all bad. Telemedicine has been around for a long time, and in some ways, the COVID-19 pandemic has been an instigator for growth that will change the way our healthcare system operates. Governments and organizations like the American Medical Association have poured resources into helping providers continue to care for patients, and entrepreneurs are responding to the increased demand for remote care with innovative solutions.
What are Some of the Challenges and Advantages of the Shift to Telemedicine?
According to Stacy Lloyd, Director of Digital Health and Operations for the American Medical Association, the initial challenge faced by physicians was the very sudden shift to remote work. If telehealth systems were not already in place in their practice, which was true in many cases, they had to adapt quickly and find innovative solutions to stay connected with patients.
On top of this, many physicians were and still are navigating working out of a new environment and figuring out how to perform exams in a remote setting.
At the same time, Lloyd says, “traditional telehealth vendors are experiencing a booming demand for their telehealth platforms and have seen significant increases in volume.” The government has also responded to the increased need for access to telehealth by relaxing certain HIPAA regulations, permitting physicians to use platforms such as FaceTime, Zoom, and Skype to perform patient video visits.
However, these technologies may not be a long-term solution after the public health emergency is lifted, so physicians may want to consider exploring more permanent telemedicine platforms for ongoing use. The AMA’s Telehealth Implementation Playbook was developed with this in mind and provides comprehensive guidance on evaluating, selecting, and contracting with vendors.
The shift to remote health has also uncovered access issues for certain populations. For example, elderly individuals are a demographic that is particularly at risk, but physicians have had issues communicating with their elderly patients and empowering them to perform certain activities such as taking their own blood pressure without in-person training. There are also patients in rural and urban areas who may not have access to the correct technologies for a visit or strong enough internet connection to support a video call.
In a more positive sense, the COVID-19 pandemic and resulting increase in telemedicine services has allowed physicians and patients alike to get more comfortable with virtual care, making it more likely to stick around even after the world begins to return to normalcy.
While non-essential in-person care starts to resume, we hope to see these telehealth services remain in place as an option so that continuity of care and access can be maintained even when a patient is unable to make it into the office for a visit. However, this may largely depend on physician and patient experiences with telehealth and the coverage expansions and other policy changes that have happened since the beginning of COVID-19 remaining in place to make it a financially viable and geographically possible.
How Are Innovators Adapting to the Increased Demand for Remote Care?
While there have clearly been many challenges to the widespread implementation of telehealth services, entrepreneurs have responded by working around the clock to find innovative solutions to address them. One of these entrepreneurs is Mark Greget, Founder and CEO of NuEyes, a digital health startup producing wearable technology to help individuals with visual impairments see again. NuEyes has recently rolled out a new service, NuCall, which is a HIPAA-compliant telehealth platform designed for the visually disabled to communicate with their physicians from the safety of their own homes.
The visually impaired are already an at-risk population, and the COVID-19 pandemic has affected them disproportionately. 11 million people in the US suffer from macular degeneration (the leading cause of vision loss) and 3.4 million have very severe low vision. These individuals are holed up in their homes with no way to travel and very limited access to healthcare. The basis for NuCall was bred years ago as a system for doctors to use the NuEyes glasses to communicate in the operating room, but when COVID-19 hit, Greget and his team decided to adapt it to be used as a widespread telemedicine platform to help this population access the care they need.
When designing NuCall, Greget says, his biggest consideration was the ease of user experience. He wanted his product to be as simple and streamlined as possible from beginning to end, and specifically needed to consider the target population of visually disabled individuals. NuCall has extra features that are not present on any other telemedicine platform, such as HD quality video, magnification abilities, the ability to mark up an image, and text extraction. The platform also incorporates secure text messaging and emails, screen sharing, and is hardware agnostic. With this attention to detail, NuEyes has been getting a lot of interest from physicians about use of the NuCall platform for sighted individuals.
So, what advice does Greget have for other innovators and physicians who are using telehealth platforms? Three simple words: ease of use. “These platforms are for communicating with patients at a time when they are at their most vulnerable,” Greget shares. “We should be asking ‘how can I make this easiest for patients?’ and at the same time ‘how can I make it easiest for myself?’’’ He feels that the biggest mistake is overengineering these telemedicine platforms to the point where they are overcomplicated and veer from that core mission.
What Does This Mean Going Forward?
Unfortunately, there is no easy answer here. “In these past few months,” Lloyd says, “many organizations, including the AMA, have been working hard to make sure that telehealth is accessible to patients and clinicians.” However, we are beginning to enter the “next phase” of this response as she describes it, where we are starting to think about what the future of telemedicine looks like and what changes we’ve seen during the pandemic may be more long-term. Another aspect is looking at where the gaps in access exist, so that strategies to address these gaps can be created.
Looking even further to a world post-COVID-19, there is no doubt that telemedicine will be more prevalent than it was before; however, it’s not likely telemedicine will replace in-person care as the norm. The expansion of telehealth, especially within physician practices, will open up the door for increased access and convenience for patients, while maintaining continuity of care and preserving the patient-physician relationship.
The American Medical Association has released a Digital Health Implementation Playbook, which includes both the Telehealth Implementation Playbook, a comprehensive, step-by-step approach to implementing telehealth for physicians, care teams, patients, and the broader community, and the Remote Patient Monitoring Playbook. The AMA also offers a Telehealth Quick Guide which is continuously updated with the latest information from the federal government and states.
For more information on innovators addressing the pandemic, visit this MassChallenge blog post.