3 experts on the telehealth challenges highlighted by the COVID-19 pandemic

Health systems across the country ramped up telehealth services this year due to the pandemic, and the rapid development of these services has highlighted numerous opportunities and obstacles..

Todd Czartoski, MD, president of telehealth, chief medical technology officer at Renton, Wash.-based Providence.
Keith Griffin, MD, CMIO of Winston-Salem, N.C.-based Novant Health Medical Group.
Adam Landman, MD, CIO of Boston-based Brigham and Womens Hospital.

The telehealth obstacles and opportunities that have actually been highlighted by the pandemic were among the topics discussed throughout a session at the Beckers Telehealth Virtual Forum on Nov. 2. The panel included:.

Heres an excerpt from the discussion, modified for clarity. To see the complete session on-demand, click on this link..

Concern: What telehealth challenges and chances have been spotlighted by the COVID-19 pandemic?

One is the appropriate amount of telehealth to continue doing. I think we actually pushed the extremes throughout COVID and we were really trying to see as lots of, really all patients that didnt require to be seen in individual, we attempted to see over telehealth but we understand many of them require examinations and do require to be seen in person. I think Keith pointed to this and discussed this however weve got to figure out a long-term plan for what reimbursement for telehealth looks like.

Dr. Keith Griffin: We went live on video gos to within our EMR 6 years earlier and tried for six years to figure out how to fit them into the system and did whatever we potentially could. Over the course of 6 years, we did about 1,200 video visits amount to, despite all those efforts. Weve been doing telehealth … for about 16 years. If you look at our total volumes over the last 7 years, in between 2012 and 2019, we did about 153,000 in person simultaneous virtual gos to, kind of like were doing right now. We saw a doubling year over year for a seven year period, 70,000 last year.

I believe general what weve revealed is that we can be effective with telehealth service providers, clients, practices. Were similar just in Brigham Health, at the peak of the COVID surge, we were doing over 77,000 video visits a month and doing that well and supplying top quality care to our clients.

We had all the facilities in place currently, so we didnt have to always create from scratch or figure out brand brand-new workflows. There was a great deal of effort down on the billing side. Due to the fact that the huge modification was so numerous of these are paid for which was the significant thing that got everybodys interest– that and the truth that you could not take care of patients otherwise without them. We hope that now it goes from being turmoil to being part of how we would constantly have actually viewed it to be as a way to deliver care to patients that makes good sense where it can be utilized appropriately..

Dr. Todd Czartoski: If any person informs you that they have this all found out and its seamless and frictionless and perfect, theyre lying to you. Were all on this journey, and I would echo Keiths remarks. For us, having the infrastructure in location and making that financial investment as a company upfront, prior to COVID, was whatever. It was seriously important. Weve been doing telehealth … for about 16 years. It actually removed about 12 years ago with telestroke and our telestroke network. Weve tried historically to try to get traction in our clinics. We do have some value-based care and capitation at risk where were responsible for populations but for one of the most part, still mainly a fee-for-service system. Because environment, its just actually tough to get traction for a conventional center check out, particularly around CMS limitations and regulations. You just cant do it, frankly. Therefore that was the biggest change for us I think.

If you look at our overall volumes over the last 7 years, between 2012 and 2019, we did about 153,000 in person concurrent virtual gos to, kind of like were doing right now. And 67,000, almost 70,000 of those came last year. We saw a doubling year over year for a 7 year duration, 70,000 last year.

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Dr. Keith Griffin: We went live on video sees within our EMR six years back and attempted for 6 years to figure out how to fit them into the system and did whatever we perhaps could. When we initially went live, we had a Superbowl advertisement about video check outs, and we had Michael Jordan on a signboard in fact about video check outs, and could never ever get any traction. Over the course of six years, we did about 1,200 video gos to total, in spite of all those efforts.

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Whats interesting is we saw that bulge early on. This explosion of volume where I think the most we ever carried out in one day was something like 16,000, practically 16,000 in one day across our clinics. However we have not seen it go away. Weve seen this long, what I describe as a long tail. And were down now to seven or 8,000 a day across all of our clinics, but were also doing close to a thousand a day of direct-to-patient or direct-to-consumer sees. Were at about 1.3 million for the year, and well most likely wind up the year around 1.6 million where it lands is type of TBD, I would state..