Infection preventionists, hospital administrators, and other healthcare professionals should turn to telemedicine to help deal with the COVID-19 pandemic. Add to that list the most important stakeholder of all—patients, says a study in the American Journal of Managed Care.
“Telemedicine systems are ideal for mitigating overcrowding of hospitals and clinics by triaging low-acuity patients while also preventing additional unnecessary human exposures and promoting delivery of high-quality care,” say investigators with the Jones Day law firm in Detroit. “Because state, federal, and international laws and regulations have expanded in recent years, months, and weeks to accommodate greater adoption of telemedicine systems (especially during this public health crisis), healthcare providers are now better situated to consider implementing such systems.”
One of the barriers that needed to be addressed was just how providers are to be paid for using telemedicine.
“A phone call would not necessarily count as telemedicine in my mind because that is not something that payors will usually reimburse,” Kimberly Lovett Rockwell, MD, JD, one of the study’s authors, tells Infection Control Today®. “I am mostly talking about video visits. Most sophisticated health systems do have the capability to provide video visits at this point though there are many who do not have such capabilities yet. The practice is growing and it is likely that this pandemic will lead to much more widespread uptake of telemedicine technologies among providers.”
The study noted other bureaucratic problems as well, involving licensure, credentialing, and ensuring compliance with multiple jurisdictions. It argues that federal, state, and local laws have been greatly adjusted in recent years to overcome those barriers.
Medicare, Medicare Advantage, and Medicaid now pay physicians and other providers for a broad array of services delivered via telemedicine. Taking a cue from the federal government, states passed legislation to encourage commercial health insurance companies to reimburse providers. In some cases, in fact, states mandated such reimbursement.
“Each of these changes has created a much more favorable environment for providers to adopt and implement telemedicine systems to deliver clinical services,” the study states.
Rockwell says that while clinicians tend to be hands-on practitioners, there are many things that can be done to help patients using real-time audio-visual systems. A lot of physician-patient interaction doesn’t require physical touching.
“Not only would telemedicine ensure that patients aren’t exposed to infections unnecessarily, but it also protects clinicians from unnecessary exposures (especially by patients with few symptoms that can stay home during infection recovery),” says Rockwell. “Telemedicine can also ensure that health care systems are not overly burdened with low-acuity patients (both those with infections and those with routine chronic illness follow-up needs such as medication refills and the like).”
There’s also been change on an international level, investigators say. The European Union and many Asian countries have expanded their use of telemedicine, including tackling the thorny topic of, again, provider reimbursement.
“In Italy, for example, which has been heavily affected by the COVID-19 outbreak, all 20 Italian regions, as of 2018, have implemented telemedicine guidelines promulgated by the Italian Health Council in 2012 to facilitate greater use of telemedicine technologies throughout the country,” the study states. “Such measures will prove critical for increasing access to healthcare services for patients who are crowded out of brick-and-mortar healthcare facilities, located in low-resource areas, or too afraid to access brick-and-mortar services for fear of exposure.”
Investigators point out that containing COVID-19 involves not overburdening health care systems, which can lead to the depletion of medical supplies and resources. Telemedicine might emerge from this crisis stronger than ever.
“Although certain legal, regulatory, and reimbursement challenges remain, the COVID-19 outbreak may be the right impetus for lawmakers and regulatory agencies to promulgate further measures that facilitate more widespread adoption of telemedicine,” the study concludes.