For decades, healthcare has looked fundamentally the same. When patients need care, they visit healthcare providers (HCPs) in a physician's office, hospital, or ambulatory outpatient clinic. During these face-to-face interactions, HCPs can gather information by listening to what the patient says and what is left unsaid; by visually examining the patient's body and body language; and, by laying hands on the patient, often one of the most important ways to initiate the healing process.
The COVID-19 pandemic upended that model – driving a perception among patients that healthcare facilities had become one of the riskiest places to visit. At the height of stay-at-home orders, face-to-face office visits dropped significantly. In their place was a sharp increase in the use of telemedicine – that is, the delivery of clinical services via telehealth technology and communications infrastructure. In fact, IQVIA research and analysis found that telemedicine absorbed one-third of office visits during the rise of the pandemic, with remote visits growing tenfold compared to pre-pandemic usage.
To be sure, telemedicine can be an ideal compromise for patients who live in remote areas and for those who are elderly and/or otherwise at high risk of contracting COVID-19. Even for other patients in lower-risk groups, remote visits have proven to be a convenient alternative to commuting to a healthcare facility, waiting to be called in, and then waiting some more to be seen by a physician.
As the United States navigates its way through the pandemic how will telemedicine play its important and unique role? As the industry makes the case for greater use of telemedicine, there are three risks and gaps that must be addressed for it to be a vital and enduring component of virtual care.
HCPs need to be comfortable with telehealth technology. In June 2020, IQVIA surveyed 1,700 physicians about telehealth and found that roughly half feel comfortable with current technology. Forty percent indicated that they are not comfortable – suggesting a lack of satisfaction with current options.
HCPs need tools for going beyond "superficial" observations. Telemedicine can be great for routine visits and follow-ups. But the nature of remote encounters means that a provider could spot "the usual" but miss "the unusual," increasing the potential for misdiagnoses or other medical errors. At present, this is arguably the greatest risk/gap in telemedicine – one that could be addressed with improved tools and greater access to detailed data.
Policies need to support telemedicine. In the U.S., healthcare remains a for-profit system, and HCPs and health systems alike need to generate sufficient revenue. Although COVID-19 prompted temporary relief – with CMS and some commercial payers reimbursing telemedicine at the same rate as in-person visits – this change has not yet been made permanent. Until there are comprehensive reimbursement policies, there will likely be gaps in telemedicine availability. Similar risks and gaps are evident with HIPAA and other licensing and credentialing requirements. Though temporarily eased during the pandemic, such policies need to fundamentally change if we are to realize the full potential of telemedicine.
Despite those gaps and risks, I strongly believe in the potential of telemedicine as part of a greater virtual care ecosystem. Telehealth is here to stay as a safe, convenient way for patients to get the care they need. The necessity of patients continuing to seek their routine care and patient safety should remain a cornerstone of managing care during the pandemic. Embracing and enabling telemedicine can help us achieve higher quality and better outcomes while reducing healthcare costs.
For more on this topic, download IQVIA's new eBook, Telehealth Transformation: Moving from crisis response to population health solutions.