Areas of focus in the virtual health ecosystem.
Steve Tolle, Partner, HLM Venture Partners
It’s no secret that telehealth use skyrocketed in the early stages of COVID-19 as both patients and health systems sought to minimize the risk of transmitting the disease.
According to data from the EHR vendor Epic Systems, telehealth visits peaked in mid-April, when they accounted for 69% of all ambulatory care visits. This percentage dropped substantially by mid-July, to 21% of total visits. However, it’s still miles ahead of the pre-pandemic levels of telehealth use. As health systems continue to care for patients with COVID-19 while developing strategies for the future of care delivery, leaders are thinking long and hard about the role of telehealth.
The future of patient care will mean leveraging technology such as telehealth where and when it makes sense. Even the most forward-thinking futurists recognize that, in certain situations and with certain patients, there’s no replacement for a hands-on, in-person appointment with a physician.
Instead, this future will be centered on a virtual health ecosystem that leverages a range of technology to enable care to shift away from the clinical setting when appropriate. Telehealth solutions have certainly earned a lot of attention, between Amwell’s IPO filing and Teladoc’s acquisition of Livongo, but recent analysis from Rock Health shows that virtual health companies raised $9.4 billion in funding through the third quarter of 2020.
This aligns with the vision of virtual health’s future, where the phone and video visits that played a vital role in ensuring care continuity this spring are one part of a larger ecosystem. Technologies that support a variety of uses cases are poised to support ongoing patient care without the need for in-person visits.
Remote monitoring. Many patients already use blood pressure cuffs, scales, and pulse oximeters at home. However, little of those data make it into the hands of care teams in a timely manner, which limits the ability to prevent hospital readmissions or high-acuity care scenarios. The true potential for remote monitoring is realized when data from medical devices, sensors, and wearables syncs with EHR systems and with virtual care platforms, as is the case with Deloitte’s ConvergeHEALTH MyPath. This lets care teams provide proactive support instead of waiting for patients to reach out — or present at the ED.
Remote diagnostics. In the early days of COVID-19, health systems and vendors alike rolled out symptom checker apps powered by artificial intelligence to help patients determine if they needed medical care before leaving their homes. This embrace of remote diagnostic tools is poised to expand to other conditions — both low-acuity cases such as strep throat and allergic reactions as well as chronic conditions such as hypertension (Philips), skin disease (DermTech), and sleep disorders (ResMed).
Chronic care management. According to data from the Centers for Disease Control and Prevention, roughly 90% of healthcare spending in the U.S. is for patients with chronic health conditions. Multimodal platforms from vendors such as Lark, Livongo, Omada, and Redbrick empower patients to manage conditions such as asthma, high blood pressure, or Type 2 diabetes through a combination of remote monitoring, health coaching, evidence-based care plans, and lifestyle management. Not only does this cut down on the need for in-person appointments, it can also improve quality of life for patients who experience better control of their symptoms.
Mental health. Interest in virtual tools such as AbleTo, SOC Telemed, and Teladoc spiked during the height of COVID-19 as patients sought treatment for conditions such as anxiety and depression. These tools reduce barriers to care while enabling providers to get a firsthand look at a patient’s home and how it may be impacting mental health.
Care team collaboration. In a pinch, and with temporarily relaxed HIPAA regulations, health systems utilized products like Microsoft Teams and Zoom to help clinician collaborate at the height of COVID-19. This was an effective short-term solution, but products specifically tailored for consults will play a more significant role in care team collaboration in the future. Tools such as RubiconMD, which enable primary care physicians to connect with specialists without leaving their native EHR system, saves time for physicians as well as patients, and it reduces the need for additional or unnecessary testing or care.
Medication adherence. Missed doses of medications can lead to the worsening of symptoms, the onset of additional chronic conditions, and more time spent in the hospital. It has been estimated that the complications of non-adherence cost the healthcare system up to $300 billion annually. Many solutions have emerged to support patients who may need assistance taking medication as directed; these range from reminder apps and smart pill boxes to ingestible sensors and robot assistants and provide varying levels of direct support.
COVID-19 accelerated healthcare’s adoption of telehealth. Many health system leaders have said they experienced many years’ worth of innovation and technology adoption in a matter of weeks. We have seen a renewed focus on the “digital front door.” Health systems no longer take for granted that patients will travel to their brick-and-mortar locations when they need care. The response to the pandemic has shown that virtual care, telephone, email, standalone apps, and even chatbots can meet patients’ care needs in certain scenarios.
As healthcare continues to develop clinical best practices for the use of telehealth, and as systems face the need to continue providing care to COVID-19 patients, it’s critical for the industry to keep building momentum. Returning to the traditional model of care, which focused almost entirely on in-person visits, is a non-starter — but so, too, is moving so much care to virtual visits that the industry loses the patient-physician connection.
By pushing beyond the telehealth visit to create and nurture a virtual health ecosystem, healthcare can seize the opportunity that technology adoption during COVID-19 has provided. This will enable more patients to access the care they need, keep more patients in a low-risk care setting, and contribute to better outcomes at lower costs.
Steven Tolle is a Partner with HLM Venture Partners.