4/09/2020

Patient Education and Telehealth: Finding Opportunity Amid COVID-19

Marta Sylvia, Senior Manager, Quality Improvement and Outcomes Research, and David Foster, Senior Director, Analytics and Insight

 

The coronavirus (COVID-19) pandemic has taught us, among many things, the need for healthcare to evolve quickly in the face of emergency. The rapid spread of this virus has forced us to adopt digital health technologies to a greater degree than ever before. While this has been a challenge, it can also be an opportunity—but only if we recognize that opportunity and take action now.

A Growing Need for Telehealth

The COVID-19 pandemic is radically changing the way medicine is practiced. Telemedicine is perhaps the biggest shift we’ve seen in care. It allows patients to communicate with care professionals from the safety of their homes. Many insurance programs, hospitals, and employers offer telehealth to members, patients, and employees—for example, the number of hospitals implementing telehealth more than doubled over the past decade—but utilization has skyrocketed in the past month as health officials ask people to practice social distancing.1 A lack of hospital beds and other resources has also contributed to the importance of telehealth. Companies say their call volume has doubled, and some experts estimate that virtual visits across the U.S. will rise from 50,000 to 100,000 per day.2

Expanded Telehealth Coverage for Medicare Patients, The Centers for Medicare & Medicaid Services (CMS), and the Health and Human Services Office for Civil Rights (OCR) have expanded coverage for telehealth services and relaxed health technology rules in an effort to protect Medicare beneficiaries who are vulnerable to infection.3 There are five important changes regarding CMS reimbursement for Medicare patients:

  • Patients can be at home or at any health care facility.
  • Patients don’t need an existing relationship with the provider in order to be reimbursed.
  • Providers can waive or reduce cost-sharing requirements without penalty under federal kickback regulations.
  • The visit must be a real-time, audiovisual interaction (or audio only in some cases).4
  • Patients and providers can use their smartphones, including technologies such as FaceTime and Skype. (The OCR will waive HIPAA-related penalties for providers using these tools in “good faith.”)

Privacy experts recommend that you let patients know about potential privacy issues when using these technologies. Also, allowing providers to use nonstandard tools may result in a lack of technology support and downstream administrative fumbles due to the absence of integration with centralized health IT systems.

This may be different for non-Medicare patients, and regulations are changing rapidly. Many local health plans are aligning with these rules, so be sure to check with your local health plans and Medicare partners.

 

Best Practices in Telehealth

You may see increased demand for equipment, such as webcams and monitors, that helps providers work from different locations. The CARES Act includes $200 million in funding for telehealth equipment, which will help address this demand among nonprofit providers.

The patients you prioritize for COVID-19 care might be individuals who are elderly or infirm. You may encounter technical support challenges with this population, despite growing consumer acceptance of the tools that support a virtual visit. The ATA is an excellent resource for learning how to use telehealth during this crisis.5

If your patients don’t already have access to your portal, now is a good time to encourage them to sign up—or remind them that it exists. According to a recent study, patients have better outcomes when they have access to a portal. Portals give you the opportunity to send them content they would normally receive in the office and provide patient education tools before patients call for appointments or come in unannounced. This is especially critical during a large outbreak of a disease, such as coronavirus or the flu.

Provide education before and after the telehealth visit to reinforce important information, such as guidelines for self-quarantine or care instructions. Healthwise has created a free Coronavirus Resource Center you can use if you need COVID-19 patient education material. It includes plain-language articles, infographics, and videos. This content is currently available to everyone for personal and commercial purposes. This content is updated regularly. Please continue to check back as we add more content that may be valuable during your telehealth visits.

It can be easy to lose sight of the patient when integrating new technology and workflows. Remember that these people are inviting you into their home—it’s a very personal interaction that involves trust on both sides. But the payoff can be tremendous. One clinician says patients have been showing him their dogs, houses, guitars, and other aspects of their lives he never would have learned about in the office.

 

Creating Opportunity After COVID-19

Any time a person is sick, worried, or in pain, they can become overwhelmed and unsure what to do. Our own research has found that many people don’t realize how important health education content can be until they have access to it, even when there’s not a pandemic going on.

At a time like this, engaging patient education has never been more important. Plain-language content is easier for many patients to understand and more likely to be read. And research shows that people are more likely to remember content that incorporates graphics, such as infographics and videos.6

Making well-designed education available will help you maintain communication with and care for your entire population, not just the very sick ones coming into the office or ER. It also helps your patients and members view you as a trusted source of information during a time when so much misinformation is floating around.

Regulators may not be willing to let the temporary expanded coverage and waiver of technology rules stand after the pandemic is brought under control, so we encourage everyone in the healthcare industry to view this time as an opportunity to measure the impact of patient education and telehealth. Even nonfinancial measurements like the amount of PPE saved can show the value of telehealth.

Collaborate with us to show the value of telehealth services so that digital health care becomes the norm rather than a last resort in a state of emergency.


1https://www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf
2https://www.syracuse.com/coronavirus/2020/03/coronavirus-way-of-life-doctors-patients-turn-to-telemedicine-like-never-before.html
3https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
4https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers
5info.americantelemed.org/covid-19-webinar-series
6https://www.ncbi.nlm.nih.gov/pubmed/16122896