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Telemedicine Access Hardest for Those Who Need it Most, Post-COVID Visits Plunge-The HSB Blog 9/8/20

Access to Telemedicine Is Hardest for Those Who Need It Most

Event: (9/3) A recent article in WIRED magazine noted the practical and technological issues that many older Americans, particularly Black and Latinx Americans have in accessing and using digital health technologies.

Description: While virtual care exploded during the COVID crisis, accounting for as much as 44% of Medicare visits at one point, studies indicate that as much as 41% of Medicare recipients don’t have an internet-capable computer or smartphone at home, with elderly Black and Latinx people the least likely to have access compared to whites. Another study in JAMA noted that approximately 13M elderly adults have trouble accessing telemedicine services, and approximately ½ of those people may not be capable of having a telephone call with a physician due to problems with hearing, communications, dementia, or eyesight, including 71% of elderly Latinx people and 60% of elderly Black people.

Implications: Although growth in virtual and telemedicine visits has exploded during the COVID pandemic, the increase in the digital delivery of healthcare services exposes and magnifies the disparities in care and access for the underserved, and is especially acute for the elderly in those groups. Providers and payers must look at methods of bridging the “digital divide” when expanding use of virtual care/remote access. They must pay attention to visual and non-visual cues to ensure understanding and incorporate other accommodations (such as automatic captioning and amplification) for elderly Black and Latinx populations.

Telehealth grew wildly popular amid Covid-19. Now visits are plunging, forcing providers to recalibrate (subscription required)

Event: (9/1) In a September 1st article, STAT News looked at the nationwide slowing of telehealth visits and, noting that although telemedicine visits are higher than pre-pandemic levels the downturn is causing providers to adjust offerings based on patient preferences and needs.

Description: As telemedicine visits have decreased from 69% of total encounters in April to just 21% of total encounters in July, providers are trying to figure out at what level the ultimate balance between in-person and virtual visits will stabilize and how visits will break down across service lines. For example, the University of Pittsburgh Medical Center launched a program to determine when patients should be seen remotely or in-person. They have found that while telemedicine visits have declined about 60% from April, most mental health visits are continuing to occur virtually while specialists are seeing more patients return to their offices.

Implications: Following the pandemic providers are going to have to adjust the level of virtual visits by investigating what mix of virtual and in-person visits best suits their patient population. They need to determine what mix of the two will be most cost-efficient and profitable for them. In addition, the leveling off of virtual visits may create challenges for large telemedicine companies that are planning to expand based on the initial surge in demand and easing in the regulatory environment. This is due to the uncertainties about whether they will be able to sustain those numbers as patients return to in-person visits and what will happen with an unpredictable regulatory landscape.

Deloitte survey shows consumers are more engaged with their health through technology

Event: (8/26) A recent article in Healthcare Finance highlighted that two Deloitte surveys (the Deloitte 2020 Survey of US Health Care Consumers and The Health Care Consumer Response to COVID-19 Survey) show consumers are more engaged with their health through technology as a result of the COVID-19 pandemic.

Description: Consumers are actively engaging in their health care, which has allowed them to discuss cost information, track health conditions, access and use their medical record data, disagree with their doctors about treatment and cost, and engage in healthy/preventative behavior. The Deloitte COVID-19 consumer survey found among consumers who had virtual doctor visits 80% would choose to have another virtual visit, provided the positive patient-physician experience which was defined as one where the healthcare provider was accessible and willing to listen.

Implications: While consumers are more open to virtual visits since COVID Deloitte’s survey found consumers still want to have a personalized physician-patient relationship with a provider who listens, shows they care, takes their time, and communicates with them. The enhanced use of technology has also exacerbated health disparities, especially along racial lines. As a result organizations need to extend access to care deeper into the communities they serve addressing both clinical issues as well as issues around the social determinants of health (SDOH).

Carewell Secures $5M For Caregiver Advocacy, Home Health E-commerce Site

Event: (9/2) Carewell, a North Carolina startup recently closed $5 million in seed funding to expand its e-commerce and home health advocacy site for home health products.

Description: Carewell was started to support and educate families caring for loved ones, particularly those who are doing so for the first time. The online shopping platform consists of vetted product recommendations as well as a subscription service for caregivers who consistently need products and resources. Additionally, the company is looking to expand and create new categories of products that will continue to serve its customers.

Implications: The demand for at-home care for seniors has exploded during the pandemic, with Carewell seeing revenue doubling and nearly 40,000 unique customers making purchases since February. With a disproportionate percentage of COVID deaths attributable to skilled nursing homes and senior living facilities, alternatives to institutionalized care and services which enable them are likely to see growing demand and interest.

Using technology to self-manage diabetes results in healthy lifestyle choices

Event: (8/28) The University of Texas Health Science Center at San Antonio conducted a study to monitor how adults living with Type 2 diabetes use current healthcare technology to self-monitor their lifestyles and current health behaviors. Research found that allowing participants to track their behaviors, led to them making healthier lifestyle choices to manage their diabetes.

Description: Using self-monitoring technology allows participants to understand the importance of making healthier lifestyle choices and helps to make sense of why certain decisions must be made to control blood glucose levels. A separate study conducted by Omada and Evidation Health also showed a reduction in participants’ A1C levels for those who used these digital chronic care management tools (please see 2nd link below).

Implications: Being able to self-manage diabetes via healthcare technology platforms can lower A1C levels, reduce diabetes complications, improve quality of life, and lower medical experiences. Programs like Omada and Evidation Health allow people to improve quantitative and qualitative measures while monitoring their diabetes and making healthier lifestyle choices on their own.

How 5G Can Enable Life-Saving Technology

Event: (8/27) A recent article in CES Tech updated the progress on 5 companies selected into the latest cohort of Verizon’s 5G First Responder Lab, launched in partnership with Responder Corp. in 2019. The 5G First Responder Labs goal is to empower first responders by delivering the life-saving capabilities they need to serve their communities. The 5 companies accepted to this round using Verizon's 5G Wideband network are Biotricity, Rave Mobile Safety, DispatchHealth, Vuzix, and Visionable.

Description: Biotricity is offering a patient-monitoring platform that allows medical professionals to remotely identify potential urgent alerts. Vuzix, whose Blade Edge smart glasses were a CES 2019 Innovation Award honoree, is creating augmented reality smart glasses to connect on-site first responders with experts to receive real-time feedback. Visionable’s collaboration platform will virtually connect medical professionals to provide follow-up care to patients remotely.

Implications: As the world faces the COVID-19 pandemic, the spotlight is on health care-related technologies. As 5G technology continues to develop and get rolled-out it will enable greater use of more innovative and powerful virtual and remote care technologies closer to the site of care. This will improve emergency care, broaden access specialists, and enhance care in rural and underserved communities.


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