A week ago, Steve Davis and his team at the West Virginia University, enrolled the first four of about 30 rural West Virginians into a pilot project. It connects patients, recently discharged from long-term care facilities, with medical professionals who can manage their healthcare remotely via technology.
Just think of a doctor’s appointment but you don’t leave your house. Instead, your doctor checks in on you through a live video chat on your tablet or computer.
While Davis’ pilot project aims to ease the transition of traumatic brain injury or aged and disabled patients back into their homes, this healthcare approach, called telehealth, may now prove to be a more versatile tool as the U.S. responds to the looming threat of the novel coronavirus.
In his speech declaring the COVID-19 pandemic a national emergency, President Donald Trump called telehealth “a fairly new and incredible thing” and threw support behind increasing the number of telehealth programs to help handle the crisis.
“The main advantage of telehealth in the midst of the COVID-19 crisis is that it can serve as a vehicle for achieving self-quarantine to mitigate viral spread while still enabling the treatment of health conditions,” said Davis, associate professor, Department of Health Policy, Management, and Leadership.
“Such mitigation can help ‘flatten the curve’ or rate of infections to help free up critical healthcare resources for the treatment of acutely ill individuals.”
“Flattening the curve” refers to slowing the spread of the illness through strategies such as social distancing or simply washing your hands, so that public health services aren’t stretched thin by a deluge of sick patients.
Another concern to emerge from the pandemic is exposure to healthcare workers and even other non-COVID-19 hospital patients.
“Additionally, telehealth can be used to treat high-risk individuals from a distance to reduce their potential exposure to healthcare workers or other patients that may be infected,” said Davis, also an adjunct professor in the Department of Emergency Medicine.
“For example, a diabetic patient could have his or her condition managed remotely using a variety of telehealth technologies. This could include remote monitoring of glucose levels, storing pictures of the skin and sending them electronically for assessment by a clinician, or even telephone consultations and live video face-to-face e-visits. These technologies would preclude the need for the patient to travel to the clinic and potentially be exposed to COVID-19, which could lead to very serious outcomes for this high-risk group.”
In order to grow telehealth use, the Trump administration will waive certain federal rules to make it easier for doctors to offer those types of services. This means doctors can practice virtually in states other than where they are licensed, but only if governors use emergency powers to allow them to do so.
Medicare and insurance payments for telehealth are another potential hurdle.
“There is discussion at the federal level of relaxing the existing stringent reimbursement requirements for telehealth that have served as barriers to more widespread diffusion of this critical, evidence-based intervention within populations,” Davis said.
“For example, historically, telehealth services were usually only reimbursed if real-time interactions (i.e., live video) occurred. Additionally, telehealth services were typically not reimbursed if the patient was located in the home. There has been discussion of waiving these stringent requirements to promote wider adoption of telehealth in the home, and some states have already taken such steps.”
Davis noted, however, that some telehealth modalities, such as remote patient monitoring and store-and-forward (i.e. emailing photos for assessment) may not be reimbursed.
“Obviously, allowing the home to serve as an originating site is critical to accomplishing the public health goal of flattening the curve of infections to ensure the viability of our healthcare system,” Davis said.
Resources on Davis’ pilot project: