Capitol Correspondence - 03.02.21

Perspective: 2021 Will be the Year of Virtual Care

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The rapid adoption and expansion of telehealth to help communities adapt to and stay safe during the pandemic has led many of our members to think ahead to what uses of technology they would like to see maintained after the pandemic. This Medium post by Michelle Davey, CEO of telehealth company Wheel, and several of her colleagues reflects on technology and policy trends within the telehealth industry. We hope our members can use these insights to inform their own advocacy for expanded telehealth access in the future.

“Many of the healthcare companies you’re familiar with turn to Wheel when they’re looking to grow and scale virtual care services — including corporate giants just starting to expand into healthcare — providing our team with a unique perspective and intimate knowledge on where the industry is today, as well as where it’s headed. I recently sat down with my Executive Medical Director, Dr. Rafid Fadul, and my Co-founder, Griffin Mulcahey, to take a few deep breaths, reflect on the last year, and ruminate on what we can expect in 2021.

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With that in mind, here’s what the Wheel team predicts we’ll see from virtual care in 2021 from the regulatory, clinical, and business perspective.

2020 WAS THE YEAR OF TELEHEALTH, 2021 WILL BE THE YEAR OF VIRTUAL CARE

While these terms are used interchangeably, in 2021 we will be able to further shift away from simply focusing on convenience and urgent needs towards prioritizing holistic care and long-term health outcomes, supported by virtual care. Advances in remote patient monitoring, team-based remote care, and at-home diagnostic services will be a fundamental driver of this shift from telehealth to virtual care — adding efficiency as we move away from simply replicating the doctor’s visit online.

Many companies and healthcare incumbents moved quickly to shift services online at the beginning of the pandemic this past year. Their future success will depend on their willingness to embrace permanent solutions that support long-term use and ability to scale now that we have the technology and infrastructure to turn this vision into a reality.

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OUT WITH THE PATIENT, IN WITH THE CONSUMER

This past year has underscored the consumer’s louder voice in their healthcare decisions, which will continue to gain steam in 2021 now that there is mainstream adoption of telehealth and virtual care. As we’ve seen with our white-labeled service, the concept of “brand loyalty” will continue to grow over time with healthcare organizations recognizing the importance of leveraging stronger brand identities in order to gain patients’ trust, as well as their wallets.

At the same time, it’s up to us to ensure the consumer-patient isn’t drowning out those who aren’t able to speak up — otherwise, we will create and even exacerbate many of the same inequities that exist in today’s healthcare system.

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THE COVID RESPONSE WILL CONTINUE THROUGH THE HOUSE CALL

It’s difficult to remain optimistic as we’re facing this current wave of infections, but in 2021 we expect to see a shift towards earlier detection and remote monitoring at home — reducing the burden on our hospitals and decreasing the spread of the virus.

One of the greatest challenges we faced with the pandemic over the last several months was connecting people with testing, education, and care while simultaneously slowing the spread of the virus and managing the burden on our healthcare system. With expanded access to testing — including improved sensitivity and specificity, as well as self-administered testing that doesn’t require clinical oversight — we will be able to identify more cases earlier on.

Patients with early diagnoses will have treatment options that do not require hospitalizations (IV antivirals, convalescent plasma, monoclonal antibodies). In addition to early identification and treatment, they’ll be able to recover at home with remote monitoring and clinical oversight — which will ideally keep patients out of ICUs, decreasing spread, and decreasing mortality.

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POST-PANDEMIC POLICY: ONE STEP FORWARD, TOO MANY STEPS BACK

We’re nearing the end of the year without clear visibility on whether many of the temporary policies put into place during this public health emergency will become permanent. Moving into 2021, we should expect to still face the uphill battle of convincing policymakers that regulation should not be written from the perspective of replicating the in-person visit virtually.

While CMS will continue to reimburse more telehealth services, it’s unlikely that payment parity will extend past the pandemic. We will also see the emergency waiver for clinicians to provide care nationwide rolled back at some point in 2021. Considering this is one of the most significant barriers to expanding care to patients, this may be readdressed overtime.

Another long-term expectation is that digital health providers will continue to put pressure behind allowing care to be delivered across multi-modality platforms (phone, email, video, text, image-sharing). Once that’s unlocked, we’ll see an acceleration of innovation and ultimately expanded access to patients.

PUTTING OUR MONEY WHERE OUR MOUTH IS

Innovators and advocates are overdue in putting evidence behind the promises, which has proven to be one of the largest barriers to shifting policies and regulations in favor of virtual care. Now that our industry has been able to push significant progress forward thanks to (albeit temporary) regulatory decisions, we will finally start to see more resources and attention put towards research, data, and insights that back up many of the claims made around the virtues of virtual care.

For example, many digital health providers are focused on shifting our healthcare system from fee-based care to value-based care. Research will be focused on how to improve patient outcomes while driving down costs, backing up the promises and tag-lines with the evidence needed for both clinical and policy buy-in.”