When Face-to-Face isn’t an option: Exploring the future of telehealth and remote care during COVID-19 and beyond

By Matt Phillion

COVID-19 has changed almost every aspect of healthcare, if not all of day-to-day life itself. One of the pieces of healthcare we’ve seen fall away significantly since the pandemic began is face-to-face, in-person visits between patients and providers. This change has often been fueled by necessity—limiting exposure and contact, for example. But without this in-person contact, healthcare organizations and professionals are under extra pressure to get the full picture of their patients’ health.

For many organizations, this has meant a shift to telehealth. This technology has been available for some time, of course, but was not nearly as widely used as it is today. How can providers make sure they have the know-how to help their patients maintain their care, live healthy lives, and get the medications and treatments they need, all while working with them remotely?

“If we take a step back, the pandemic surprised people in some sense, but we’ve been preparing for some time for something like this,” says Steve LoSardo, vice president of healthcare solutions with Mobiquity, a digital consultancy firm. “Digital solutions, telemedicine: Those things have been available, but fewer people were using them.”

His organization has been tracking the shift to telehealth, looking at whether both patients and physicians are ready for virtual visits—the move to digital is a culture shift for both parties, after all.

“The question is, can you get the same level of care from televisits?” says LoSardo.

Encouragingly, his organization has seen that patients across the age spectrum—be they seniors, baby boomers, or younger patients—have taken to telehealth during this crisis. “The technology is in place, and people are realizing it’s a viable way to care and communicate,” says LoSardo.

While the technology is there, given the access to smartphones and other devices, organizations should be aware of other barriers to success beyond just talking online or by phone—specifically the ability to capture data and share information.

Information sharing is key

Many current challenges with telehealth tie back into long-standing conversations in healthcare, particularly around the topic of electronic health records (EHR).

Roughly 10 years ago, the push for EHR hit full speed, and electronic records were rolled out across the U.S. The vendors who provided EHR platforms also started to think about things like mobile applications, digital portals, and other options for patients to communicate with physicians and provide input into medical records. Vendors of billing systems also looked for ways to connect with other systems.

For a variety of reasons, patients didn’t necessarily use these options. But they put the industry in a good place to transition to more remote or telehealth modalities when the need arose.

“This technology let you talk to your healthcare facility, your physician, or even your payer. It wasn’t as hard of an extension to move to more virtual” during the pandemic, LoSardo says. “The pieces were in place, but people didn’t use them, and then suddenly it’s the only tool they had.”

Some barriers remained, naturally. Even tech-savvy people can struggle with new technology—perfectly capable adults get turned around by digital assistants like Alexa or Siri, for example. So an early barrier to success was frustration, and friction in the use of mobile apps or platforms.

LoSardo points to user experience as key in avoiding that friction. “The tech was put into place without a lot of thought to user experience,” he says. “Now, the thought process is start with user experience and worry about the technology later.”

His group works with hospitals, pharmaceutical companies, and even biotech to look at ways other industries have taken user experience into account. As examples, he brings up mobile apps that even non-tech-savvy users find helpful. “Consumer products, retail, the food industry have all been on the bandwagon of removing friction and making lives easier,” LoSardo says.

Focusing on aspects that mitigate user frustration, such as minimizing clicks or simplifying a user interface, makes a huge difference. Importantly, so does talking to the users themselves.

“If we’re going to design things for users, why aren’t we talking to the users?” he says. “If you start with the technology for technology’s sake, you’re making a huge mistake.”

What are patients looking for? How about providers?

For the most part, users will explain what they need—if given the opportunity. And “users” aren’t just patients. Physicians and other healthcare providers are just as susceptible to user-unfriendly interfaces and apps, so hearing from them is vital as well.

“We recruit both patients and providers. We want to hear both sides of the equation,” LoSardo says. This also includes capturing feedback from other countries and cultures, as this can have a huge impact on the design and usability of a portal or app.

It’s also worth looking at what’s already out there. “You don’t want to reinvent the wheel. You want to enhance it and learn from those who came before you,” LoSardo says. “If you pull all this into a solution, it’s a tool patients and providers will use.”

What you do with the data

Technology in general, and especially in healthcare, is often about pushing information out into the world. “What has not been done as much,” LoSardo notes, “is things like patient-reported outcomes.”

If you look at the big picture, he says, the healthcare industry knows a lot about how patients are diagnosed, how their conditions are progressing, and what their costs are. The piece often left out when assessing quality of care is how patients are doing with their care. Newer technology enables artificial intelligence to capture freeform text from patients, make sense of it, and use it to support improvement initiatives.

“For example, we’re working with a pharma company looking to help patients who struggle with medication adherence. The patients have trouble remembering to take the drug,” says LoSardo. “A companion app asks questions they answer every day. How are they sleeping, are they feeling depressed, how are they feeling? The data can then be matched up to see why they might stop taking the drug or aren’t seeing improvements. It’s actually collecting and using information from the patients.”

It’s important to note that patients opt in to sharing information knowing that their privacy is protected and data is secure, in accordance with government regulations like the Health Insurance Portability and Accountability Act (HIPAA).

Beyond just providing care remotely, telehealth during the pandemic has begun to open doors to things like clinical trials. “When the pandemic began, virtually all clinical trials were delayed or canceled. People were afraid to travel”—including to hospitals; facilities, for their part, also discouraged all but emergency patient visits, LoSardo says.

LoSardo has talked about methods for setting up remote clinical trials to avoid risks of exposure to COVID-19, and these trials actually have additional benefits. For example, they can recruit patients from further afield, expanding the base of patients, and remove or decrease the burden of traveling to a clinical trial site often.

Increasing access to physicians

Another unplanned benefit from an increase in remote treatments or telehealth is the potential to lessen physician burnout.

Doctors are overburdened, LoSardo notes, particularly in certain specialties. Digital tools used in telehealth can give them time back in their days. It also allows physicians to remain in the workforce if they choose.

“Maybe they’re of retirement age, or they can’t do clinical hours anymore,” he says. “Telehealth can provide these physicians who may still want to work in some capacity the opportunity to triage, make use of their vast medical knowledge, help a patient in a virtual call, and then refer the patient to a physical site if needed.”

This could change the employment picture for physicians in the future, attracting more providers to the system or keeping those who might be considering dropping out. “We know there’s a shortage and that the system is taxed,” says LoSardo. “So we want to find ways to do the job more gracefully that doesn’t feel like a factory, that enables them to spend more time with the patient.”

All of this feeds into the future of healthcare based on interoperability standards, where patient and physician experience meets data collection and analysis. This leads to a frictionless healthcare ecosystem where the information collected can be mined for ways to improve outcomes and lower costs.

“It’s gaining a lot of traction,” says LoSardo. “It’s an opportunity to engage patients wherever they might be with innovative digital solutions and a platform approach.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com. This story originally ran on PSQH.