“Real knowledge is to know the extent of one’s ignorance”
A Brief History of Telehealth Use
For over two decades many clinicians and healthcare leaders, especially in smaller health systems, smaller clinics, or behavioral health agencies have not taken telehealth (“delivering care at a distance”) seriously.
Before the Covid-19 health crisis, telehealth had a fringe existence focused on giving rural patients access to specialists at academic medical centers. In the early 2010s a few forward-thinking health system leaders recognized telehealth’s (minor) relevance and started investing in building their own telehealth expertise. Starting with video visits, some programs expanded into remote patient monitoring and store-and-forward solutions.
But for the most part, prior to the Public Health Emergency (PHE), utilization was fairly low and limited to trailblazing clinicians of the “early-adopter” kind.
And that was despite Medicare continuously adding new billing codes for telehealth reimbursement on an annual basis (though their hands were tied to lift the ban on telehealth visits originating from the patient’s home), most Medicaid programs reimbursing the basic telehealth visits and RPM, and commercial payors in most states being required to reimburse for telehealth, in some even at parity.
(A valid excuse for FQHCs and RHCs was that the rules prohibited them to provide any kind of patient care to their patients, though they were “allowed” to facilitate video visits with others, mostly academic medical centers).
Fast forward to March 2020 when suddenly everyone was forced to switch to telehealth – though due to the lack of clinician training on webside manners, a lack of Telehealth TechChecks to powerfully prepare patients, and a “here’s a webcam and a video software login” approach to “support & training” by IT staff, most “telehealth” visits quickly turned into (much less efficacious) phone calls.
Utilization quickly rose, then fell, then rose again during Omicron and the rise of other variants in 2021. But in 2022 the numbers (except for a number of behavioral health teams) plummeted back into the single digits as a percentage of overall visit volumes.
For the most part, many healthcare executives were (and are) completely oblivious about the actual utilization — with little to no preconceived notion what level of telehealth was “good” or “desirable” for their organization and their patient population. As they say: “Ignorance is bliss.”
The Multifold Value of Telehealth
I strongly believe that “every system is perfectly designed to get the results it gets”.
With that mindset, I further believe that the lack of attention to telehealth by healthcare leaders is simply a lack of understanding how much value telehealth can add to the bottom line.
As outlined above, many healthcare leaders think of telehealth merely as a Covid stop gap measure. Or as something that only some young millennials would want (but not their aging patient population).
With so many healthcare organizations being concerned with their financial situation, I thought it would be helpful to highlight how telehealth as a clinical tool and as a strategic tool,
So here are a few ways how telehealth can add to the bottom line by increasing revenue, avoiding losses, and decreasing expenses.