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Telehealth after COVID-19 – Many doctors agree it's here to stay

As the COVID-19 public health emergency fades, most physicians and other clinicians say they will continue to use telehealth and develop remote patient care capabilities.

“Telehealth has very important applications. Patient convenience, for one, and it helps augment and supplement patient care,” said Steven Peskin, MD, Executive Director of Population Health and Transformation at Horizon. “It will continue to be synergistic, a part of clinical medicine and patient care going forward.”

Dr. Peskin leads Horizon's Telehealth Clinical Advisory Board, which was formed in late 2020 and meets quarterly to discuss telehealth usage in physician practices. The information gathered will help shape telehealth strategies and business decisions. The Advisory Board includes members from some of the largest physician practices in the state, whose usage of telehealth spiked drastically during COVID-19 and continues to be a valuable component of patient care. A few practices represented on the Advisory Board are Summit Health, Vanguard Medical Group, Rutgers Health and Axia Women's Health.

Many physicians say they would like to continue using telehealth post COVID-19. According to The Telehealth Impact Study by the COVID-19 Healthcare Coalition, 73 percent of physicians surveyed want to continue to use telehealth post COVID-19 for chronic disease management. More than 50 percent want to use it for medical management, care coordination and preventive care. More than 40 percent want to use it for hospital or Emergency Room follow-up care, specialty care and mental/behavioral health care.

Telehealth during COVID-19

Summit Health, a primary care and multi-specialty practice in New Jersey, has more than 1,600 providers who see on average 60,000 visits per week. Summit Health deployed telehealth technologies for two-thirds of patient visits during the height of COVID-19 in March and April of 2020, allowing the practice to continue to provide continuity of care across all its specialties. Telehealth usage stayed at eight to 10 percent of daily visits after May 2020.

“Particularly in our elderly population, Medicare Advantage and Medicare traditional, we were doing annual wellness visits via telehealth the whole time. Because it doesn't require a physical exam, you can do screenings, sleep quality assessments, depression screenings, medication review, and creation of a preventive five-year plan,” Jamie Reedy, MD, MPH, Chief of Population Health, Summit Health, said.

The many facets of digital health

Telehealth is just one important facet of digital health, Dr. Peskin explained.

“Digital health is an even bigger topic. It's using chatbots and SMS or mobile web messaging and those kinds of efforts that are in a broader domain. And wearables, uploading information from a patient device to their physician's electronic health records (EHR), like blood pressure readings, hemoglobin, A1C and monitoring of heart rhythm,” Dr. Peskin said.

Summit Health is looking to expand its remote patient monitoring capabilities, which will play a large role with keeping patients safe in their home, said Dr. Reedy.

“For those with a chronic illness, whether its asthma, chronic obstructive pulmonary disease, heart disease or diabetes, remote patient monitoring is really important. And now we're working on new protocols for determining how often the patient needs to be seen in the office versus at home. We're working through our plans at this point for what we see as evidence-based, high-quality ways of managing patients going forward with telehealth,” Dr. Reedy said.

Remote patient monitoring has applications in other specialties. Horizon is working on a pilot program with Axia, one of the largest women's health organizations in New Jersey, that will monitor pregnant women remotely.

Challenges in the digital health age

As the use of digital health technologies increases, providers face several challenges, including how to integrate digital health information with EHR and choosing the best systems for their practices.

“We are doing deep due diligence on the vendors that exist in the market, how they might interact and integrate with our EHR, and how that would fit into our bigger technology strategy. That's something that we and quite frankly, every other large health care organization is working on across the country right now, because they know that telehealth with remote patient monitoring is certainly here to stay,” Dr. Reedy said.

Based on numerous studies and feedback, the majority of doctors and other providers are motivated to increase the use of digital health in their practices and expect it to play an important role in future health care delivery. Horizon commends participating providers who are striving to provide digital tools for their patients.