Expanding Telehealth Beyond the COVID-19 Pandemic

The COVID-19 pandemic is entering a new stage of global spread. The outbreak has generated a frenzy of activity related to telehealth, which offers a unique capacity for remote screening and treatment, and can be a powerful tool for reducing transmission of the disease.

Kevin Campbell, MD, says the time is now for medicine to embrace telemedicine and remote monitoring not just for the coronavirus crisis, but long-term.

The opinions expressed in this commentary are those of the author. The following transcript has been edited for clarity.

The coronavirus is now a global crisis. Patients who are not significantly ill should not go to a physician’s office, clinic, or hospital. Still, patients continue to have needs, and chronic diseases must be managed.

In my world of EP [electrophysiology], for example, many device clinics have decided to cancel routine checks for pacers and ICDs [implantable cardioverter-defibrillators]. However, it is important for these devices to have ongoing management and for these patients to have clinical “touchpoints.” Many of my colleagues are turning to telemedicine for non-urgent visits. JK Han from UCLA has tweeted about her experience in beginning these visits and has had good success with remote patient management.

Remote monitoring of devices is standard of care and has been for a long while. According to one meta-analysis, for every 1,000 devices that are remotely monitored, nearly 50 lives are saved and more than 25 strokes are prevented. However, remote monitoring of devices continues to be something that many clinics only use on occasion and is often only an afterthought.

Telemedicine began to pick up steam in the last decade. Initially used as a way to reach patients in remote locations, it was born out of necessity. Now, insurance companies see telemedicine as a way to save money and reduce the impact of patients on the overall healthcare system. According to a survey by American Well [now Amwell], physician use of telemedicine services has increased 340% between 2015 and 2018 — 22% of doctors used it in 2018, up from 5% in 2015.

Additionally, 34 states and Washington, D.C., have laws mandating that private insurers cover telemedicine services in the same manner that they cover in-person services. Patients are now much more open to this type of visit — according to a 2017 survey, 77% of patients would consider seeing a physician virtually. With the coronavirus crisis in full swing, I believe this demand is only going to increase further.

While the coronavirus spreads rapidly throughout the globe and social distancing seems to be the new standard for mitigating its impact, I see this as a real opportunity for medicine to embrace telemedicine and remote monitoring. The time is now. We can do so much more for our patients and put both ourselves, our colleagues or staff, and our patients at much lower risk by handling many routine tasks and visits for chronic disease management over the internet.

There are some obstacles to overcome: A Deloitte 2018 survey of U.S. health care consumers and physicians found that while 90% of physicians view “virtual care” positively, just 14% have video visit capabilities today.

The current coronavirus crisis presents us with a real opportunity. We can work now to improve access to care for all Americans via telehealth and remote monitoring. Every physician and healthcare system throughout the country should be examining their own video and remote monitoring capabilities and working to improve infrastructure.

It’s time to stop talking about these virtual care opportunities and begin to implement them nationwide. Remote monitoring is already proven to save lives and prevent stroke and CHF [congestive heart failure] admissions — telehealth may very well provide similar benefits.

I believe that these benefits will stretch long beyond our current coronavirus crisis. Let’s use this as an opportunity to move into the next phase of remote and virtual care medicine. It will prevent the spread of disease now and may also solve many other “system” problems in medicine going forward.

Kevin Campbell, MD, is a cardiologist based in Raleigh, North Carolina, and chief innovation officer at biocynetic. In addition to his weekly video analyses on MedPage Today, he is the official medical expert at WNCN in Raleigh and makes frequent guest appearances on other national media outlets such as Fox News and HLN.