U.S. hospitals are seeing a rise in telehealth and virtual care usage as the coronavirus outbreak accelerates, easing emergency department patient volumes in some of the worst-hit areas of the country.
Beth Zborowski, senior vice president of member engagement and communication for the Washington State Hospital Association, said one health system in the Seattle area has reported that telehealth usage has multiplied by 30 since the outbreak hit the state. Other member hospitals have reported a sharp increase in video consultations and usage of nurse triage lines.
Washington is one of the worst-hit states in the U.S. with 366 total confirmed cases of COVID-19, the respiratory disease caused by the virus, and 29 deaths as of March 12, according to the Washington State Department of Health.
The state's hospitals have reported an increase in patient volumes due to the outbreak but services are not being overwhelmed, partially due to telehealth and virtual care services that were not available just 10 years ago, according to Zborowski.
"Without [telehealth] options ... we would see an even greater volume of folks coming into the ER and potentially overwhelming the system," Zborowski said in an interview. "If this had happened 10 or 15 years ago, we might be experiencing a different situation."
Telehealth primarily involves the remote delivery of healthcare including connecting emergency rooms to specialists in hospitals hundreds of miles away and providing basic consultations through technology like a live-video feed.
Aaron Martin, chief digital and innovation officer for Providence St. Joseph Health, one of the largest hospital companies in the country, said in a March 11 emailed statement that usage of certain virtual care services has increased by about six times since before the outbreak began in the U.S. The Washington-based hospital company's coronavirus online assessment tool, a chatbot people can use to input symptoms and help determine if they need in-person care, has seen nearly 9,000 users since launching on March 8, according to Martin.
American Well Corp., a privately-held telehealth provider, reported an 11% rise in urgent care video visits since about the time of the first patient death in the U.S., which the U.S. Centers for Disease Control and Prevention announced Feb. 29.
Teladoc Health Inc. CEO Jason Gorevic said at the telehealth provider's March 5 investor day that the company will have a large role in combating the outbreak and a material impact for earnings is expected. However, he declined to give specific guidance.
The U.S. overall has a reported 1,323 confirmed cases of COVID-19 and 38 deaths, according to a tracker from Johns Hopkins University's Center for Systems Science and Engineering.
Congress opens up telehealth payments
Telehealth is an emerging treatment option for the healthcare industry, but experts say that regulatory and reimbursement challenges have slowed adoption among providers. In an effort to encourage telehealth usage amid the coronavirus outbreak, Congress passed an $8.3 billion emergency spending bill that eased certain payment restrictions in the Medicare program. President Donald Trump signed the bill on March 6.
Zeynep Summer King, vice president of regulatory and professional affairs for the Greater New York Hospital Association, or GNYHA, told S&P Global Market Intelligence that member hospitals were already implementing telehealth strategies as part of their response to the coronavirus outbreak and influenza season, but loosening the Medicare restrictions will "absolutely" increase telehealth usage.
Beginning in February, some GNYHA hospitals started using services like video consultations to examine potential COVID-19 cases without putting doctors, nurses or other patients in a facility at risk, according to Summer King. If an in-person visit is ultimately required, hospitals can use the same virtual care technology to coordinate treatment plans and prepare ahead of time for a patient's trip and admittance to a facility.
Providence St. Joseph Health is using telehealth to remotely monitor patients who come into an emergency room with COVID-19 symptoms and require further evaluation but may not need to be admitted, the company's Chief Clinical Officer Amy Compton-Phillips said during a March 11 webinar. The event was held by the Healthcare Information and Management Systems Society, an organization focused on healthcare technology.
Compton-Phillips said doctors are providing patients who are likely carrying the coronavirus with devices such as digital thermometers and finger pulse readers so symptoms can be monitored from home.
"One of the things that we've seen with this particular germ: the patients can be okay for a while and then decompensate rapidly," Compton-Phillips said. "Having this capacity to monitor at-risk patients at home has made a huge difference and made our clinicians much more comfortable treating patients at home rather than admitting patients for observation."