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virtual health

The virtual health evolution

Published on 11/6/2019

Estimated read time: 8 minutes

Amid an evolving, dynamic health care environment, virtual health care is emerging as a powerful tool that enables providers to deliver more cost-effective, connected and personalized care. 

Virtual health care on the rise

Virtual health care encompasses telehealth or technologies that support care delivery over an extended geographic distance, as well as other ways to communicate and monitor patients remotely. This technology has seen an explosion in growth during the last five years, quickly becoming an indispensable capability for providing care:

  • A recent American Well study found between 2015 and 2019 telehealth use increased by 340 percent among surveyed providers
  • 50 percent of the providers not currently using telehealth expect they will use it within the next few years
  • 75 percent of hospitals reported they are currently using or implementing telehealth technology

Consumers are also showing an increased willingness to adopt virtual health care interactions. A survey conducted by the Advisory Board found 77 percent of consumers would be willing to see a provider virtually and 19 percent already have – figures that are expected to rise as availability and awareness of virtual health services increase. Those who have already engaged in virtual health care tend to be under the age of 50, urban rather than rural, and privately insured. This finding is echoed by another study that found among all generational groups, Millennials were the most likely to report a preference for providers that offered video-conferencing options, with Generation Z and Generation X the next most likely groups to make decisions based on the availability of virtual care.

Members of older generations are also receptive to incorporating new technology into their health care experiences. Among “tech-savvy” seniors – baby boomers who already use digital technology in their day-to-day life – 62 percent were interested in using technology to monitor health issues, and 61 percent were interested in using technology for accessing, storing or transmitting personal health information or records to providers. The takeaway: There’s a growing portion of health care consumers who are currently engaging or willing to engage in virtual health, and among younger consumers, who will come to expect it.

A tool for convenience and value

So, what’s driving the upsurge in virtual health care? The top motivator is convenience. Consumerism in health care means people increasingly expect their health care experiences to be as flexible, customizable and seamless as other products and services they consume in their daily lives. An American Well study found 67 percent of consumers have delayed seeing a provider because they’re too busy and it took too long to get an appointment. With an average 24-day wait for a first-time appointment with a provider and an average total visit time of 121 minutes, it’s easy to understand why people might put off non-urgent health issues, such as wellness or preventative measures. Virtual visits that leverage video or phone can be scheduled and completed in less time than a traditional office visit, and 77 percent of patients who have tried virtual visits report a high level of satisfaction.

Convenience is also a factor for individuals who live in rural communities and have longer commutes to access care. The crisis in rural health care has been well-documented, and patients who face long drives to receive primary or follow-up care from specialists often forgo care entirely. Visiting and communicating with providers virtually can help bridge the gap created by long-distance commutes.

For providers, value is a strong motivator for adopting virtual health technology. With the introduction of value-based reimbursement models, hospitals and health systems are under increased pressure to provide quality care at the best cost, even as the number of patients with chronic conditions grows:

  • Care for people with chronic conditions currently makes up 90 percent of the annual $3.3 trillion annual health care spend in the United States, according to the Centers for Disease Control
  • Conditions like hypertension, diabetes and asthma affect six in 10 Americans
  • For adults 65 or older, 36 percent are living with three or more chronic conditions

As the number of adults over age 65 continues to grow, the number of patients with chronic conditions will also grow, putting an additional financial strain on hospitals and health systems.

Remote patient monitoring (RPM) has emerged as a way to provide support and care for individuals living with chronic conditions so they don’t evolve into serious, costly medical events. Medical devices like digital blood pressure cuffs, heart rate monitors and medication audio reminders help engage individuals in monitoring their condition daily, and the sophistication of sensors in RPM technology has enabled them to be used to monitor body temperature, heart rate and other indicators of health and wellness. The data gathered from these devices can be made available to health care providers in real-time and integrated into the patient record. This enables providers to be alerted when potentially dangerous changes could lead to a costly hospitalization.

RPM promotes patient-centered care because it puts the focus on the needs of the individual and enables the entire care team to monitor the individual in their home. A recent survey found that among providers, the greatest benefits of RPM included improved patient outcomes (49 percent) and compliance rates (44 percent), and an increase in patients taking ownership of their health (42 percent).

"There’s a growing portion of health care consumers who are currently engaging or willing to engage in virtual health, and among younger consumers, who will come to expect it."

What’s next for virtual health care

Virtual health care is on the upswing and will continue to grow – the worldwide telehealth market is expected to reach $9.5 billion by 2021. During the next few years, there will be key factors to watch that may help support or hinder this growth:

Reimbursement: One barrier to the broad adoption of virtual health care has been lack of reimbursement, but that’s changing. The CHRONIC Care Act of 2017 passed by Congress in 2018 allows for increased Medicare coverage of telemedicine for chronic conditions, and the Centers for Medicare and Medicaid Services (CMS) recently announced coverage of telehealth services would be expanded for Medicare Advantage plans beginning in 2020.

The new rules will loosen geographic restrictions on telehealth and enable virtual visits with providers from home. Previously, telehealth reimbursements were restricted to patients living in rural or underserved areas, and telehealth episodes had to take place in a provider’s office, hospital or another medical facility. The expanded reimbursement parameters will make it easier for seniors to take advantage of virtual health services without leaving home.

Telehealth reimbursement with commercial insurance is governed by state laws, and currently, 39 states and the District of Columbia have laws in place. As states recognize the benefits virtual health care can provide, many are moving to make it more accessible. Arizona recently passed a bill that supports coverage of asynchronous services where patients log health data and providers review it at a later time, as well as RPM services, in order to help alleviate the shortage of primary care providers in rural areas. This change in state regulations is reflected in the percentage of private insurance claims filed for telehealth services, from less than five percent in 2012 to 45 percent in 2017 for urban dwellers and nearly 40 percent for rural residents.

Interoperability: The explosion of new telehealth services and applications during the past few years means there is a wealth of new patient data available. To create a consumer-centric health care experience, this data must be integrated into the EHR and be accessible across providers and venues. The American Telemedicine Association outlined the challenges with scaling interoperable telehealth in a white paper. The group also recommended health systems leverage telehealth vendors that incorporate interoperability standards into their solutions, and that newer specifications like SMART Health IT and the HL7 FHIR standards be used to enable organizations to easily integrate services. Health systems have learned the importance of connectedness as the industry continues to develop standards for EHR interoperability. Since the virtual health care market is still in its early stages, there will be an opportunity to create a more connected system as the industry reaches real scale.

Security: The range of new devices and communication methods available in virtual health care brings up questions of data security. Video visits and asynchronous information sharing can take place on a mobile device, laptop or tablet, and devices used for remote monitoring may be constantly sharing data with a patient’s provider. Every instance of data transfer is an opportunity for a potential security breach. HIPAA privacy laws extend to data and information transferred and stored electronically, so health care organizations must ensure information gathered via video visits or remote monitoring is in accordance with HIPAA requirements.

A recent Deloitte study found 33 percent of providers reported data security and privacy concerns deterred them from adopting virtual health care. The industry has historically lagged in investing in IT security infrastructure. For virtual health care to scale to the next level, both patients and providers must have confidence that data is secure and protected. 

There’s no doubt virtual health will continue to play a vital role in delivering care and support when and where individuals need it. For health care organizations already implementing virtual health care services or those seeking to do so, it is important to be aware of both the benefits and challenges associated with adopting a virtual health care strategy and develop a connected, enterprise-wide strategy for the long-term.

Andy Penn focuses on the strategies and solutions that enable virtual health care on Cerner’s platforms. During his 16 years with the company, he’s held executive leadership roles in the consulting, solution management and business development organizations. Andy earned his bachelor’s degree in Business Administration, Management Information Systems from the University of Texas.