After a pandemic-induced surge, telemedicine services and healthcare providers are shifting from meeting increased demand for telemedicine tech to ensuring its successful integration at all points in the virtual care continuum.
“This really was a kickstart,” Brian Wayling, executive director of telehealth services at Intermountain Healthcare
, said of the pandemic. “Telehealth has been going on for a long time, but we’re really at the beginning.”
How Telehealth Tech Pros Handled the Pandemic Surge in Demand
When COVID-19 reached North America, the need for telehealth services exploded. Overall telehealth usage in April 2020 was 78 times higher
than in February 2020, according to McKinsey data. By July 2021, usage had stabilized but remained well above pre-pandemic levels.
Telehealth providers faced tech-related barriers to meeting that rapid increase in demand for their services. “The challenges were the same that existed pre-pandemic, only it’s now magnified by an X factor because of the scale of adoption,” said Eric Bacon, president of AMD Global Telemedicine
Organizations that were ahead of the game on telemedicine still faced challenges. Intermountain is a not-for-profit system of more than 30 hospitals, including a virtual hospital. “At the time, we had a fairly robust telehealth system, but nothing in comparison to the demand,” Wayling said of the early days of the pandemic.
Expansion of its services to meet pandemic demand required additional support for its established hospital-to-hospital telehealth services, Wayling said. Other work responded to the overwhelming demand for their direct-to-consumer service, which became a first point of triage for many patients when in-person appointments with primary care physicians – or trips to an emergency room – became risky.
Intermountain worked externally with a vendor to increase server access to meet their needs once the pandemic began, Wayling said. Internally, they boosted their network. Some of the technical challenges were more mundane, he said – helping users learn how the systems worked , for example, or dealing with connectivity issues on Wi-Fi networks. Doing the work to ensure users could access health services as intuitively and reliably as with the apps they were used to using every day was initially a big lift for caregivers, he said.
“We’re all used to something like Amazon, where you click on a button, and it works, and you always have connectivity, and you get your product,” Wayling said. “We struggled with that [user expectation], just because it went from zero to 1,000, and that caused some frustrations.”
For AMD, meeting that demand required both making services more portable within traditional healthcare settings and expanding its services into new care environments like people’s homes. Its services were already well established in hospitals and other healthcare facilities, Bacon said, which made it possible to pivot their services and offer them across large healthcare systems – but that portability didn’t necessarily translate within the facilities themselves.
In a modern hospital, good bandwidth to run dedicated systems is a given, Bacon said. The same assumption can’t be made for equipment brought from room to room on a wireless connection. A hospital built just 10 years ago might have been designed for devices meant to be plugged directly into a wall without consideration for wireless signals.
The same issue persists when telemedicine care moves into patients’ homes, especially for patients in remote areas who can most benefit from that care. Providing telehealth solutions requires identifying network and bandwidth challenges for facilities so they can be corrected, Bacon said, and choosing technology that fits within the constraints of the network patients are on, because wider issues of infrastructure are outside AMD’s control.
Building Future Capacity
Going forward, those wireless networks must reach an ever-increasing number of end locations, especially as the care setting continues to move into the home. With the share of Americans who own a smartphone
up to 85%, according to Pew Research Center, the expanding role of mobile tech in those end locations is inevitable.
“If you have a thousand patients, you now have a thousand other end locations you have to deal with,” Bacon said. “That means making sure you pick a technology that’s going to fit within the constraints of the network that those individuals are on.”
Intermountain is also reviewing video bandwidth and network capabilities in its facilities to ensure they meet the ongoing technical challenges to providing effective and secure telehealth services to patients and healthcare providers in rural and remote areas, Wayling said – now, and for the expected demand a couple years down the road. The same areas that can often most benefit from that access often have lower-quality network connections available, or may find it more difficult to access the hardware needed.
But the challenges of providing services to an expanding number of patients and healthcare providers in a growing number of end locations are also part of the success story of telemedicine, Bacon said.
“We’re providing remote access. We’re providing much-needed care to people in very remote areas,” he said. “Physicians are now able to increase their outreach.” This not only increases the number of ways a patient can interact with their primary-care doctors but also broadens their ability to access specialist caregivers.
The Future of Telehealth Tech
In early 2020, online engagement with a care provider was new to many patients. Those patients underwent a trial by fire of sorts out of necessity. However, amid the challenges, the evidence so far indicates that telehealth services can facilitate effective care that satisfies patients. Research is ongoing, but several studies
so far have found high levels of patient satisfaction for both video and telephone consultations.
Both Wayling and Bacon expect telemedicine to continue to grow, due to the financial benefits it provides to healthcare providers and the efficacy and patient satisfaction reported so far. Expanding the field and building on its successes requires incorporating telemedicine training into more education programs, Wayling said. “We have this moment in time where in their personal lives, [students] probably use all of these technologies, but a lot of medical schools are not teaching telehealth and not teaching digital engagement,” he said.
Preparing those future doctors and nurses during their education is important when we know they will deal with telemedicine once their careers start, he said. “Embedding technology in the educational model is going to become really, really fundamental,” Wayling said.
That technology itself is likely to become increasingly complex, he said, pointing to early-stage or expected developments like machine learning analysis of the data generated by telehealth tech, or the interaction of that tech with smart-home devices and applications in home-based care settings.
The expansion of telemedicine during the pandemic is also shifting patient expectations of what healthcare can look like, Bacon said. “Pre-pandemic, we kind of just accepted healthcare as it was….but having the immediacy of access with these remote systems, you could see a doctor that day, that afternoon,” he said. Healthcare consumers now realize that telehealth can facilitate service that is both convenient and effective, and healthcare systems are responding to meet those new expectations.
“Quite frankly, for these health systems post-pandemic, every one of them has a telemedicine plan or program in place,” Bacon said. “If they don’t, they’re in the process of doing it.”