Overcoming Telemedicine Barriers And Gaps In Delivery of Remote Healthcare

Telehealth Obstacles are being addressed across many different sectors

Telehealth visits more than doubled in 2020, driven predominantly by the need to provide safer care during the COVID-19 crisis. But even prior to the pandemic, over two-thirds of physicians said they would try virtual care and the number of doctors who adopted telemedicine services increased by 340% between 2015 and 2018.

However, despite the growing popularity of telehealth, not all doctors are onboard. One universal concern is that symptoms could be missed during an online visit, particularly those that might be picked up during an in-person appointment.

Practitioners have other concerns too, as reported in a Deloitte survey of virtual healthcare trends:

• 36% they are worried about the potential for medical errors
• 33% are worried about patient privacy and data security
• 23% say their patients aren’t interested in e-health tools
• 22% said it doesn’t fit their current workflows

For some doctors, telehealthcare has added to  “screen fatigue” and information overload that they already experience.

And the swiftness in which telemedicine was implemented during the beginning of the pandemic has contributed to higher levels of physician exhaustion and burnout. However, as virtual care has become more mainstream, the initial stress has lessened.

Despite some initial reservations, many doctors are positive about the future of remote care.

A survey of clinicians conducted by the American Medical Association (AMA) showed that 75% of doctors believe telehealth helps them provide quality of care in these key areas: acute care, chronic disease management, follow-up care, care coordination, preventive care, mental/behavioral health, and COVID-related care. And 60% feel that patient health is improved with telehealth.

Patients Are Positive, But Usage is Inconsistent

Telehealth is popular with most patients, as well. A whopping 83% of people expect to use telemedicine once the Coronavirus health crisis subsides.

Telehealth has also been shown to improve patient engagement. However, not all are on the bandwagon. Some are just not comfortable using electronics for online care, while others lack the resources to take advantage.

A study from the University of Pittsburgh and Harvard Medical School found that 41% of Medicare patients don’t have access to a desktop or laptop computer with a high-speed internet connection at home. Forty percent don’t have a smartphone with a wireless data plan, and more than 26% didn’t have access to either.

Income, race, and geography also influence which patients are likely to use remote care. A JAMA, Internal Medicine letter describes how individuals with lower socioeconomic status and those who live in communities of color lack digital access necessary for remote care.

And Black and Hispanic patients were more likely to go to either the Emergency Department or a doctor’s office instead of using telehealth, as opposed to White or Asian patients.

Barriers to Telehealth Getting Knocked Down, One by One

As virtual care becomes more mainstream, many of the obstacles facing clinicians and patients are being addressed. For example, data shows that many of the concerns around compromised care quality appear to be unfounded.

A report released by the Kaiser Family Foundation says that telehealth can actually improve quality of care since it removes barriers, and patients often receive a more rapid response from their clinicians.

Also, advancements in artificial intelligence (AI) in medicine are taking remote care to another level. According to the National Institutes of Health, tele-assessment, tele-diagnosis, tele-interactions, and tele-monitoring are examples of ways AI is being integrated into the remote delivery of care.

There has been more research on the disparities among populations using remote care, including a recent report from the Journal of American Medical Informatics Association. The JAMIA study concludes that future telemedicine technology will take into consideration “knowledge, attitudes, cultural beliefs, health behaviors, adherence, language, health literacy, social support, religious beliefs, self-efficacy, preferences, and psychosocial factors.”

It’s also believed that telecare will become an “equalizer” in underserved communities, especially when combined with support from community health workers.

Gaps in internet access are also getting attention. The Federal Communications Commission has recently announced the Connected Care Project, a $100 million funding initiative which aims to improve broadband connectivity in underserved parts of the country where access to care is limited or hindered.

Healthcare policy is also trending toward virtual care. The AMA is advocating for telehealth policies and coverage that support a long-term, sustainable use of telehealth as an option for physicians and patients.

Additionally, the U.S. Centers for Medicare & Medicaid Services (CMS) have added more than 200 Medicare-covered telehealth services and permanently expanded coverage to include telehealth. As of February 2021, most states require some level of telemedicine coverage by commercial insurance payers.

HIPAA privacy rules governing telehealth were relaxed in 2020 and are expected to last through 2021, with noncompliance penalties being suspended. However, once the public health emergency subsides, it’s expected that HIPAA will be more strictly enforced in virtual care delivery.

When that happens, physicians and patients will have less freedom about the platforms they use for telehealth. In other words, only those that are HIPAA-compliant will be certified for telemedicine.

The Future of Remote Care

The healthcare community adapted quickly to the need for telecare during the pandemic and it’s unlikely to ever return to pre-pandemic levels of usage. However, there are still many lessons to be learned that will improve and expand the delivery of telehealth.

As the country (and the world) emerges into a post-pandemic “normal,” the outlook for remote care can be summed up by this quote from an AT&T-produced white paper:

“Healthcare stakeholders have high hopes for telehealth as an essential ingredient for creating a better system of care. The future of remote care delivery depends on powerful technologies and smart networks to attain these aspirations. With rising healthcare costs and unprecedented pressures on healthcare systems to connect care across the continuum, the time is right to use telehealth to break down the barriers to make healthcare more efficient, more connected and more affordable.”