Telehealth – A Silver Lining We Need to Promote
The COVID pandemic was an experience that we all hope we never have to go through again. It killed millions of people, caused financial hardships, and separated us from our loved ones. It caused some of us to distrust formerly trusted public institutions and even to distrust the very vaccines that would prove to save millions of lives. It seemed to have a negative impact on almost every part of our lives. As bad as it was, there were a few silver linings, one of which was telehealth.
Before 2019 telehealth was often discussed as one way we could lower the cost of healthcare, but it was kind of like the weather, everyone talked about it, but nobody did anything to change it. I remember a long discussion at a conference about telehealth and how it could lower costs, especially for rural patients, but nobody knew how to get patients to consent to it, doctors to try it, insurance companies/Medicare to pay for it and the technical infrastructure to support it. It was just a mountain too high to climb, a bridge too far, and then came the pandemic.
The pandemic forced our hand – we were essentially trapped in our houses, and hospitals and doctor’s offices were considered unsafe except for the extremely sick. Older people, especially those with existing health problems, were considered the most at risk. They also bore the brunt of the pandemic’s sickness and death. Telehealth was thrust into the forefront as a way to have safe contact with healthcare providers. The first hurdle was the lack of high-speed internet available to many seniors. The second barrier was the lack of electronic communication know how of many older Americans, and the reluctance to use the service at all. It was a definite quandary our country faced. The very people who needed to use telehealth to stay in contact with their healthcare providers had the most barriers to using it.
Here are some interesting statistics about how we used telehealth before the pandemic and after a year. These results were taken from a National Poll on Healthy Aging done by the Institute for Healthcare Policy and Innovation at the University of Michigan. They polled adults age 50-80. Click here to see the full report on the results. The poll first shows where seniors stood on using telehealth prior to the pandemic. In May 2019, nearly a year before the pandemic, they found that only 4% had ever participated in a telehealth visit. They also found that, the most common concerns about telehealth visits among older adults surveyed were that a health care provider cannot conduct a physical exam (75%) and that the quality of the care is not as good as in-person (67%). Other concerns noted were not feeling personally connected to the healthcare provider (45%), having difficulty hearing or seeing the healthcare provider (25%), and privacy (24%). Seniors were just not acquainted with, or had some reservations about, using telehealth. But this was about to change.
Since I qualify as one of these older Americans, I take pride in how seniors rose to the task of dealing with the pandemic. Even though seniors bore the brunt of its fury, researchers found that they had better coping mechanisms when it came to the emotional stressors associated with the COVID-19 pandemic. Despite their greater concern about the virus, they reported less depression and anxiety compared to younger individuals. They also proved they could adapt and, contrary to the old saying that you can’t teach an old dog new tricks, they began using telehealth.
Even though only 4% had used telehealth before the pandemic, there was a huge increase once the pandemic hit. 26% reported using telehealth in the 4-month period leading up to June 2020 alone. Of those who had a telehealth visit in that period, 76% reported it was with a primary care provider, 32% with a specialty care provider, and 18% with a mental health provider. Respondents said that their most recent telehealth visit was conducted via video using their phone (33%), video using a tablet or computer (31%), or by phone with audio only (36%).
The concerns with telehealth decreased after that first year of experience. Older adults’ concerns about privacy in telehealth visits decreased from 49% in May 2019 to 24% in June 2020, and concerns about having difficulty seeing or hearing healthcare providers in telehealth visits decreased from 39% in May 2019 to 25% in June 2020. Concerns about not feeling personally connected to the healthcare provider decreased slightly (49% to 45%).
Seniors proved they could adapt. I must mention that surely part of the increase in seniors using video and audio to communicate was the fact that the pandemic kept them from visiting their children and grandchildren. That fact was a great motivator for them to adopt this new technology. So where are we now?
We were forced into adopting telehealth and now we have gained experience and overcome the barriers and proved it could be a vital part of our healthcare. We should be forging ahead to reap the savings we have talked about for so long. The problem is that the emergency legislation that allowed the payment for telehealth visits and opened up ways it can be used is due to expire at the end of this year. We need our law makers to pass permanent laws that allow us to reap the benefits that telehealth offers. The new technology that allows remote monitoring of many vital measurements will only increase the value and accuracy of telehealth. One vital aspect of telehealth is the ability to use telehealth with providers that don’t have to be geographically close. This aspect will increase competition and control prices while allowing access to providers that are best for your requirements. We need to retain this flexibility.
Tell your lawmakers that we can’t risk losing the experience we gained as we used telehealth during the pandemic. We need permanent legislation that encourages the use of telehealth.
Best, Thair