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COVID-19 has accelerated the use of telehealth and generated enthusiasm for its possibilities and questions about its shortcomings.
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Telehealth: Problems and Possibilities Beyond COVID-19

By IHI Multimedia Team | Monday, May 4, 2020

Telehealth Problems

Reed Tuckson, MD, FACP, the former President of the American Telemedicine Association, summed it up in seven words: “The genie is out of the bottle.”

And this genie is virtual.

During the COVID-19 pandemic, many health care professionals have turned to telemedicine to diagnose, monitor, and triage patients when traditional office visits are perceived as risky.  More than 1,000 of those professionals registered to hear the May 1 IHI Virtual Learning Hour — Telemedicine: COVID-19 and Beyond — and heard a timely presentation from Tuckson and Creator of Project ECHO® Sanjeev Arora, MD.

Tuckson and Aurora highlighted the huge leaps in utilization they are seeing. For example, NYU Langone Health reported that non-urgent telehealth visits increased by more than 4,000 percent from March 2 to April 14; urgent care visits increased 135 percent during that same six-week stretch.

The speed of this transformation globally has even surprised another Virtual Learning Hour guest, IHI President Emeritus and Senior Fellow Don Berwick. “What I thought would take years,” he said, “has taken weeks.”  

That acceleration, although forced by the pandemic, has generated enthusiasm and possibilities for leaders like Arora and Tuckson.

Tuckson noted that telehealth was part of a “consumer-centric” care movement that was well underway before COVID-19, with people using their personal devices to track their own health data. Now, he described how using virtual platforms has enabled even physicians who have been under quarantine or retired to see patients or assist with triage during the pandemic. While acknowledging that many complicated issues (including reimbursement) need to be resolved, Tuckson expressed hope that providing more care outside of hospitals would ultimately help to reduce health care costs. The key, he observed, will be how to “increase access and quality but not add to the cost burden for patients.”

Arora is a longtime proponent of using interactive video technology to “democratize” knowledge among health care providers. He noted that he has seen “telementoring” improve skills, reduce isolation, and increase joy in work among community providers and specialists who use telehealth platforms to collaborate on patient care. The key, Arora said, is using technology to “exponentially expand [a health care system’s] capacity to amplify best care.”

Arora also noted that during Project ECHO’s almost 20-year history, he has seen too few health care providers with training on quality improvement or patient safety. And both Tuckson and Arora agreed that making the most of telehealth’s full potential will require more clinicians to learn how to provide team-based care.

“You need physician champions,” Tuckson said, adding that more practices need to train all staff members to work “at the top of their license.” One Virtual Learning Hour participant, for example, suggested that administrative staff can help patients work through connectivity and other technical issues during pre-visits before meeting with clinicians.

To learn about other potential solutions to telehealth challenges, watch and listen to the full Virtual Learning Hour. Learn more about IHI’s special series of weekly COVID-19 Virtual Learning Hours.

You may also be interested in:

Recommendations for Designing High-Quality Telehealth

The Keys to Effective Telemedicine for Older Adults

Is Team-Based Care the Key to Successful Population Management?

More COVID-19 Guidance and Resources

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