Surveys have shown that most healthcare providers thought telehealth would stay at pandemic levels or even increase. But telehealth utilization has since dropped, and while it remains higher than it was pre-pandemic, it’s not meeting those expectations. Teladoc, as well as other large telehealth providers, have seen challenges over the past few weeks after revenue results reflected these trends. Competition, market saturation, and consumers’ increased openness to seek care in-person again have all been cited as factors.
Now, we’re seeing a lot of questions about telehealth’s staying power after the pandemic. We’re also looking more closely at the model that most of the largest telehealth companies are using – companies that primarily facilitate concierge medicine and acute care services. Is virtual care sustainable in a post-covid world?
If we’re trying to understand telehealth’s impact in the future, these are the wrong questions to be asking. During the telehealth boom, we’ve focused heavily on access to urgent care virtual visits, and primary care, as well as transitional care. Telehealth, as we experienced it during the pandemic, was about expanding care geographically and/or delivering care that doesn’t require diagnostics, labs and physical contact. This approach primarily supports the type of care that can be delivered episodically or intermittently such as fevers, rashes, flus, allergies, and other similar episodes, most of which are intermittent in nature and lack high utilization. Chronic conditions, on the other hand, require continuous engagement and have high utilization but require multiple touchpoints and deep data.
In fact, 85% of our healthcare costs are attributed to chronic conditions, where continuous care delivery combined with deeper insights is a necessity for outcome improvements. The 15% of people who account for these costs need a different kind of telemedicine – one that facilitates improved care coordination and continuity of care. Whereas telehealth today is primarily focused on two use cases, episodic or urgent. The addition of chronic care would not only grow telehealth but increase utilization.
We know that continuity of care positively influences both healthcare outcomes (Hospital readmissions) and activation/engagement, especially for chronic disease patients. If telehealth can act as a bridge to keep patients connected to providers, it can help improve management as well as provide important health education. Integrating with diagnostics, lab data, and the various touch points within the chronic patient journey will deliver deeper insights to in-person and remote care teams, driving better outcomes and utilization. This is what will move the mark on patient satisfaction and outcomes, while improving healthcare conditions. Connecting patients with a long-term provider or care team ensures continuous relationships, management, and, ideally, prevention. We need to move the needle far enough forward to allow for the prevention of disease instead of just better management.
What does this mean when it comes to telehealth strategy? Well, telehealth companies weren’t really in need of a post-pandemic strategy. What these companies needed, was a better understanding of the best use cases for telemedicine visits – complex chronic diseases, and other healthcare concerns that really benefit from continuous provider access. Instead, telehealth companies were working on only one part of the patient journey to solve healthcare challenges that occur at multiple different points. They didn’t build the capacity to provide services throughout the full patient journey –diagnostics, treatment, management and maintenance.
Yes – the ability to see a provider through your phone, whenever you need, is incredible. But virtual concierge medicine won’t move the needle on the healthcare outcomes/challenges we need to address the most. And, as we are seeing, doesn’t have the utilization or retention rates of servicing individuals who are suffering from chronic issues and are most in need of continuous access to care. Many of the people who would benefit from telehealth the most, have yet to be able to test its potential.
Telehealth will continue to grow if it becomes most useful for patients who require frequent check-ins: individuals at risk for or diagnosed with chronic issues. Provided of course, that telehealth providers are integrated with or support the full patient journey that spans diagnostics, treatment, management, and maintenance. Telehealth, as a part of digital health, is what can help transform healthcare, but standalone it’s just one part of the patient care journey.
Ultimately, the promises of telehealth were made without understanding what it takes to address healthcare biggest challenges. Telehealth won’t revolutionize healthcare if it can only address 20% of the problem. However, when we start to address these issues and build solutions that can integrate whole person care (digital health), it will start to chip away at that eighty percent, and then we’ll start to see real transformation. Making predictions about telehealth usage based on these two very different sets of groups will not work. We’ve yet to really see how telehealth will apply in the latter case, where it will be a game-changer.
One thing is clear: We shouldn’t aim to go back to the pre-pandemic normal. Even if telehealth utilization drops, and most end up preferring in-person care, the dialogue opened on telehealth’s effects on supporting individuals with chronic issues, underserved communities and others who have trouble accessing care – will continue. Telehealth can help, but not alone.
Photo: Nuthawut Somsuk, Getty Images