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The Challenges of Maintaining Quality Outcomes Through Virtual Care

When HealthStream published our blog post two years ago about the potential value of virtual care, we focused on how virtual care, also known as telehealth or telemedicine, could be a potential solution to a broad set of operational and strategic challenges that healthcare providers and professionals confront on a daily basis. Some of the specific virtual healthcare trends we singled out were to lessen staffing issues, support aging-in-place, reduce the use of the hospital/ER, and to improve care in rural areas. Here in the midst of the COVID-19 Pandemic, these are all true, but they are side benefits of the big reason that the use of telehealth/virtual care has skyrocketed—to prevent infection and maintain care continuity during a pandemic.

Escalation of Telehealth as a Response to COVID-19

More recently, we’ve posted a blog about how telehealth became a crucial alternative to in-person visits for patients whose need to stay home was critical, whether due to age or pre-existing conditions. It also was an important pressure valve as clinicians struggled to meet the demand for hospital beds as they were swamped by patient needs and emergencies due to COVID-19. Eventually the pandemic curve flattened, leaving many people to wonder whether the use of telehealth would dwindle or is this now an inflection point where virtual care and telehealth become a norm. From the point of view of provider services, not only has the COVID-19 pandemic pivot to telehealth changed everything about privileging, but we are seeing a pandemic-generated acceptance of telehealth on a professional and payer level that isn’t likely to disappear.

The Jury Is Still Out on Virtual Care, Quality, and Outcomes

The healthcare industry is still working to confirm the link between virtual healthcare and quality, as well as improved outcomes. A September 2020 Fierce Healthcare article describes a survey where “close to 60% of physicians have lingering reservations about the quality of care they can provide remotely.” The same article offers that “industry leaders say there needs to be more research on the impact of telehealth to address ongoing concerns about care quality and to evaluate potential barriers for underserved populations.” Also, "Some physicians also expressed concerns over the quality of telehealth visits, such as an inability to conduct a physical exam. Furthermore, for providers too many things may have changed at once, making it difficult for them to assess the independent impact of telehealth on quality of care.”

The Taskforce on Telehealth Policy is a joint effort between the National Committee for Quality Assurance (NCQA), the Alliance for Connected Care, and the American Telemedicine Association—its focus is to develop “consensus recommendations for policy makers to drive quality and safety standards for digital health care delivery, nationwide.” In September 2020, Healthcare IT News shared that “the task force found that the evidence base for telehealth is strong, particularly when it comes to the remote management of chronic conditions.” Chronic care management is another area where virtual care shows much promise.

As virtual healthcare becomes more the norm, it has great potential to improve outcomes. A September 2020 Kansas City Business Journal article about the possible advantages of telemedicine includes the following potential benefits that could contribute to improved outcomes:

  • Removing barriers to primary care use
  • Quicker access to care providers
  • Counteracting physician shortages
  • Facilitating linkages to care based on laboratory test results
  • Enabling care for multiple patients at one time via chat and text

Ultimately, it is too soon to know how virtual care will change the healthcare industry and the patient experience. No one imagined a year ago that telehealth would be playing a role as big as what we now know. Given the growing need for care as our population ages, it is very likely that telemedicine is here to stay.

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