Learning From Covid-19: Our Remote Care Revolution
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This article is part of a series in which OECD experts and thought leaders — from around the world and all parts of society — address the COVID-19 crisis, discussing and developing solutions now and for the future. It aims to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge. Opinions expressed do not necessarily represent the views of the OECD.
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This article was originally published on Medium by Derek Ross and Michael Hodin.
Many healthcare advancements and transformations can be tied to the responses emanating from historical pandemics. Though we don’t yet know how deep and profound the impact of COVID-19 will be, we are beginning to see the rapid rise of telehealth, also known as remote care or virtual care enabled by digital tools. This healthcare transformation to new care models could help solve the current crisis and last far beyond it.
And while Skyping with your doctor is a good start, the remote care model is capable of far more. Remote patient monitoring — powered by innovative, secure, sophisticated digital tools and enabled by AI — could fundamentally and permanently shift the healthcare delivery paradigm to save lives, reduce costs, and improve quality-of-life for millions of people.
In the case of COVID-19, healthcare is moving into people’s homes — will it stay there, and how can we ensure it will benefit everyone and push greater innovation going forward? This would represent one of the biggest changes in community care since the modern development of surgery and anesthesia in the 19th century, when today’s hospital really took shape. Amid this current crisis, hospitals need to focus on critically ill COVID-19 patients to avoid contagion and preserve scarce medical resources. In response, people are turning to telehealth en masse, using videoconferencing for virtual doctor’s appointments. This has been an incredibly rapid, massive shift; a British physician quoted in The New York Times described it as the equivalent of “10 years of change in one week.” In the U.S. alone, it’s estimated that there could be more than 1 billion telehealth visits in 2020, a figure that’s probably understated as these things tend to scale exponentially.
However, telehealth is just the beginning of what’s possible. There is huge untapped value in remote patient monitoring: professional, medically re-enforced devices and systems that collect, analyse, and transmit health data, connecting and informing a patient and their care team. Upon the launch of CMS reimbursement fees and codes in 2019, remote patient monitoring has mainly been used for chronic conditions — and during our current crisis, it’s exactly the patients needing and using remote patient monitoring who are most at risk. The potential is immense, far beyond its current application, as indicated by the explosion of telehealth. If scaled more broadly, remote patient monitoring can relieve pressure on the healthcare system, mitigate risks to healthcare professionals and patients, and aid both chronic and acute care to enhance lives and reduce costs.
Read the latest OECD report on digital health: Empowering the health workforce: Strategies to make the most of the digital revolution
Perhaps most importantly, remote patient monitoring has potential not just for the immediate needs of Covid-19, but for an entirely new era in medicine. Here’s what it will take:
Immediately support remote patient monitoring to reduce the spread of COVID-19, especially among at-risk populations already using these tools for chronic care. Health systems can continue to leverage these technologies to keep patients with chronic, often age-related, conditions — from diabetes and heart failure to osteoporosis, vision deterioration, and Alzheimer’s and other dementias — at home, healthy, and safe during the current crisis. Assessing reimbursement values for these uses should be part of policymakers’, regulators’, and payers’ overall response to COVID-19 — as well as an effective strategy to meet long-term goals for healthier aging — leading to revised care standards, pathways, and sites of care.
Permanently expand the use of remote patient monitoring for acute health needs. While these tools have primarily been used for chronic care, payers and regulators should make permanent the initial public health emergency expansion for use with acute conditions. This should also include permanently waiving requirements for a pre-existing patient-provider relationship. RPM was launched as a Part B fee for practices and providers. It should also be expanded as a Part A program to allow RPM in general hospital wards for patients out of the ICU but not ready to go home, and then to transition the monitoring seamlessly for in-home care without burdensome reporting and billing requirements.
Empower patients with their healthcare data. Starting now and learning from the COVID-19 crisis, individuals should collect and own their healthcare data as a source of life-saving knowledge and power, especially if proper safeguards address data protection anxieties. The role of individuals, families, and caregivers to possess and understand this data has never been more important.
Accelerate innovation. We must keep the innovation engine on full throttle through tax and fiscal measures that ensure continued improvement of the technologies now capturing everyone’s imagination. While remote patient monitoring is ideal for the needs brought by COVID-19, it can also serve as a vital tool for age-related conditions that were already rapidly growing. It will take a sustained innovation push to fully explore and refine these uses in at-home settings, including measuring the resulting improved health outcomes and cost savings.
For all these points, payer channels — public and private — are central to upping our standard of care, which will also achieve smarter and more cost-effective health systems overall.
COVID-19 has thrust us into a new world, defined by new threats and requiring new solutions. Born from this necessity, we can create a new era of patient care, prevention, and earlier and more effective health monitoring, detection, and diagnosis for both communicable and non-communicable diseases. This may be the historical moment when care largely moves from the hospital to the home and community — for good — but only if a wide range of stakeholders recognise and support the urgent need for continual innovation.
Derek Ross is Business Leader of Population Health Management at Philips and serves on the Board of Directors of American Well.
Michael Hodin is CEO of the Global Coalition on Aging and Managing Partner at High Lantern Group.
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