Telehealth programs were implemented with great speed this past year, but not likely with the depth of analysis required to assure their long-term success. Telehealth is here to stay, but programs that were introduced or expanded to meet the emergency needs of the COVID-19 pandemic may not be configured to provide optimal patient care. ECRI delved into the problems and challenges associated with rapid telehealth adoption as topic No. 3 on its list of the Top 10 Health Technology Hazards for 2021.
The COVID-19 pandemic prompted health care delivery organizations across the United States to rapidly implement or expand telehealth technologies and programs, sometimes in a matter of days or weeks. To illustrate the point: the U.S. Department of Health and Human Services reports that the number of Medicare primary care visits that were provided through telehealth increased from less than one percent in February 2020 to more than 40% in April 2020 (0.1% versus 43.5%; see: HHS Issues New Report Highlighting Dramatic Trends in Medicare Beneficiary Telehealth Utilization amid COVID-19.)
The rapid adoption of telehealth technologies for various use cases in 2020 was driven by the need for health care organizations to continue providing services during stay-at-home orders, to conserve personal protective equipment (PPE) and to protect clinical personnel and patients. This shift was aided by government funding provided in the CARES Act, relaxed enforcement of HIPAA regulations and policy changes instituted by the U.S. Centers for Medicare & Medicaid Services (CMS) that expanded its list of covered telehealth services during the pandemic.
While the sudden change has been necessary to meet the immediate need, the rapid deployment and expansion of telehealth solutions may create its own problems and challenges. “Challenges could impact both patients and providers,” notes Juuso Leinonen, a senior project engineer in ECRI’s device evaluation group, “particularly as facilities transition from the pandemic response to new telehealth care delivery models.” Addressing these challenges may result in the eventual need to switch, modify, reconfigure or completely cease the use of some of these technologies, software, programs or workflows.
Following are seven tips from ECRI for safeguarding patient care and ensuring the long-term success of a telehealth program. Failure to address these challenges could adversely affect patients – it could lead to suboptimal treatment, increase the risk of medical errors or hinder certain populations from accessing care, for example – and it could put the patient’s and the facility’s data at risk.
Effective cybersecurity measures can protect patient and facility data and can help minimize downtime. ECRI recommends conducting a security risk assessment for any implemented telehealth solution to verify that facility expectations are met and that appropriate security controls are in place.
“Telehealth technology expansion is here to stay. There’s no going back,” explains Leinonen. “But what programs will look like as the dust settles after COVID-19 is unknown.” Regulatory, reimbursement, reliability and usability factors all will help shape future telehealth technologies and programs. His bottom-line? “Established telehealth programs may need to evolve in order to be viable in the post COVID-19 world.”
– This article is adapted from ECRI’s Top 10 Health Technology Hazards for 2021 and related content, including a series of ECRI webcasts addressing Telehealth during the COVID-19 Pandemic. Each year, ECRI produces its Top 10 Health Technology Hazards report to help hospitals direct their time and energy toward technology management activities that can have the greatest impact on patient safety. An Executive Brief version of the report is available for complimentary download at www.ecri.org/2021hazards. The full report, accessible to ECRI members, provides in-depth discussion of each hazard, including detailed steps that organizations can take to prevent adverse incidents. To learn more, contact ECRI at 610-825-6000, ext. 5891, or by email at firstname.lastname@example.org.
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