By Jonathan Langer
If anything positive comes out of the COVID-19 crisis, it will be how healthcare technology played a prominent role flattening the curve. And most notably, how virtual care solutions kept patients in self-quarantine to help fight the spread of the virus across our communities. Both in hospital isolation rooms and in patient homes, its use in patient triage has expanded dramatically during the crisis. Even more, it has allowed for more effective allocations of healthcare workers and vital medical equipment. Could COVID-19 become telehealth’s watershed moment?
Fear of an overwhelming surge in caseloads fast-tracked a number of policy changes negating obstacles to telehealth applications, including consultations and remote patient monitoring (RPM). Although the relaxed restrictions are said to be temporary, one thing is clear, incentives to use and expand remote care have been added and there aren’t many who believe that they will be rescinded. And with studies projecting the RPM market will reach a staggering $31.3 billion by the end of 2023, and given the lower cost patient access benefits, what other options can compete with telehealth’s current resume? Regardless, what is the likelihood that the health conveniences now viewed by patients as a “right” will be taken away?
The telehealth waiver under Medicare HR 6074 was implemented on March 17. Not only were location-based restrictions lifted, making patient’s homes eligible regardless of where they live, but the waiver list of eligible practitioners now goes beyond physicians, to include nurse practitioners, physician assistants and other nurse specialists. Even clinical psychologists and social workers are eligible. Medicare is reimbursing, the Current Procedural Terminology (CPT) codes and guidance on how to apply them are clear and for most telehealth services, you’ll pay the same amount that you would if you received the services in a physician’s office. It seems that all of the industry’s “rowers” are finally pulling in the same direction. The idea that it took a pandemic to expedite such change is surely not uncharacteristic of how things tend to happen, especially in industries as risk averse as healthcare.
Coincidentally, telehealth’s recent momentum also coincides with a research project currently being conducted by the National Cybersecurity Center of Excellence (NCCoE). The project bears the impeccably timed title “Security of Telehealth and the Remote Patient Monitoring Ecosystem.” And because it is using the NIST framework, the resulting recommendations should not be a surprise to anyone. As a reminder, here’s a quick NIST framework summary. These are the cybersecurity guidelines that care providers should be following:
- Develop a cyber-risk organizational foundation/reference architecture
- Institute safeguards to protect and improve that foundation
- Enable the timely detection of a cybersecurity event
- Have the ability to contain the impact of a detected cybersecurity event
- Develop playbooks that support a quick response/return to normal operations after a cybersecurity event
So, where do you start? As always, with visibility. And when considering how stunning the lack of clinical network/medical asset visibility has been during the crisis, the credibility of the business cases supporting investments in a “fix” have been established. Not to pile on, but a primary source of both perceived and real COVID-19 panic remains centered on questions about the status and availability of medical equipment for treatment. Bottomline, an automated, accurate way to provide such visibility – to identify the numbers, locations, status and security posture of medical devices required to treat vulnerable patients – should be an on-demand capability, all of the time.
Thankfully, such weaknesses in clinical visibility will soon be addressed, in part, by the more than $100 billion stimulus, also being described as a “Marshall Plan for Healthcare.” And with good reason, as healthcare’s cybersecurity infrastructure is riddled with gaps in foundational capabilities.
It seems that COVID-19 will hasten the digital transformation of U.S. healthcare. More than accelerating the adoption of modern solutions that can deliver health systems the ability to quickly and securely scale, COVID-19 has given health systems a reason to reassess how they engage patients in their own care.
Clinical networks are expanding and fragmenting, and telehealth is just one of many drivers. The pace at which it all comes together, meaning remote care delivery, reimbursement and cybersecure networking, may have just changed forever. At the very least, the COVID-19 experience has sparked an evolution to the world’s healthcare infrastructure that will harden it against the absolute certainty of future outbreaks.
Jonathan Langer is CEO and co-founder of Medigate.