Telemedicine Usage Surges During COVID-19 Era

Telemedicine has seen a surge in popularity in 2020. For the workers’ compensation community, this is great news as telemedicine is one more tool available to assist injured workers on their road to recovery. 

In its most basic form, telemedicine is the virtual delivery of healthcare. Physicians and patients communicate using electronic, audio, and video platforms that can be hosted on almost any computer, tablet or mobile device. Like a traditional office visit, a physician can assess an injury or illness, develop a care plan, write a prescription, and schedule a follow-up visit while communicating and interacting with the patient virtually.  

Telemedicine offers many benefits. Known for convenience, telemedicine offers patients access to a physician’s expertise while saving travel time and expense associated with a more traditional office visit. It is also a way to deliver healthcare to patients in remote or rural areas as well as those with physical disabilities or limited transportation options. 

Interest in telemedicine skyrocketed this year driven largely by COVID-19. Any previous hesitations or misconceptions around virtual visits quickly dissipated at the thought of sitting in a crowded waiting room with an increased exposure to infection.  

McKinsey & Company has conducted interesting research as it relates to the broader category of telehealth services and their relation to COVID-19. According to McKinsey & Company, consumer adoption of telehealth services increased from 11 percent in 2019 to 46 percent in May 2020, notably due to telehealth taking the place of visit cancellations. 

With a focus on how COVID-19 has changed the outlook for telehealth, McKinsey & Company also found that while the surge in telehealth has been driven by the immediate goal to avoid exposure to coronavirus, 76 percent of survey respondents indicated they were highly or moderately likely to use telehealth going forward. Additionally, 74 percent of telehealth users reported high satisfaction with the service.¹ 

In addition, telemedicine offers attractive options for the medical community and public health sector. Telemedicine allows physicians to see a high number of patients in a very efficient manner. Moreover, virtual visits help reduce staff exposure to infection, lessen the demand for personal protective equipment, and free up capacity at healthcare facilities. 

Regulatory changes and relaxed restrictions in response to the COVID-19 pandemic have also facilitated the rise of telemedicine. The Centers for Medicare & Medicaid Services broadened access to Medicare telehealth services for its beneficiaries considerably.  

Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payments for telehealth services at the same rate as in-person visits. And, physicians and patients are no longer required to have an existing relationship in order to schedule a telehealth visit. Additionally, state license restrictions are relaxed allowing providers to offer services in all areas of the country. The list of those able to provide telehealth services has also been expanded beyond physicians to include nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians, and nutrition professionals. And, location restrictions have been eased such that telehealth visits can now take place from a patient’s home.² These types of regulatory changes bode well for the future of telemedicine and its wider acceptance and usage among the general population. 

Telemedicine is not a panacea for all occupational injuries or illnesses.  Severe injuries or illnesses with extensive complications are better addressed onsite at a healthcare facility with a medical team and necessary equipment.  Moreover, some individuals simply prefer seeing a physician in-person.  Some may not have access to the necessary technology or are not comfortable using technology in this manner. Others have privacy concerns and choose not to discuss personal matters in a virtual environment. 

However, today more individuals are open to telemedicine as a means of healthcare delivery. Telemedicine can be an excellent option for minor injuries or illnesses including colds, sprains, strains, cuts, bruises, or abrasions. Virtual visits can be used effectively for triage and to make an informed determination as to whether more extensive medical treatment is required. Telemedicine is also excellent for re-checks and follow up visits.  Additionally, some supporting services such as physical therapy can be delivered in a virtual setting.  

Mental and behavioral health services are well suited for virtual healthcare delivery. In a year dominated by headlines around widespread COVID-19 outbreaks, financial woes stemming from layoffs and business closings, and disruption created by stay-at-home orders, social distancing guidelines, and mask mandates, the demand and strain on mental health services cannot be ignored. Virtual visits provide a way to extend much needed help to those with existing mental health conditions as well as new cases arising from those impacted by this year’s events. 

 Many industry experts will agree that telemedicine is here to stay. Technology continues to improve, and public acceptance is increasing. In a year in which people are searching for good news, the advancements in telemedicine are something we can all celebrate. 

By Dr. Teresa Bartlett

Teresa Bartlett is the Senior Vice President and Senior Medical Officer at Sedgwick since January of 2009. Her background in Family Medicine led to a business career with a large automotive manufacturer. She has experience managing large self-insured, multi-state workers’ compensation programs and the Canadian workers’ compensation program.The short term disability (STD) program which Dr. Bartlett managed was union negotiated. She developed an evidence based medical substantiation process which saved millions of dollars and reversed the escalating STD trend. She led the team that won the Corporate Health Achievement Award from ACOEM in 2005 for the Development and Implementation of a Best Practice Clinical Model.

During her career she has had the opportunity to manage and mold wellness and fitness programs which evolved into award winning programs that were integrated into the benefit and claim structure. Dr. Bartlett was the recipient of the Crain’s Detroit Business 2008 Health Care Hero Award for bringing a new and innovative program to address back pain into the workplace. In 2012 she was a Business Insurance recipient of Women to Watch. In 2015 Dr Bartlett was the recipient of the President’s Honor Roll of the Comp Laude award for Work Comp Central for her work with physicians who had aberrant prescribing patterns in California. In 2017 she was appointed to the inaugural Board for the Women to Watch Foundation. Dr. Bartlett volunteers each week as a crisis counsellor for Crisis Text Line providing help for those in the moments of great need. She is a frequently requested national speaker on various health topics in the industry.  

As the Senior Medical Officer for Sedgwick, Dr. Bartlett is an advisor in matters affecting the design and delivery of medical management services for the company’s claims clients. She provides strategic counsel and operational support in all areas of medical management including case management, return-to-work, behavioral health interventions, medical outcomes protocols, pharmacy interventions, telemedicine and health and safety matters. Dr. Bartlett also advises on best practices to integrate the delivery of occupational and nonoccupational medical services and the matters affecting healthcare as part of the claims services process.

Sources: 

(1)   “Telehealth:  A quarter-trillion dollar post-COVID-19 reality?” by Oleg Bestsenny, Greg Gilbert, Alex Harris and Jennifer Rost of McKinsey & Company, May 29, 2020 https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality#  

(2)   “Medicare Telemedicine Health Care Provider Fact Sheet, March 17, 2020 https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet 

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