Telehealth for Hospitals
Fact checked Medically reviewed by: Dr. Utibe Effiong, Board Certified Internal Medicine Physician
Updated: April 23, 2021
Virtual visits, video calls, patient portals and remote monitoring devices have become a healthcare mainstay during the pandemic when hospitals accelerated their adoption of telehealth. The benefits of telehealth include greater access to care, reduced disease exposure, convenience for patients, and efficiency. You’ll likely secure a telemedicine appointment faster than an office visit.
Before the pandemic, 11% of Americans tried telehealth, but 76% expressed interest in telemedicine now, according to a May 2020 McKinsey COVID-19 consumer survey.
Telehealth enabled hospitals to protect caregivers and patients, “and to avoid surges on the facility when it was not necessary,” says Joseph Hall, president and CEO of the health benefits advisory company, Remedy Advisors. “If I can triage you from a distance and you don’t need to get into your car and go to the ER, overwhelm the staff and expose yourself and caregivers, everyone benefits.”
Telehealth is more important to hospitals than ever before, according to a report by Teledoc Health. Hospitals are responding to consumer demand for more convenient care. Headed into 2021, 26% of providers surveyed said telehealth is the number one priority in their organization compared to 8% in 2017.
“Ultimately, telehealth in hospitals is advancing consumer-driven healthcare”, says Matt Heelan, COO and vice president of business development for Illumisoft, a Kansas-based software development company focused on the healthcare space. “What COVID-19 highlighted and the industry has moved in this direction is the demand for value-added healthcare,” he says. “It’s the idea that now we are going to put the consumer or patient at the center of the experience, and we are going to treat healthcare like any other consumer experience.”
There are many ways hospitals are embracing telehealth, from managing chronic diseases like diabetes to gathering patient vitals or linking patients to specialists. Telehealth in hospitals is a fast-growing, rapidly advancing arena that offers so many benefits to patients.
How Hospitals Use Telehealth
There are several telehealth tools hospitals are adopting to improve patient experience and conduct virtual visits, either by synchronous video calls or asynchronous video. Technically, telehealth also includes phone calls with providers, and patients’ ability to access data or make appointments. According to Neoteryx, a blood microsampling innovator, the main apps and devices used today are online patient web portals, video chat technology, remote monitoring, and private apps.
- Patient portals: Secure, online portals allow patients to check lab results, schedule appointments, request medication refills, upload information like vitals (blood pressure, glucose, heart rate), and also send emails to providers. Portals can also send reminders for vaccines, tests or procedures, and offer bill payment tools.
- Video: Customized video tools might be accessed through the patient portal, or providers might rely on video apps designed for the healthcare industry like VSee or thera-LINK. Providers are also using Zoom, FaceTime, Skype, and Google Meet to conduct virtual visits.
- Remote monitoring: Connected devices that measure blood pressure, glucose levels and heart rate can send vitals to an app for providers and patients to access. This allows care providers to gather data without requiring patients to come into the office.
- Telehealth apps: Apps designed to facilitate telehealth offer a range of services, from facilitating video chats to scheduling and at-home testing.
Telehealth for Managing Chronic Disease
Telehealth allows patients to use devices and apps to gather critical data like blood pressure and to easily connect with providers via video or online portals. Because patients with chronic diseases tend to see specialists more frequently and require ongoing follow-up care, telehealth offers a convenient, efficient avenue for getting proper care—and appointment cancellation is reduced. Telemedicine also can be used to improve medication compliance.
The Community Preventive Services Task Force (CPSTF) suggests telehealth tools like secure messaging for medication reminders and appointment reminders, apps for setting goals for fitness or other wellness factors and transferring data like patient vitals to providers.
Also, telehealth is an effective follow-up method for patients with cardiovascular disease, high blood pressure, diabetes, HIV, end-stage renal disease, asthma, and obesity, according to the Centers for Disease Control & Prevention (CDC). In a Massachusetts General Hospital study, 79% of patients said scheduling a telehealth follow-up visit was more convenient than an in-person follow-up.
Remote Patient Monitoring
Patients can collect medical and health data by using digital, connected devices that gather and record information, the upload data so it can be sent to providers. Remote monitoring can be used to gather weight, blood pressure, heart rate, blood oxygen levels, glucose levels, and electrocardiograms. Data is then uploaded and transferred securely to providers so they can use the information to make recommendations. Ultimately, remote patient monitoring improves patient self-care and accountability, and it allows vital information to be transmitted to specialists without an office visit.
Accessing Specialists with Telehealth
With telehealth, patients can make appointments with specialists outside of their region, which expands opportunities for care and can result in a faster appointment if a specialist across town has availability sooner than the one closer to home. “Normally, we saw people who traveled to hospitals only in the region, but now, someone from Indiana can do a telehealth visit with a doctor at the University of Kansas Medical Center,” Heelan says, adding that a lift on geographical barriers during COVID-19 and extended telehealth regulations that allow Medicare patients to access telemedicine.
Hospitals are using telehealth to augment their offerings, too. “Anytime you go in for surgery, there is a technician that sits and monitors your brain activity,” Heelan relates. “Those neurology technicians are in dire need, especially in rural communities. Oftentimes, there will be a technician 100 miles away that will travel to sit in on a surgery to provide expertise. We built a platform that allows the technician to be at home, monitoring a surgery in a hospital that is across the country, so they can perform their job function the same as if they were on site.”
How ERs use Telehealth
Telemedicine in the ER allows patients with non-urgent conditions to see a doctor without going to the hospital, and it gives Emergency Department physicians the ability to focus on critical patients. Telehealth can be used to capture vital signs and send those to an ER doctor. A video consultation can be scheduled if necessary, and a patient can receive treatment recommendations or be referred for an in-person visit, if necessary. For patients, this is a dramatic cost-savings since ER co-pays and visit fees can be steep. Telehealth could reduce ER visits by 27% in aging adults.
Direct Primary Care
Virtual, direct primary care allows patients to connect directly with their physician without going through a call center or intermediary. “If you are my direct primary care provider, I am calling you directly and saying, ‘Doctor, this is Joey,’” Hall says. “We are having a direct relationship that just happens to be virtual.”
“Direct virtual care is being embraced by not only primary care doctors but hospitals and the entire healthcare delivery system”, Hall says.
Telehealth for Clinical Trials
“When COVID-19 ramped up in March 2020, hospitals across the country shut down a significant number of clinical trials”, Heelan says. “They put the trials on pause to minimize exposure, but we designed a clinical platform for a 600-person study about the impact of exercise on diabetes and every one of our study participants could collect data from the comfort of their homes,” he says.
An app and connected devices pulled data from participants such as insulin and activity levels. “We provided that to the team of researchers that will publish articles on their findings,” Heelan shares.
Telehealth can allow for decentralized clinical trials and open the doors for more participants from across the country, Heelan adds. “With technology, clinical trials can continue to move forward as long as we employ ways of gathering data for the studies.”
Will Insurance Cover Telemedicine Visits?
One of the first questions patients want to know about telehealth is whether their insurance provider and Medicare will cover a virtual visit. The pandemic has triggered regulatory and policy changes that are important for providers and patients. Namely, the Centers for Medicare & Medicaid Services (CMS) expanded Medicare coverage of telehealth services. Before the COVID-19 public health emergency, 15,000 fee-for-service beneficiaries each week received a Medicare telemedicine service, according to CMS. Since March 2020, CMS added 144 telehealth services to coverage, including emergency department visits. Data from CMS shows that more than 24.6 million of 63 million Medicare beneficiaries and enrollees used telemedicine from March to October 2020. Currently, telemedicine is covered through the public health emergency.
Make the Most of Hospital Telehealth
You can leverage the convenience, efficiency, and safety of telehealth by:
- Asking your provider how to use the hospital’s online portal or see if there is a tutorial to help you get started.
- Considering virtual visits for appointments with counselors, psychologists, and other behavioral health specialists. The use of telemedicine in behavioral health increased by 50% according to a Teledoc Health 2020 Supplemental Survey.
- Leveraging remote monitoring devices if you are managing a chronic condition and your provider requires follow-ups to gather vitals.
- Expanding your provider options for specialty medical appointments by using telehealth to meet with providers outside of your region.
- Using telehealth as the first stop to get a checkup or evaluate a medical issue, then allow the provider to recommend whether an in-person visit is necessary.
After years of relatively slow adoption, the pandemic healthcare crisis shined a light on how telehealth can deliver a spectrum of medical and health services to the masses in an efficient, effective way—and it will continue to grow. “Hospitals will continue to see the value and benefit of it,” Haleen says.
- Medicare Coverage of Telehealth
- Center for Connected Health Policy
- America’s Health Insurance Plans
- U.S. Department of Health and Human Services
- American Academy of Pediatrics
- American Telemedicine Association
- American Medical Association, Telehealth
- U.S. Drug Enforcement Agency — Filling Prescriptions with Telehealth
- Centers for Disease Control & Prevention, Telehealth for Chronic Disease
- The National Consortium of Telehealth Resource Centers
- Teledoc Health
Medicare Part B will cover certain telehealth visits. The official Medicare site offers direction regarding coverage of telehealth visits, particularly during the COVID-19 public health emergency. For example, those with a Medicare Advantage Plan will not pay out-of-pocket for COVID-19 tests. There are more telehealth services than what was included in 2020 benefits. And, telehealth can be used for “medically reasonable purposes,” from offices, hospitals, homes, nursing homes and assisted living facilities. While some providers are reducing or waiving deductibles and coinsurance, that’s not a given.
Access the latest changes on a federal and state level and check out COVID-19 policy update videos. The Center for Connected Health Policy (CCHP) explains telehealth insurance coverage and includes easy-to-read charts that describe services, locations and other factors related to telemedicine benefits. A helpful telehealth resources section for consumers includes tools for analyzing bills, fact sheets, policy updates and videos.
Insurance providers are members of this national association, which is focused on improving the health and financial security of the insured. Telehealth updates, research and education is available through AHIP.
Learn about telehealth, find telemedicine options, and gain an understanding of billing and coverage from the U.S. Department of Health & Human Services telehealth hub. There is also a digital health directory where you can find on-demand telehealth providers. The resource was compiled by the Consumer Technology Association and American Telemedicine Association.
Learn what to expect from a telehealth visit and how the American Academy of Pediatrics is advising providers to deliver remote care. You’ll also gain an understanding of the difference between live virtual visits and asynchronous (or store-and-forward) care. While this resource is designed for providers, it’s also a helpful patient guide.
Telehealth basics from the American Telemedicine Association (ATA), founded in 1993, breaks down terminology, explains telehealth benefits and offers policy updates. Check out this resource if you’re looking for a comprehensive primer on what telehealth is and how it works.
A wealth of articles and updates related to telehealth from the American Medical Association (AMA) will help you stay up-to-date on the latest developments in the telemedicine arena. Also, doctors share what they wish patients knew about delivering telemedicine, and the perspective will help you prepare for a telehealth visit.
Can you get prescriptions refilled by using telehealth? Online prescribing is possible when patients have an existing relationship with their provider and have previously experienced an in-person visit. However, some leniency to this during the pandemic allows providers to prescribe controlled substances following a telemedicine visit.
Asserting that telehealth is here to stay, the CDC shares how virtual medicine can help patients struggling with chronic diseases including heart conditions and diabetes. Along with a guide of definitions to help you understand telehealth language, this CDC resource reveals how medication compliance, clinical outcomes and dietary goals can be improved by using telemedicine tools like texts, emails, apps and video calls.
This collaborative includes 12 regional and two national Telehealth Resource Centers that implement telemedicine programs for rural and underserved communities where the digital divide can form barriers to accessing telehealth services. Check out an informative webinar that explains the role of telehealth amid COVID-19, including how telehealth is expanding services to rural areas.
One of the largest telehealth apps is Teladoc Health, and you can learn how it and many other telemedicine platforms work. Teledoc links you to care providers who offer telemedicine visits, while some other apps are more focused on monitoring (heart rate, blood pressure, glucose), or wellness like achieving fitness goals.
These experts offered insight into telemedicine for hospitals:
Joseph Hall, president and CEO, Remedy Advisors
Matt Heelan, COO and vice president of business development, Illumisoft
- Sources [-]
McKinsey May 2020 COVID-19 Consumer Survey
Teladoc Health 2020 Supplemental Survey