So, how is your independent practice getting along during our global pandemic? Did it survive, maybe even thrive? Unfortunately, many of your peers were not able to adapt and evolve. According to a discouraging June 2020 article in JAMA Network, small private practices around the country reported steep declines in revenues. The rise of telemedicine helped pick up a small portion of the slack, but 97 percent of the practices in a MGMA study reported that they had experienced a negative financial impact directly or indirectly related to COVID-19.
In April 2020, practices were seeing as high as a 55 percent decrease in revenue, and 60 percent decreases in patient volume. Business picked up as progress was made with vaccinations, but concerns are currently rising as the Delta variant appears to be equally bothersome. We do not want to have to resort to lockdowns and quarantines again, but many practices have better coping mechanisms with telehealth and EHR systems to help them continue providing care if our worst fears should be realized.
While medical practices rethought the way they provided care, patients were also starting to view healthcare services differently. Here is some of the latest information, presented from the patient’s point of view.
Surveying Health Consumers’ Changing Perceptions
From April through September 2020, PwC’s Health Research Institute (HRI) conducted a series of surveys to uncover insights about how and why specific groups of patients used health services during the pandemic, and their willingness to use them again in the future. It also surveyed health executives in August and September to gain their perspectives.
Summarized as “Consumer Health Behavior and the COVID-19 Pandemic: What Have We Learned?” these insights can provide direction to independent practices as to how they can become more patient-centered by redesigning healthcare for the people they serve. Integrating these indicators into your practice might be just the jolt needed to help it not only survive but thrive as we continue to wind our way through this very treacherous, long-term event.
PwC Survey Finding: “Consumers have grown bullish about receiving more of their healthcare at home.”
While this question was directly in response to the idea of a medical professional coming to the home in-person for a wellness, sick or chronic care visit, the foundation might be in place for transforming that to a virtual visit. More education and experience are needed to make the potential of remote care a reality, but COVID may have opened the door just a crack.
PwC Survey Finding: “Providers and consumers may be misaligned on how telehealth should be used.”
Perhaps out of desperation, or possibly because of CMS’ expanded coverage, more independent practices took on the challenge of integrating telehealth into their way of providing care. Some did it well, while others made missteps in communicating to patients.
Almost two-thirds of the survey respondents said they would be willing to use virtual care in the future, but there is a disparity between the types of services they would be willing to receive virtually and what provider executives thought would be most effective. Patients were most enthused about remote care for initial assessment and ongoing treatment of a condition, while only a small percentage of the executives thought they would be effective for these purposes. In contrast, the executives thought virtual care would be good for mental or behavioral health issues, but the patients were not as enthusiastic.
This could represent a missed opportunity in the way your independent practice provides telehealth services to patients. In addition to addressing more routine care needs, telehealth can also be particularly effective in serving patients with chronic care management issues, or those who are ignoring critical care needs because they are still too afraid to come to an office. Perhaps it is time to conduct a survey of your own patient base to determine their views, and then set up an implementation team within your practice to determine which types of virtual visits make the most sense for your specific patient population.
PwC Survey Finding: “New care settings get a lift from COVID-19. Will they become the new norm post-pandemic?”
American health consumers are becoming more accustomed to receiving care outside a traditional office visit. There was a definite positive increase in the receptiveness to virtual visits, especially among those over age 65 or with complex chronic care issues. But independent practices are also fighting increased acceptance for the retail clinic or urgent care center environment. It is important for the independent practice to prevent the newer care channels from becoming a disconnected source of healthcare. Educate your patients about the benefit of having a committed care coordinator at your practice that can orchestrate all aspects of their in-person and virtual care.
PwC Survey Finding: “18-24-year-olds have been most affected by the mental health impacts of COVID-19. Here’s where they are turning for help.”
Younger demographic populations appear to be experiencing more distressing mental health issues associated with life in a pandemic, but they are also willing to turn to newer delivery forms for guidance and support. They are open to the idea of a video telehealth visit with their primary care provider or mental health professional. Although they might seek help from online resources, telehealth mental health checks should be an integral part of care for practices that focus on pediatric and young adult healthcare.
CDC Guidance on Using Telehealth to Expand Access to Essential Health Services
In mid-2020, the Centers for Disease Control and Prevention was quickly beginning to realize that the landscape of medical care could be dramatically altered by using telehealth to provide virtual care during and beyond the COVID-19 pandemic. Although adaptation of telehealth had been slow before the pandemic, necessity and policy changes rapidly reduced physical and psychological barriers to telehealth care. Potential uses they saw for implementing telehealth as a means of providing a strong continuity of care include:
- Screening patients with potential COVID symptoms for treatment recommendations.
- Providing low-risk care for non-COVID-19 conditions.
- Enabling access to primary care providers and specialists, including mental and behavioral health professionals.
- Supporting chronic care management and medication management treatment plans.
- Removing the sense of isolation patients may feel as they deal with weight management, substance abuse, or mental health conditions by providing ongoing coaching and emotional support.
- Offering video sessions to support physical therapy, occupational therapy, and other modalities when in-person treatment is not an option.
- Using remote patient monitoring to measure and transmit data for specific chronic medical conditions.
- Extending care to hard-to-reach patients, such as those in remote settings, or those with mobility issues.
- Following up with patients after hospital stays or emergency care visits.
- Supporting interoperability to maintain levels of care and communication with other medical providers and medical care specialists.
Strategies to Increase Telehealth Acceptance During COVID
It appears we are a long way from seeing the light at the end of the COVID tunnel, so telehealth will probably continue to be an accepted method of delivering patient care for the foreseeable future. Here are some strategies you can use to implement telehealth as a part of your patient-centric healthcare delivery mechanism:
- Determine when in-person care and virtual care options are appropriate for your patient population.
- Understand the availability of covered telehealth services and provide clear definitions to patients.
- Strategically engage your patients to maximize the impact of your telehealth services. Develop an outreach system to contact patients with limited technology and connectivity capabilities. Offer local community options or discuss non-video options as needed.
- Continue to stress the value propositions of convenience, communication, saving time and money on office commutes, removing transportation barriers, better management of chronic conditions, reduced risk of contagion, and increased access to specialized care.
- Constantly touch base with patients to assess how they feel the telehealth program is going and solicit their input for any improvements you can make.
- Work with a vendor like Amazing Charts that understands the needs of patients and medical professionals. Our solutions can help your practice negotiate the path to implementation with ease and efficiency.
Examples of Success in Meeting Patient Health Needs During COVID
A “Practice Spotlight” feature in the AMA® Telehealth Implementation Playbook tells the story of Edwin, a telehealth lung cancer and COPD patient. His doctor uses telehealth to cut down on the number of in-person visits and decrease time between testing and action. Instead of the usual lapse of a week or two after blood tests or scans are taken, Edwin and his doctor connect via telehealth only a day or two later, allowing them to make faster adjustments to his medication and treatment plan. Previously these visits were also tied to some type of treatment, but removing that association allowed the patient to become less distracted, ask questions, and feel more engaged in his care.
An interesting NPR article on “How Health Care in the U.S. May Change after COVID: An Optimist’s Outlook” featured an interview with Dr. Shantanu Nundy, who is a primary care physician practicing just outside Washington, D.C., and the chief medical officer at Accolade, a company that helps people navigate a health care system that they often feel is much too confusing. Dr. Nundy shared a personal story about his mother’s experience during the pandemic as a way of providing a glimpse into what is possible with changing attitudes toward health care.
The doctor’s mother struggled with Type 2 diabetes for 25 years and was on insulin for the last 10 years. Concerned about the higher risk of diabetic COVID complications, she enrolled in a virtual diabetes service. The service sent her a glucose meter and scale to obtain data which she sent to a diabetes care team. Regular televideo visits were held with a doctor, and she also had 24/7 access to a health coach who she could message with questions or concerns. Another patient connection provided her with moral support and dietary guidance. Within a very few weeks, she managed to lose over ten pounds and safely get off insulin. Nearly a year later, she still has her diabetes well under control.
Post-pandemic predictions from the Arizona Telemedicine Program include:
Telemedicine will Become a Standard Service Offered across all Care Settings
Some 50 percent of healthcare executives interviewed thought at least a quarter of all preventative care, outpatient care, long-term care, and well-being services would be managed through virtual delivery by 2040.
Telemedicine will Become an Efficient Option for Preventative Care
Nearly half of U.S. adults have a chronic disease, while almost one-third are living with more than one chronic disease.
Patients will Make Medical Choices Based on Telemedicine Access
This particular prediction cited the results of a survey conducted by Doctor.com, which showed that almost 83 percent of patients are quite likely to continue using telemedicine, even after COVID-19 subsides.
Patient expectations and consumerism in healthcare have changed dramatically during the COVID pandemic. Technology and medical support systems are rapidly evolving to support independent practices as they fight to survive and provide the highest levels of medical care. Examples of advanced solutions from Amazing Charts that can take your practice to the next level of evolved care include telehealth services, Electronic Health Records (EHR), Virtual Preventative Care Assistant, and our Medical Billing Service. We help independent practices thrive by providing easy-to-use solutions for delivering patient care that match your patients’ evolving views about the way they receive that care.
Healthcare Technology Solutions Designed By and For Independent Practices
Amazing Charts was founded in 2001 by a practicing family physician to help medical practices thrive. We have grown consistently since then by creating easy-to-use solutions for delivering patient care. Today, we offer a variety of additional capabilities designed to help independent practices succeed, including Electronic Health Records, Practice Management, Billing Services, Population Health and Remote Care. Call 866-382-5932 to learn about our products, schedule a practice consultation, and learn more about telehealth pandemic lessons that can help your independent practice grow.
