Tech Companies Are Transforming People’s Bedrooms Into ‘Virtual Hospitals.’ Will It Last Post-COVID?
Hospital-style care iTelehealth options exploded during Covid, but will insurers continue to pay for it when it's over?
, a nonprofit that analyzes private health insurance claims. More than nine million Medicare beneficiaries used telehealth services during the first three months of the crisis. And at University of Virginia’s network, which already had a more robust telehealth program than many others, virtual visits increased 9,000% between February and May.
“COVID-19 changed everything when it comes to telemedicine services,” says Dr. Karen Rheuban, director of the University of Virginia Center for Telehealth. “The genie’s not going back in the bottle.”The Trump Administration is now pushing for more telehealth access. On Aug. 3, the President signed an executive order calling on CMS to permanently expand the kinds of telehealth services that Medicare covers, and the agency’s administrator Seema Verma has also said she believes access to telehealth should continue beyond the public health emergency. Broader expansions would need to come from Congress, where dozens of bills on telehealth have been introduced in recent months, but lawmakers have not yet seriously considered the topic.
Curtis Carlson and his family at their home in Ukiah, California.Courtesy of Adventist HealthTelehealth advocates say now is the time to act. A range of virtual offerings could be revolutionary for patients who are seriously sick, need long-term care, or live in rural areas, where hospital closings have left millions of Americans without easy access to treatment. “The environment in a hospital, although it’s very conducive to high intensity care, is not that conducive to being able to engage in normal activities of daily living that might be actually important for recovery,” says Dr. Michael Apkon, president and CEO of Tufts Medical Center.
In March, when Apkon watched Italian hospitals overflow with coronavirus patients, he sped up Tuft’s long-simmering telehealth plans. Apkon called Raphael Rakowski, the CEO of the tech startup Medically Home, and by April, the two organizations had launched a program that would provide hospital-level care in patients’ homes. Rakowski says he’s spent years telling hospitals they could reduce overhead costs and improve the patient experience by embracing care at home. “Sadly, it took a pandemic to amplify the patient’s role in their own care,” he says.
In order to be eligible for the Tufts-Medically Home partnership program, patients must typically have a similar profile to Curtis Carlson: they must have relatively stable health, be suffering from common conditions such as heart failure, diabetes, pneumonia, or kidney infections, and they must have a safe, stable place to live. If a patient meets that criteria, Medically Home provides all the equipment, including communications devices, monitors, backup internet, cell signals and power sources. (Some locations are admitting patients such as those with cancer, COVID-19 or who need longer-term care, and over time those will grow, says Rakowski.)
In Boston, where Medically Home is based, the tech company itself employs nurses, paramedics and other staffers who visit the Tufts patients in person several times each day to administer IVs, do blood tests or provide other care, and the patient checks in with their doctors via video. In California, where Carlson was treated, and in other locations, Medically Home’s partner hospitals provide the staff. Teams of nurses and physicians also monitor each patient 24 hours a day from a “command center,” and can be reached immediately if any questions or complications arise.
Even accounting for the time and cost of staff traveling to visit patients at their homes, Rakowski says at-home hospitalization costs about 20 to 25% less on average than care in a traditional hospital setting. In California, where Carlson was one of Adventist Health’s first patients to use the Medically Home model, Adventist Health President Bill Wing sees significant savings in the future. Maintaining hospital facilities and building new infrastructure is very expensive, he notes, so if Adventist Health can care for more patients remotely, it could potentially avoid hundreds of millions in construction costs.
“I believe that longer term we’ll see at least 20 percent less utilization inside the four walls,” Wing says. Adventist Health had been considering building a couple new hospitals, but may no longer pursue those plans, he says.Keeping patients healthyRead more: TIME Health »
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