Tom Sullivan | December 16, 2020
The rise of telehealth during 2020 was among the most surprising and dramatic technology accelerations not anticipated prior to the pandemic.
While some organizations reported more than 10,000 percent increases in April and May, telehealth utilization rates have since settled down. Even still, they remain at levels notably higher than before COVID-19. And while it’s too early to know what the lasting percentage of care delivered via telehealth technologies will ultimately become, the substantive questions now are what new opportunities will the increased telehealth usage open? How will those ultimately contribute to the betterment of health care in a system that is more affordable, accessible and equitable?
To address those questions, Health Evolution Editor-in-Chief Tom Sullivan interviewed Danielle Rusella, President of Strategic Partnerships at Amwell during the webcast, The future of telehealth: virtual care, provider enablement, and improving equity.
What follows is an abridged version of the interview. A link to watch the video on-demand is at the bottom of this article.
Health Evolution: The increased utilization of telehealth has been a significant storyline of 2020, at least in health care, but what are some of the lesser-known lessons learned during the pandemic?
Russella: Let me give you some of the top ones. I think the emergence, and perhaps better said the proliferation of, hybrid care models have become more understood. Virtual primary care would be a great example of hybrid care. This is the stitching together for the consumer in a very profound way of virtual and physical care, because it is not just one episode but an ongoing care experience.
That leads into my next point, telehealth’s role in enabling longitudinal care more comprehensively, from injury to illness to chronic disease, in some cases, end of life, in clinic, and hospital. We have providers that are now trained and clinic staff that are trained, to get patients set up with telehealth and apps, so that they can have their follow-up visit using technology. The wide range of use cases was under our noses this whole time, and amazing things were already happening, but there was still some reluctance to push the boundaries.
Another is telehealth’s role in helping to keep providers safe, but it isn’t just providers or doctors. Case managers, coaches, social workers, customer service reps, advocates and support staff — they all got online, too, and offered patients and consumers a more personal immersive experience. Overall, it’s really about understanding the broad range of caring that could be accomplished utilizing telehealth.
Danielle Russella, Amwell
Health Evolution: Following that, what are some of the unique telehealth use cases that have emerged in 2020 that are not discussed as much as triage and emergent care?
Russella: Even before the pandemic we had 100 plus different use cases. So as you can well imagine, there were already a fair amount of what we would call unique use cases out there in the market. To me, the permutations have truly become limitless. But, in 2020, we saw creativity take new form from surgical recovery to infectious disease to isolation comfort, to mental illness, and support for adolescence, to cancer recovery, and chemotherapy support. These are some really very specific use cases and in many instances, they included virtual care teams that consisted of more than just a provider or a doctor, they included nurses, nutritionists and specialists.
Health Evolution: From your vantage point, how are you seeing payers and providers come together to address the digital divide and use telehealth to advance equality and equity in health care?
Russella: I’ll give you an example. United Health Care’s Health Plan of Nevada and Optum’s Southwest Medical Associates, both in the state of Nevada, are an excellent example of payer and provider collaboration. The two organizations have come together since 2013 when they launched NowClinic. They serve approximately 800,000 members across Medicare, Medicaid, and commercial. They had 50 Southwest Medical providers on the system serving this population when the pandemic hit. In March and April, because these two partners had already seen successes and really understood the impact of what they could do engaging members in terms of utilization, optimization, lowering costs and being more effective, they brought on more than 500 new providers in, literally, a matter of weeks to deliver added care demand. The big hockey stick effect. And in 2020 alone, we’re going to see this this group do more than 110,000 visits. Now, in the health plan’s book of business, growing numbers of specialty visits and scheduled visits and use cases are covering over 20 areas of specialty. This is collaboration at its finest between a provider and health plan where each knows the membership well and engages with that membership. That is offering an incredibly valuable benefit — and, importantly, it’s a relationship with a multi-specialty clinic making them part and parcel of how those providers can deliver valuable services to the membership.
Health Evolution: What are the key virtual care trends you see emerging relative to telehealth as the world moves beyond 2020 and the pandemic? And at what point do we stop talking about it as virtual care or telehealth and just consider it part of everyday care?
Russella: We always believe telehealth is, at the end of the day, it’s just care. It’s not replacement. It’s not online. It’s not virtual. It’s not digital. It’s delivery of health care services. So we subscribe to that whole–heartedly. To me, the big aspects that I see emerging right now are the hybrid care models around virtual primary care, that fully integrate the physical and the virtual world in a very meaningful, immersive and continuous way. That is a model and a path forward. Another is the expanding role of connected devices in the home. Think of connected TVs. There’s so much that we can be doing in the home, where most of us want to access care. So, I think the expanding role of devices and other connectivity in the home setting is something we can’t ignore because it will come from natural extensions to other programs, services, portals, and online places. There’s going to be many more digital front doors often not even affiliated with a provider, health system or health plan. Virtual health care services that will be connected are going to be behind those doors — and they’re going to connect us back to providers we know, plans we have a relationship with.