While telehealth has been available for decades, when the COVID-19 pandemic emerged, an unprecedented demand arose for the remote delivery of safe and reliable assessments and treatment recommendations via computers, smart phones, and tablets (i.e., virtual care).
Over the past year, we have discussed telehealth and the potential risk exposure for clinicians with our Candello Community members. In May 2020, on a special member call, we were joined by industry experts who discussed the potential implications for patient safety/risk management, underwriting, and claims management. Key takeaways from that conversation are available in this blog post.
David L. Feldman, MD, MBA, CPE, FAAPL, FACS, Chief Medical Officer for The Doctors Company and for the TDC Group of companies (who joined us for the conversation in May 2020) spoke with us again in January 2021, for an update which you can watch here.
But as the height of the COVID-19 crisis appears to wane, what can we expect for the future of the virtual visit?
WEBINAR ABOUT VIRTUAL VISITS: A CONVERSATION WITH DR. JOSEPH KVEDAR
As the landscape of telehealth continues to shift and evolve, and as we look to the future beyond COVID-19, we invited Joseph C. Kvedar, MD to share his insights and expertise with our Candello Community. In the webinar, The Virtual Visit, Then, Now, and What Lies Ahead, Dr. Kvedar, Chair of the Board of the American Telemedicine Association (ATA) and Editor-in-chief of npj Digital Medicine, shared his thoughts about the impact of COVID-19 on telehealth and his perspective on the future of the virtual visit.
Dr. Kvedar began by sharing a telehealth taxonomy grid his colleagues at Massachusetts General Hospital Center for Telehealth developed to create a common nomenclature about telehealth visits and consults. This taxonomy helped level-set the conversation to talk about the tools and technology within telehealth.
While telehealth is appropriate for some care, it is not the right method for all care. Dr. Kvedar emphasized that it is a work in progress to determine what can be done via telehealth and it will differ by specialty as well as by the doctor and/or patient preference. But it all comes down to what information does a clinician need to make a diagnosis or care plan (and does the clinician need to touch the patient to get that done)? Some of the types of care he discussed included:
- Mental health
- Virtual urgent care (i.e., respiratory symptoms, sore throat, etc.)
- Follow up for chronic conditions, assuming certain information is available to the clinician like blood pressure readings (i.e., hypertension, diabetes, etc.)
Trends to watch that Dr. Kvedar addressed covered regulatory, including reimbursement, technology for HIPPA compliance, and licensure. He also discussed virtual visit "add-ons," for example home devices and digital biomarkers.
Of course a big question when discussing telehealth is addressing liability. He cited a JAMA study from 2019 in which study authors found no cases of medical malpractice that involved direct-to-consumer telehealth. However, the landscape is evolving so its important to understand that there could be potential risks and to minimize those risks. Some of the things he discussed to address this, while not an exhaustive list, included:
- Be aware of the tension around quality and convenience
- The importance of documentation
- Communicating effectively when a patient needs to be seen in-person
- Always check with your malpractice insurer before implementing a telehealth program
Watch Recording: Virtual Visits
About Joseph C. Kvedar, MD
Dr. Joe Kvedar has focused on driving innovation, creating the market, and gaining acceptance for connected health for nearly three decades at Mass General Brigham (formerly Partners HealthCare). He is now applying his expertise, insights, and influence to advancing adoption of telehealth and virtual care technologies at the national level. Dr. Kvedar continues to guide the transformation of healthcare delivery as a respected thought leader, author, and convener. Dr. Kvedar is a Professor of Dermatology at Harvard Medical School. He may be reached at www. joekvedar.com.