Telehealth and RPM – 2023 Health IT Predictions

Telehealth and RPM – 2023 Health IT Predictions John Lynn

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions.  We asked the Healthcare IT Today community to submit their predictions and we received a wide ranging set of responses that we grouped into a number of themes.  Check out our communities predictions below and be sure to add your own thoughts and/or places you disagree with these predictions in the comments and on social media.

Check out our community’s telehealth and RPM (Remote Patient Monitoring) predictions.

Dr. Reza Hosseini Ghomi, Chief Medical Officer at BrainCheck
Digitally-enabled care is the future of telehealth – “telehealth” has become industry norm since the start of the pandemic and used as a catchall term for everything from virtual doctor’s appointments to at-home testing kits. What’s most important and impactful about telehealth is the technology’s ability to enable care and improve accessibility.

For cognitive health, specifically, digital cognitive assessment tools have made access to baseline cognitive resources more widely available without removing healthcare providers from the care model (a common point of criticism in response to telehealth and the “DIY health economy”).

In the year ahead, we can expect to see continued traction in telehealth; however, it’s the resources and technology that enable clinicians to be more successful that will truly move the needle. An end to the Public Health Emergency (PHE) is likely to be announced and end mid-January followed by a grace period of approximately 5 months. With the end of PHE, clinicians and patients will need clarification on the rules regarding telehealth.

Ankit Gupta, CEO at Bicycle Health
The past two years have taught us that telemedicine is a highly scalable and successful way to deliver quality healthcare across the United States. We have seen unprecedented growth in the digital healthcare space and this momentum will only continue in 2023 – bringing more innovation, smarter technology, and impactful legislation and business initiatives.

Here are six telehealth predictions for the New Year:

1. Legislation and a key policy amendment will advance access to telehealth. There is mounting pressure by lawmakers and major stakeholders for the U.S Drug Enforcement Administration (DEA) to collaborate with the Department of Health and Human Services (HHS) and enact a special registration process under the Ryan Haight Act that would enable physicians to prescribe controlled substances via telehealth without a prior in-person exam. And with the Public Health Emergency (PHE) set to expire in January, stakeholders are urgently calling upon Congress to pass the Advancing Telehealth Beyond COVID-19 Act of 2021. Both are life-saving measures for delivering mental and behavioral health services and treating people with substance use disorders.
2. Fight for quality investors. Digital health startups banked a record-breaking $29.1B in 2021. With the market downturns we’ve seen in 2022, that trend will shift. Digital health companies that can’t demonstrate momentum in terms of growth, engagement or evidence-based clinical outcomes will struggle to find funding in 2023. Investors are going to be looking for good outcomes, good economics, and a path to profitability.
3. M&A will also be a bigger factor in the digital health landscape next year. Following from the previous comment, in markets where there is considerable competition — like digital therapeutics for behavioral health, for example — expect companies to merge in order to consolidate resources and increase market share. I think we’ll see an uptick in consolidations in crowded arenas like DTX and telehealth.
4. Telehealth will transform how we address chronic conditions. Chronic disease is the leading cause of death and disability in the United States. Two of the biggest blockers for patients trying to better manage their health are the costs and logistical hurdles associated with physician visits. Finding time to get to the doctor is a challenge. Conditions like COPD, hypertension, diabetes, cardiovascular disease, and kidney disease can be effectively managed via telehealth. At-home and wearable devices connected to the patient’s EMR reduce the number of physician visits and allow for medication adjustments as needed, resulting in better disease control at lower costs. Earlier this year, a Harvard Business Review article cited a Kaiser Permanente study that showed members in California and the mid-Atlantic region with access to virtual primary care were 14 percent less likely to die from stroke and 43 percent less likely to die from heart disease. Telehealth reduces cancellations, allows for staff to be more efficient and makes it easier for people to access care. In the area of substance use disorder, stigma is a major roadblock that telehealth overcomes. Studies show that people who can access behavioral healthcare virtually stay in recovery longer.
5. More payors will contract with national/multi-state medical groups. Telehealth offers administrative and cost-savings benefits for payors that enter contracts with national or multi-state medical groups. With virtual providers, it’s easier to establish reimbursement rates for patient services across state lines. This significantly reduces the varying cost, logistical, and administrative factors associated with providing coverage for different local medical groups.
6. I expect employers and leaders in every industry to get more involved in combating substance use disorders and mental health challenges. The Leidos-Milken partnership in spring 2021 launched a collaborative initiative aimed at bringing together leaders in the private, government, academic, and nonprofit sectors to address the national opioid epidemic and mental health crisis. Since then, the Milken Institute Center for Public Health has been a resource and motivating force for employers to tackle substance use disorders and other mental health challenges, helping to destigmatize these issues impacting so many Americans today. We will see more leaders provide resources for their staff in new, innovative ways – with telehealth continuing to be one of the driving forces behind the solutions.

The pandemic brought forth an era of unprecedented challenges in how we deliver and do business in healthcare. By continuing to learn from the innovators and embrace the benefits of telemedicine, we can bring substantial advancements to a more value-based, cost-effective, and sustainable healthcare system in 2023.

Rachel Disselkamp, Senior Director of Healthcare Solutions at Skedulo at Skedulo
In 2023, I predict that telehealth and remote patient monitoring will continue to grow in focus and investment. These high-profitability, scalable options help healthcare organizations both provide different services and sustain higher levels of patient engagement, while also offering more flexible work options to a workforce that has largely been excluded from the shift to “remote work”.

More healthcare organizations are shifting from a purely episodic care mindset to a care continuum strategy. This invites a more holistic, long-term approach to treatment, necessitating a higher-touch experience between patient and provider. Facilitating this requires new modes of meeting the patient when and where is convenient for them, and ensuring limited gaps or delays in care.

Logging in for a telehealth appointment may be easier for some patient populations than driving to a facility. Similarly, remote patient monitoring helps providers understand the right times to intervene rather than sticking to an arbitrary schedule or waiting for an episode to occur.

Dan Trigub, co-founder and CEO at MedArrive
I believe that healthcare has begun, and will continue, to move into the home, which will ultimately become the “hub of care.” To make this a successful endeavor, given the economic environment and the potential for a recession (assuming we are not already in one), we must focus on building sustainable, profitable/margin-positive businesses. It’s no longer possible to build these businesses on just topline growth and hope you can figure out unit economics in the future; rather, you have to think about building sustainable businesses from day one. Now more than ever, that should include building high-functioning, high-caliber, and diverse teams while being fully remote and not centralized in one main office location.

One thing I found surprising this year is that health equity still remains a big area of focus/concern for Payers and Providers. What’s more, concerns over clinician burnout and shortage of healthcare labor occupied the headlines – though with more options than ever for care at home, patients increasingly can find the medical attention they need outside of the hospital. Finally, patient mental health and emotional well-being became more of a focus for businesses – and consumers – showcasing the need to humanize healthcare.

Carlene MacMillan, MD, VP, Clinical Innovation at Osmind
There will be a shift away from D2C telehealth platforms and toward Care Ops management for clinicians and admin staff, due to the failure of a lot of telehealth companies to continue to attract customers and the number of clinicians leaving the field due to burnout. We believe better Care Ops technology in EHRs and Practice Management Systems are a better long term bet than standalone telehealth or symptom tracking point solutions.

Susa Monacelli, General Manager at Propeller Health
Implementing new CMS codes: Beginning January 2023, remote therapeutic monitoring (RTM) services can now be furnished under general supervision as opposed to direct supervision, making remote monitoring more practical for health systems and, as a result easing the mounting physician burnout. Additionally, CMS (Centers for Medicare & Medicaid Services) will repeal the patient data collection requirements needed to bill certain RTM codes, removing a substantial barrier to billing and making it easier to adopt remote monitoring solutions for patient care.

Attaining health equity: Three new Joint Commission measures will require health systems to execute more focused and structured approaches to attaining health equity, opening the door for digital health solutions to play a major role in achieving equitable healthcare across populations. We will also see updates take effect to ACO memberships and ACO Reach models, creating an opportunity to further expand value-based care and focus on health equity.

Integrating digital health solutions into EHR: To reduce the administrative burden on providers, it will be critical to integrate digital health solutions into mainstream EHR platforms. Additionally, health systems must continue working with and expanding partnerships with digital health companies to meet the growing demand from patients and providers looking for telehealth options and support.

Omri Shor, CEO and Founder at Medisafe
I believe that incorporating digital health tools earlier in the prescription process and combining digital with traditional medication therapy will increase in 2023. As more digital medication management solutions gain FDA approval, there is an increased opportunity to integrate digital support as part of the medication process and reduce medication abandon rates.

Wayne Johnson, Vice President of Special Operations at Sunwave Health
Remote care is here to stay: This next year will likely see the codification of telehealth and a rise in remote and home-based care across all healthcare sectors. While there is some ambiguity about the final state of telehealth following the public health emergency (PHE), there has been a significant movement to congeal aspects of telehealth policy that apply to SUD. In particular, the finalized 2023 PFS rule permanently extends the PHE allowance for opioid use disorder treatment programs to begin medication-assisted treatment through telehealth.

Moreover, America’s Health Insurance Plans (AHIP) is leading the call for private payers to embrace telehealth to expand SUD access and address barriers to care. Additionally, remote patient monitoring continues to expand. A quarter of US adults will be treated with remote patient monitoring tools in 2023. And the payer community sees remote patient monitoring as a critical component of SUD care.

Elder care takes center stage and brings challenges: Coined the “gray tsunami,” approximately 10,000 people per day cross the Medicare eligible threshold. And by 2030, all boomers will be at least age 65. This increase in older patients requires adaptation for SUD providers to meet complex barriers to care and clinical requirements. As patient populations mature and their needs grow in complexity, behavioral health practices require implementations that simplify processes, automate requirements, and bring efficiency to well-worn foundational operations to meet the demands and complications of this aging wave on the horizon.

Roozbeh (Rooz) Ghaffari, CEO & Co-Founder at Epicore Biosystems
2023 will be a pivotal year for diagnostic wearables. As new classes of devices will move beyond biometrics and increase support toward understanding the underlying metabolic biomarkers, support for these novel biochemical metrics will see uptake and new products will enter the market. In the more distant horizon, we will begin to see a convergence of multiple biochemical and biophysical markers.

Chris Sullivan, Global Healthcare Practice Lead at Zebra Technologies
Interest in telehealth – and the emergence of new use cases inside hospitals and clinics – will continue to grow. The rise of telehealth (or telemedicine) during the pandemic has proven that virtual care can still be quality care. Heightened visibility into the potential of telehealth, chatbots, and remote patient monitoring have healthcare providers trying to determine the right care model and service delivery balance moving forward.

Though most people think of telehealth as a provider consulting with an at-home patient, expect to see more inpatient oversight via telehealth through 2023. In both scenarios, high volume telehealth utilization will drive greater use case sophistication – combining communications, asynchronous video and AI applications. Traditional telehealth will also continue to gain traction outside the hospital throughout 2023.

In the past two years, healthcare providers have seen just how much they can impact people outside the local communities they normally serve. Telehealth has given new meaning to the phrase “doctors without borders,” as clinicians are now available 24/7/365 to conduct routine checkups and triage medical crises. Additionally, beyond increasing care access for billions of people in both developed and mobile-first nations, telehealth has increased the convenience and comfortability of care for patients everywhere. People no longer must go to the hospital or clinic for every appointment – or to get a prescription renewal or specialist referral. And they no longer must be concerned with commuting or wait times. They simply need to be virtually accessible for their scheduled appointment.

Dr. David Feldman, Chief Medical Officer at The Doctors Company
Telehealth is here to stay: Despite the end of the Public Health Emergency Act, we can expect telehealth to remain a fixture of the way care is delivered. However, we can also expect telehealth usage to decrease over the next year as patients return to the doctors for in-person consultations and treatment. When providing telehealth, physicians need to remain vigilant, check their licenses, and understand the care they can provide to patients remotely and when to refer to a local provider.

Be sure to check out all of Healthcare IT Today’s telehealth and RPM content and all of our other 2023 healthcare IT predictions.