Telemedicine And Telehealth In 2023 And Beyond: From Leveling Out To Leveling Up
Telemedicine And Telehealth In 2023 And Beyond: From Leveling Out To Leveling Up Jiang Li, Forbes Councils Member
Jiang Li, Ph.D., is the Founder and CEO of Vivalink, Inc.
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Projecting what’s next for telehealth isn’t linear. Progress doesn’t always come in a straight line. It instead proceeds through ups and downs. We all know telemedicine is more common today than just a few years ago. The Journal of the American Medical Association said telehealth visits increased from 840,000 in 2019 to 52.7 million in 2020 during the pandemic. In 2021, 37% of adults used telemedicine, according to the Centers for Disease Control and Prevention (CDC). Telemedicine has made important strides, but 2022 marked a plateau in many respects. What has to happen next to help advance telehealth from leveling out to leveling up?
We have to examine each step as an investment. Robert Louis Stevenson said, “Don’t judge each day by the harvest you reap but by the seeds that you plant.” The groundwork of the last few years is foundational to potential progress in 2023 and beyond. Looking ahead to the coming year, we can start to formulate probable advancements by examining the current pain points and determining how we can best address them.
There are multiple elements to the full picture. There’s remote patient monitoring (RPM), there are decentralized clinical trials (DCT) and there’s telemedicine. These are somewhat intermingled, and each can positively influence the others. Let’s examine some of the primary challenges surrounding them so we can prepare for what’s coming next.
Assessing The Components Of Telemedicine
A key component of successful telemedicine is remote patient monitoring. RPM consists of connected medical devices and sensors, mobile devices and cloud platforms to monitor and store data—and software to analyze the information. As far back as 2014, there was a big movement for personal wearable devices. On the personal side, we’ve seen Jawbone, Fitbit, Apple Watches, etc. But the reality is that a decade later, some of those are nonexistent, and others still don’t provide medical-grade information. There’s always a new wave on the consumer side, which definitely plays a role in patient awareness, but medical-grade devices are necessary for real progress. As patients become more comfortable with devices, sensors will get smaller and more efficient, driving patient adherence, but the devices aren’t the problem. Beyond the actual hardware, the technology must be agnostic enough to seamlessly integrate into a viable data collection, delivery and analysis system.
Going forward into 2023, integrating that technology is key to alleviating another challenge for independent providers, healthcare systems and those entities that conduct clinical trials. A shortage of qualified people is a major obstacle across the board. Forbes cited a “Clinicians of the Future” report by Elsevier Health that said 56% of clinicians think they will use artificial intelligence as the basis for clinical decisions within 10 years; however, almost 70% say they also find digital health tech daunting. So when it comes to implementing virtual health technology, that staffing shortage presents a unique dichotomy—better technology helps providers be more efficient, but it requires qualified people to make it work. Quality tech can help provide distilled information specific to a particular therapeutic or condition, presented in a way that’s understandable and actionable.
Next year should focus on experimentation with new methods. It should be a year for people to expand virtual care. An American Medical Association (AMA) editorial regarding projected physician shortages of 37,800 and 124,000 by 2034 specifically cites telehealth and the broader use of technology as potential solutions. To help reduce the burden on practitioners, the technology must be available and accessible. There’s a macro trend of using AI technology in disease diagnostics, which is still in the early phases, but there’s viability for disease prediction as data sets are more robust, and the algorithms improve. Using remote capabilities to offer care at home or in skilled nursing facilities are options now, but as technology becomes more commonplace in different care segments, we can learn which will work long-term to benefit both patients and providers.
The bottom line for any hope of progress must include just that—consideration of the bottom line. Reimbursement codes often influence the pace of progress. Changes were implemented during the pandemic, and the Centers for Medicaid and Medicare Service (CMS) announced another series of new codes for telehealth home services effective as of January 2023, but more is needed for widespread use. However, the lessened focus on the Covid-19 health emergency could lead to some negative impacts on the reimbursement side for virtual health care. Overall, most of the technology and service providers will try to ride on the existing reimbursement codes while implementing more advanced technologies for better patient care.
Value Of Virtual Care Beyond Telehealth
For providers, telehealth services can broaden access to care, and digital technology can reduce the number of people necessary to personally monitor vitals for awareness and diagnosis. For the pharmaceutical industry, it reduces the need for in-person monitoring by facilitating a data stream to a centrally located hub. In time, that shift to decentralized clinical trials or hybrid models, with both in-person and at-home participation, represents a change to the commercial landscape. The timeframe for that shift should come in the next year or so.
In the complex machine that is the pharmaceutical industry, the value of technology must be clearly verified before it can be adopted, which takes time and proven evidence. The study sponsors and the clinical research organizations (CROs) running the trials don’t often move quickly to adopt new processes. Technology is no different, so I expect more of a moderate pace in the next year than seismic shifts.
There are already plenty of seeds planted to help telemedicine services grow beyond the current level. But no single element is going to drive considerable progress. It will take complementary advancements in technology, application and use to see a real difference. There’s no turning back; telehealth is part of the healthcare ecosystem and should continue to become more fundamental. Progress can move as quickly as those who develop and use the technology allow.
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