Consumers continue to need healthcare services during a pandemic and need access to providers that can answer their questions, diagnose, and provide guidance and treatment. This is a challenge as patients will resist coming to providers and providers want to avoid unnecessary exposure both for themselves (and family) as well as their patients[14].
Providers are critically impacted in two ways. First, they are unable to provide the care they want and need to provide to their patients, and second, financially as their revenues are reduced significantly from both appointments and associated diagnostics, procedures, etc. The COVID-19 pandemic experience is showing significant impacts due to isolation from care and the failure to deliver ongoing care. Example: deaths due to CHF increased substantially during COVID 19, and the majority of these deaths have been attributed to a breakdown in the continuity of care.[15]
One effective solution is to see patients virtually for urgent care, primary care and specialty consultations (where in-person examination is not required) using on-demand and scheduled telemedicine solutions.[16] Urgent and initial consultations are occurring more and more through “direct to consumer telemedicine” services and platforms. This creation of a “Digital Front Door”, already adopted by many organizations pre-pandemic, is a fast-growing area of convenient access to healthcare for day-to-day operations whether there is a pandemic or not. This trend increased substantially (over 700%) during the COVID-19 pandemic and any future pandemics will demand the same type of services.
Implementing such telemedicine capabilities in place may not only increase organizational market share in a competitive world but it will become an easily deployed business continuation strategy when a future pandemic strikes. This type of platform also provides surge capacity by allowing as-needed access to the physicians on the platform as well as a potential staff replacement strategy for critical specialists and other healthcare staff who are absent due to exposure, illness, or deployment elsewhere.
On-demand and scheduled specialty consultations can also be delivered through the same type of telemedicine platforms. Many of these platforms can be integrated into the EMR. (See TTAC report: On-Demand/Direct to-Consumer Telemedicine).
Direct-to-consumer capabilities in three ways:
- Buy the service from a current provider.
- Offer the service yourself using the healthcare organization’s own providers and using an available telemedicine software platform.
- Implement a hybrid approach using your healthcare organization’s providers when available and augment services by using the providers from an outside service when needed.
Another method to provide care is to move more care into the home. (See Critical Issue #7)
Ideas:
- Choose a video platform that will be used for remote care and standardize it across services. Consider the availability and usability to the patient/consumer.
- Implement some form of remote scheduling system for making appointments now in your normal course of business.
- Encourage providers to conduct remote follow-up visits via telemedicine
- Implement direct-to-consumer urgent care online telemedicine as a normal course of business and as a method of preparing for a crisis situation.
- If possible, implement a complete direct-to-consumer telemedicine solution.
- See the TTAC Direct-to-Consumer Telemedicine Assessment.