The pandemic has proved that patients like to receive care remotely, opening up a huge wave of innovation in virtual care. This digital-first revolution in healthcare has the potential to increase access and patient engagement while reducing glaring inequity. This monumental shift, however, impacts existing reimbursement models and puts pressure on hospitals and health systems to adapt quickly while maintaining high quality and compliance with patient safety and privacy regulations.
The first wave of virtual care was basic functionality: communication with patients via secure chat, video, photo uploads, and text. The current wave of innovation is the rise of digital-first clinics with a primary care focus. In the next wave, implementation of consumer-friendly, effective digital solutions and programs for specific chronic diseases will mature. Our industry’s challenge will be to assure that we integrate human engagement and virtual technologies without sacrificing healthcare outcomes.
The Growth and Promise of Remote Therapeutic Monitoring
The good news for providers is that more types of virtual care are now reimbursable thanks to new rules created by CMS. For instance, by recently approving a new set of reimbursement codes for Remote Therapeutic Monitoring (RTM),1 CMS has made it possible for health systems to get paid for a wide range of virtual therapeutic encounters.2 RTM also provides reimbursement mechanisms for digital programs that help patients follow “doctor’s orders” in between appointments—including taking medication properly.3
One area that has not progressed as quickly as others is the use of artificial intelligence in virtual care. To go beyond fairly simple algorithms and truly improve outcomes, we need larger data sets and more granular patient-level data. The problem is that much of our healthcare data remains siloed. Also, so much of what influences health takes place outside of traditional healthcare settings.
We know, for example, that half of patients do not take their medications as prescribed. This leads to death and preventable hospitalizations, among other terrible outcomes. Yet we do not employ the data systems and technologies to track the exact causes and cadences of medication non-adherence.
While COVID-19 pushed us to digitize healthcare interactions, there is hope that innovations such as RTM will provide the incentive needed to manage patient health in between physician visits.
References:
2. https://emocha.com/how-cms-is-boosting-telehealth-and-rtm-with-new-cpt-codes.
3. https://emocha.com/evidence-based-medication-adherence-interventions.
