Digital perspective: COVID accelerates healthcare without walls
As healthcare moves outside the walls of traditional healthcare organizations, patients inevitably will seek care where and when they need it.
The following article is excerpted from a blog published by the Providence Digital Innovation Group.
In the past, when you got sick, you went to the doctor, the hospital or another healthcare facility to receive the care you were looking for. With distributed care, many of the services you need come to you instead.
Distributed care is about decentralizing healthcare services—such as monitoring vital signs or diagnostic testing—and putting them closer to you, the patient. In some cases, that may mean adding virtual or telehealth capabilities. In others, treatment is available at convenient locations such as pharmacy-based clinics or urgent care centers. Innovative technology that lets you monitor and test from nearly any location also plays a vital role in making distributed care a reality.
“The basic concept of distributed care is that, historically, care has been locked inside the hospital and inside the clinical office. That’s where all care, more or less, takes place,” said Matt Cohlmia, executive director of digital strategy at Providence. Cohlmia is the editor of the Digital Perspective, “Where Does Health Happen?”
“We know, however, that the healthcare facility is not where health happens,” Cohlmia writes in his report. “If the healthcare system is going to transition away from being a ‘sick care’ system, care must extend beyond the four walls of the clinic to become Distributed Care.”
Removing the barriers to care
The trend towards distributed care began long before COVID-19 made an appearance, but the pandemic dramatically shortened the timeline for adopting new ways to deliver and access care.
As the healthcare industry struggled to balance the ever-growing demand for services with shelter-in-place requirements and social distancing, several of the barriers to distributed care began to crumble, according to Cohlmia.
Pre-pandemic, most insurance companies either didn’t reimburse or reimbursed at a different rate for care that happened outside a traditional healthcare setting.
“That changed during COVID,” said Cohlmia. "People did video visits and virtual visits. And health insurance companies said, 'Not only will we cover those visits in a way that we didn't use to, we will pay you the same amount that we would've paid you if your patient had come into your clinic."
Changes to payment reimbursement weren't the only change prompted by the pandemic. Traditionally, physicians can only practice medicine in the state in which they are licensed. During COVID, those regulations were relaxed to allow virtual care to occur across state lines as needed to handle the demand.
Traditionally, physicians can only practice medicine in the state in which they are licensed. During COVID, those regulations were relaxed to allow virtual care to occur across state lines as needed to handle the demand.
Before the pandemic, insurance companies typically required that patients be in a clinical facility to receive services. Virtual visits were primarily held to connect specialists with physicians in facilities that did not have access to their type of expertise. Devices used to transmit any kind of telehealth or virtual service had to meet such a restrictive security level it was impossible to meet for the average patient.
“With COVID, all of that broke wide open,” said Cohlmia. “You could get care from anywhere from any device. It was transformative.”
It’s difficult to predict which changes healthcare will keep and which will be discarded or adapted once the pandemic is over. Reimbursement rates, methods and requirements will have a tremendous impact on how the industry moves forward. Convenience, affordability and accessibility are likely to keep virtual visits and telehealth options a permanent part of the healthcare landscape. However, other changes, like care that crosses state lines regardless of licensing, are likely to revert to pre-pandemic use.
Convenience, affordability and accessibility are likely to keep virtual visits and telehealth options a permanent part of the healthcare landscape.
“We need to be prepared for a world in which care isn’t just bottled up inside the clinic or the hospital,” said Cohlmia. “If patients and doctors have all gotten comfortable with this, and if businesses have been able to build themselves up and grow and invest in technology in this window of opportunity, all of that will create an ecosystem where distributed care becomes much more of an inevitability. We’ll get there.”
At Providence, the Providence Digital Innovation Group is sharing its research and knowledge around how digital technology can help transform the care we provide. Within the Resource Center are digital perspectives that cover a wide range of topics in four main categories:
- Distributed care for access and convenience
- Navigation and personalization
- Helping marginal and underserved populations
- Scaling behavioral health
See the full blog here.