Interest in remote patient monitoring (RPM) and its positive impact has skyrocketed in the wake of the COVID-19 outbreak. Providers across the country are implementing expansive telehealth programs to enhance patient monitoring and disease management while reducing the strain of healthcare resources.
Explore recent research on the efficacy of telehealth in response to the COVID-19 pandemic in HRS’ June 2020 Research & News Recap.
Part I. Research Findings - Remote Patient Monitoring and Telehealth
In this section, hear from healthcare organizations across the country who rapidly deployed telehealth programs within the last few months in response to COVID. The articles demonstrate the feasibility of telehealth and remote patient monitoring to combat the COVID outbreak and to extend patient care beyond the COVID pandemic. Additionally, the articles provide best practices for the deployment of telehealth from lessons learned during the COVID-19 pandemic.
Cardio-Oncology Care in the Time of COVID-19 and the Role of Telehealth
What was studied?
During the onset of COVID-19, looking at historical outbreaks of infectious diseases, we quickly learned that patients with pre-existing conditions, particularly cardiovascular disease and cancer, had a higher risk for acquiring the virus. Additionally, once infected, these patients were, and are, at a greater risk for the virus resulting in adverse, even dire outcomes. Reducing exposure among these populations has been and remains critical. Many providers are canceling and rescheduling routine appointments to enforce social distancing and ensure patients avoid the risk of exposure. For patients with a dual-diagnoses of cardio-oncology, cancelling and rescheduling appointments is often not an option. Routine appointments provide necessary support and care; cancelling them would endanger the patient greatly.
In this article, physicians from the Vanderbilt University Medical Center share how their organization has leveraged telehealth to continue to provide crucial treatment to cardio-oncology patients and other patient populations in which routine appointments are essential. In the article the authors discuss the advantages of telehealth for the cardio-oncology population, as well as the clinical challenges they had to quickly overcome to ensure their telehealth program would be successful.
Advantages of Telehealth
Overcoming Clinical Challenges
Access the full article, here.
Date Published: April 2020
Parikh, Amar, et al. “Cardio-Oncology Care in the Time of COVID-19 and the Role of Telehealth.” JACC: CardioOncology, Journal of the American College of Cardiology, 22 Apr. 2020, www.sciencedirect.com/science/article/pii/S2666087320300685?via%3Dihub.
Managing Patients with Chronic Pain During the COVID-19 Outbreak: Considerations for the Rapid Introduction of Remotely Supported (eHealth) Pain Management Services
What was studied?
In the US, more than three million Americans suffer from chronic pain caused by past injuries or surgeries, arthritis, or nerve damage. Not only does chronic pain have a significant impact on a person’s physical health but can also cause contribute to depression and anxiety among other mental health conditions. During the COVID-19 outbreak, remotely treating patients with chronic pain, has become a necessity. Even as elective casework is delayed and primary care providers are required to socially distance, chronic care patients require continued medical support and assistance with their ailments.
Published by the International Association for the Study of Pain, this article proposes guidance for healthcare providers looking to leverage telehealth and virtual care for patients with chronic pain. The authors breakdown the guidance into four categories: public health considerations, delayed care consequences, options for remote patient assessment and management, and clinical evidence supporting remote therapies. In a fifth category, the authors present best practices for healthcare providers attempting to rapidly transition to telehealth and the lessons learned for future application of telehealth and remote care.
Public Health Considerations
Distance Assessment and Treatment with Technology
Evidence for Efficacy and Harm of Telemedicine and DTx Interventions
Access the full article, here.
Date Published: May 2020
Eccleston, Christopher, et al. “Managing Patients with Chronic Pain during the COVID-19 Outbreak: Considerations for the Rapid Introduction of Remotely Supported (EHealth) Pain Management Services.” Pain, Wolters Kluwer, May 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7172975/.
Telehealth Transformation: COVID-19 and the Rise of Virtual Care
What was studied?
In this article, published in the Journal of the American Medical Informatics, physicians at the Duke University School of Medicine outline the virtual care platforms incorporated under the umbrella of telehealth. In their outline, the authors include examples of each modality, limitation, and opportunities for expanded use post-coronavirus.
Using examples from US healthcare organizations, including the Duke University School of Medicine, the authors describe the application of telehealth during the COVID pandemic in three phases: stay-at-home outpatient care, initial hospital-surge, and pandemic recovery. Each phase requires coordination between people, telehealth process, and the telehealth technology in order for the health system to successfully deploy and scale telehealth. The authors outline best practices for phases one and two and present considerations for utilizing telehealth post-COVID.
Phase 1: Outpatient care during “stay-at-Home” actions taken:
Phase 2: Initial inpatient surge
Phase 3: Post-pandemic recovery
Access the full article, here.
Date Published: May 2020
Wosik, Jedrek, et al. “Telehealth Transformation: COVID-19 and the Rise of Virtual Care.” OUP Academic, Oxford University Press, 17 May 2020, academic.oup.com/jamia/advance-article/doi/10.1093/jamia/ocaa067/5822868.
Telemedicine in the Time of Coronavirus
What was studied?
Countless journal articles have, at this point, been published outlining the use of telehealth to screen patients, monitor recovery and extend care services during the pandemic. However, not many articles have focused specifically on providing telehealth services to palliative patients during or after the COVID outbreak. Prior to the COVID-19 pandemic, the use of rpm and virtual care platforms was growing substantially in hospice and palliative care practices where virtual care saves valuable time for in-home visits and increases capacity at care facilities.
In this article, three physicians from the Division of Palliative Medicine at the University of California, San Francisco (UCSF) provide best practices for implementing telehealth in palliative care. The considerations presented focus on telehealth set-up, patient experience, and clinical effectiveness.
Best practices & considerations for palliative telehealth
Access the full article, here.
Date Published: March 2020
Calton, Brook, et al. “Telemedicine in the Time of Coronavirus.” Journal of Pain and Symptom Management, Elsevier, 31 Mar. 2020, www.sciencedirect.com/science/article/pii/S0885392420301706.
Part II. Reimbursement Updates
Throughout the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) have made changes to their policies in order to make telehealth more accessible across the country. Insights from our reimbursement team are included below.