A Conversation About the Applications and Benefits of Telemedicine in Addressing COVID-19

By: on April 28, 2020

Early in April, I spoke with Logan Plaster, editor of StartUp magazine, about how telemedicine was uniquely poised to help doctors and patients face the COVID-19 pandemic, how regulations have changed to make this technology more accessible to providers and patients, and how independent practices that weren’t using telemedicine previously can go about finding the right software quickly

Meet the players

Lisa Hedges

Senior Content Analyst at Software Advice

Hi, that’s me. I’ve covered the medical market at Software Advice for the past two years. In that time, I’ve conducted original research and reported on all kinds of healthcare IT trends, including telemedicine.

Logan Plaster

Editor at StartUp Health

Logan Plaster is the Editor in Chief and Media Director at StartUp Health as well as the host of the Health Innovation Matters podcast. He’s been covering healthcare tech, entrepreneurship, global health, and emergency medicine for 15 years.

Listen to the podcast here

Logan Plaster: Welcome to the 30th episode of Health Innovation Matters, the international podcast on cutting edge issues and solutions in healthcare diagnosis, treatment, administration, and policy. This is a podcast where you’ll find out what’s really happening in healthcare today, and we’ll look around the corner for what’s happening tomorrow. We cover a range of diverse topics by interviewing key thought leaders, and I’m your host Logan Plaster, editor of StartUp Health magazine.

So we are recording this particular episode in the age of the Coronavirus pandemic, which has completely, and I would say forever, altered health innovation, the subject of this podcast. So this is a dynamic conversation, a dynamic episode if ever we have had one because things in the industry are changing daily it seems. With that in mind, we’re stepping back from talking to CEOs and founders to talk to a healthcare writer and analyst to really get a sense of what’s happening in the industry. So with us today, we have Lisa Hedges, a senior content analyst covering the healthcare market for Software Advice. Her work has been cited in publications like Healthcare IT News, Healthcare Innovation, and the Chicago Sun Times. Lisa Hedges, thanks for joining me on Health Innovation Matters.
Lisa Hedges: Thanks for having me, Logan.
Logan: So I guess I think the first question that’s always necessary in a Coronavirus interview is where are you right now? Are you in a bunker? Are you safe and healthy?
Lisa: Yes, I am in my very makeshift at-home office. My partner has very generously offered to work from our kitchen for the time being, so we’re making it.
Logan: And where are you in the world?
Lisa: We’re in Austin, Texas.
Logan: Austin, Texas, yes. I had plans to go to South by Southwest that got canceled. That was a sad moment.
Lisa: Yeah, I think we all had plans to go to South by Southwest.
Logan: But that was at that critical moment too; that was an interesting time because that was one of the weekends when it was becoming really real to everyone, wasn’t it?
Lisa: Yeah, that was kind of a big moment, you’re right. Because the conversation around “Do we cancel? Do we not?” was happening not just for South by Southwest but other huge things like HIMSS, which I was scheduled to go to, and so on. For a while we were in this very weird, gray, unknown area, and then all of the sudden, like dominoes, they just started canceling and going to digital and things like that. So, yeah.
Logan: And here we are. So I’m glad that you’re safe and healthy there in your space in Austin. So let’s dive right in and talk about telemedicine. I know you write a fair amount about telemedicine and clearly remote care, or virtual care, is having its moment. A lot’s been written about it recently. So what are you seeing in terms of the trends around telemedicine? What have you written about recently?
Lisa: Yeah, recently, it’s been a lot of, really, what are the telemedicine options available? What are the legislative and regulatory changes happening around telemedicine that are making it more accessible for doctors and patients? And then a lot of it is how can practices who weren’t previously using telemedicine start, and how can they start quickly?
Logan: What are some of those challenges that you’ve seen firsthand in your reporting?
Lisa: Yeah, I mean, one of the biggest challenges specifically around Coronavirus was kind of the obvious one; it was how to treat patients with this very highly contagious virus while minimizing spread. And then also how to treat immunocompromised patients who maybe have chronic conditions without risking their exposure to it as well. And fortunately, this problem had a ready-made solution already in place, which was telemedicine, and was already being used by a relatively small portion of medical providers compared to how many are using it today. And really, it didn’t take long for doctors and legislators and patients and everybody else to see how valuable telemedicine is going to be in dealing with the COVID-19 outbreak.
Logan: So I feel like it was a solution that, it’s been germinating for so long, decades, and here we have this catalyzing moment and everyone’s like, yes, we’ve got to have telemedicine, we’ve got to do it now. So then I think the interesting question is, what were the hurdles that appeared? So the desire was there, so then what were the big challenges to implementation that happened over the last few weeks that you’ve noticed?
Lisa: Yeah. I think what you were saying about how telemedicine was already in place really is something interesting that makes it pretty unique because, you know, telemedicine isn’t new. It wasn’t a brand new solution that was built to address Coronavirus. And so it’s had time for vendors to work out kinks and bugs. And that makes it an even better solution to this strange problem that we’re now facing. Some of the barriers though that still exist or existed as Coronavirus started to really affect the U.S. were regulatory barriers. So there were a couple of regulations in place that really just limited accessibility. For example, providers who use telemedicine had to be licensed in the same state that patients were located.
Logan: Right, right. Yeah.
Lisa: And also Medicare beneficiaries had to go to approved care sites in order to seek telemedicine care. So those kinds of things needed to be addressed very quickly as we started looking more towards telemedicine to help us through COVID-19. And then that’s what brought about things like the Coronavirus Preparedness and Response Supplemental Appropriations Act (that’s a mouthful) and the CARES act, both of which did a lot to expand the coverage and the accessibility. So those were two really big, monumental things that have happened just this year.
Logan: I don’t know if you have a comment about this but have you noticed or how have you seen the big players in the telemedicine market respond to both the regulatory changes and also just the challenges that we’re all seeing in the Coronavirus? You know, the, the Teladocs, the American Wells; what are they doing right now?
Lisa: Oh, man. Yeah, that’s a tough question. You know, I’ve been reading about all of the telemedicine vendors who are offering free trials and subscriptions, and that’s been pretty great, honestly; pretty uplifting to see how everybody is just trying really hard to help everyone in this moment.
Logan: Yeah.
Lisa: I also saw, I think it was last month, a vendor was tweeting about some outages, and they tweeted that they normally see between 2,000 and 3,000 new providers sign up in a month for their telemedicine service—at that time they were seeing 2,500 new providers sign up each hour.
Logan: Oh my goodness.
Lisa: Yeah, it tells you a little bit about what the vendors are dealing with right now and what doctors are dealing with, you know; they’re all learning new technology, essentially.
Logan: And was that one of the big players you’re talking about?
Lisa: Yeah, it was a pretty big one. Yeah.
Logan: Very interesting. Yeah. I think one of the interesting points about this moment is that as many telemedicine providers as there are, and as clear as the need is, I still have had many, many people tell me, okay, now which one should I use? Like I have Kaiser insurance. I know Kaiser has a telemedicine component, but getting to it on the portal is complicated. If someone doesn’t have any sort of telemedicine through their insurer, then they know that there are probably like a hundred direct-to-consumer options, but which one do I choose? So there’s still an interesting barrier, even though the time is right, the companies are there, it’s having its moment, etc. What are your thoughts about that? Kind of like that last mile problem?
Lisa: Yeah, there’s a lot of moving parts to getting this new… not new, but getting a new software system to doctors and patients who hadn’t previously ever used it or had access to it. So I think a lot of good is being done, and while there are still plenty of barriers to adoption and issues with getting it out there, I think everybody’s trying their best, which is a positive.
Logan: So we’re talking about telemedicine platforms, you know, everyone seems to be doing their part, they’re trying to offer their platform for free. Every provider, practice, every clinic knows they’ve got to get into it. They need to be doing this, otherwise they will literally go out of business. So how can independent practices who haven’t yet adopted telemedicine go about finding the best technology for their practice?
Lisa: Yeah, this is a really good question to think about, especially right now, because there’s such pressure to find this new technology and find it quickly. And when you move fast, you know, sometimes you skip over things and that can lead to other issues. So if you want to think about the process for choosing a new telemedicine provider, you can think of it as having five steps. Step one is going to be to assess your needs. Think about things such as are you a specialty practice? If so, what are the unique requirements you’re going to have? Can you get by with a general telemedicine system that offers more basic features like just video conferencing and chat? Or do you have to have the more robust software systems with things like data encryption and e-prescribing? So step one is just about really figuring out exactly what features you need to start using telemedicine right away.
Logan: Okay, so user assessment.
Lisa: Yeah exactly, which is step one in a lot of these types of software seeking processes. From there, you get to move into your budget planning. And as we know, there are a lot of vendors who are offering free trials right now, which is really amazing. So you should think about, when you’re looking at those vendors, do they offer the features that you need? Or do you need something more robust? That’s going to make you look for a system that might cost a little bit more. And then of course, if you really need a system with more features or one that integrates with your existing software, EHR, or whatever you have, that’s probably going to cost you some money. And then the other thing that I like to recommend at this point is to think about how long you want to use telemedicine. Is it a solution that you’re just interested in as we deal with Coronavirus, or is it something you think that you would like to keep offering your patients after the pandemic subsides a little bit?
Logan: That’s an interesting point. You know, I’m operating off the assumption that, in my optimism, that this is the catalyst for telemedicine to become, you know, the standard of care in many, many areas. And yet, you bring up the good point that this could be a bump, and then we go back to business as usual. Is that, is that what you see possibly happening?
Lisa: You know, I, I see this as an opportunity for patients and doctors to start using telemedicine where they were hesitant, for whatever reason, before. And I think what’s going to happen is everybody’s going to see how easy it is to use, how convenient it is. And they’re going to keep on wanting it even after we finish dealing with this crisis. So for me, you know, I think it’s something that is a good investment in the long term. But yeah, I will also be interested to see how that actually plays out.
Logan: Okay, so I cut you off, you’re giving more strategies for choosing a good telemedicine platform. I think you gave me a couple of the points.
Lisa: Yeah. So let’s see, I think we were talking about where you want to plan your budget and all the things you need to consider there. So once you do the pre-work and you figure out what your feature needs are, what integrations you have to have, and how much you can spend, then you get into the research phase where you’re actually looking at telemedicine vendors. And so the thing that I like to recommend here is to essentially create a shortlist. I think you don’t want more than five products on your list, because when you get into product demos, it’s just going to take a lot of time if you are doing demos with many more than that. So it’s whether you want to do it yourself and go to those telemedicine provider websites and, you know, do that kind of research on your own, or Software Advice actually has a service. We have medical software advisors with market expertise. And you can give them a call and they’ll ask you some questions about, you know, what is your budget? What do you need? Are you a specialty? And then if you talk to them, after 15 minutes they can give you a shortlist of telemedicine vendors who actually meet all of those criteria, and then you can move on from there. So that’s really convenient. And that’s really helpful in expediting the process which is a big goal for a lot of practices right now.
Logan: Sure, sure. I can see that being very helpful. Just for full disclosure, do you have preferred vendors that you work with that you’re guiding people towards? Are you totally agnostic? How does it work?
Lisa: As an analyst in my content that I produce, I am vendor agnostic. I don’t have a relationship with a vendor. So any ratings or things that you see with my byline on our website, those are objective, as they’re based on user reviews. Our advisors have, they know these vendors and they understand what features they offer; they have additional information about costs and things like that. So that kind of stuff allows them to select the best products that truly do meet the unique requirements of the practices who call us.
Logan: Interesting. Okay. I think you’d mentioned five strat—I don’t know if you have more strategies that you were going to mention.
Lisa: The next steps are pretty, pretty easy. After you get your shortlist, you just want to schedule those product demos, and use that time to really talk to the sales rep about, you know, things like how they’re handling the additional influx of users, what kind of customer support are they going to offer, what integrations they have, things like that. And then you just pick your winner and you get to move on with purchasing and implementing.
Logan: Interesting. Very cool. We’re running a little short on time, but in your writing, thinking about kind of where we’re at, how this moment is changing our adoption of telemedicine, I wonder, when you think about a post-Coronavirus world, what gets you excited about where we’re heading, where healthcare technology is leap frogging? Where do you see us landing that gets you optimistic and excited about healthcare?
Lisa: It’s a big question. That’s a good question. Um, I think, for me, I’ve covered telemedicine over time, and I’ve seen the slow growth and adoption, and that’s been really—it’s a trend that we have marked over time. Software Advice runs a survey annually of patients around telemedicine. And so, over time, we have seen trends from that survey around an increased interest in and awareness of telemedicine from patients.
Logan: Mhmm.
Lisa: And what we’ve seen is a pretty gradual growth in those areas. And I think when we run that survey again, it’s not going to be a gradual growth. I think it’s going to be huge how many patients say that they are aware of telemedicine, have used telemedicine, and really want telemedicine from their providers. Which I mean, that’s already a big number. The last time we ran that survey, I think 84% of patients said that they were more likely to choose a doctor that used telemedicine over one that doesn’t, which is a pretty big number. So I think patients have always wanted telemedicine, and I think that the doctors who have used telemedicine recognize how convenient it is. So what I’m really excited about is that this is an opportunity for everybody to really see those benefits and to continue, you know, using them.
Logan: Yeah, yeah, there’s so many interesting downstream benefits that if we can just get this deployed at scale, I really believe we’re going to start seeing just amazing increases in access to care. You know, lowering cost, the availability for rural patients to see specialists, starting to expand that into global health and telementoring. There’s just so many interesting byproducts of this if the infrastructure can get up and running, you know.
Lisa: Absolutely. And some of the changes around the regulations that have been made are temporary, which I think is important to note. You know, some of this stuff is pretty much just a stopgap; for instance, I saw that the CMS was waiving that requirement that providers be licensed [in the same state where patients are located], and the HHS announced that it’s practicing enforcement discretion around penalties for HIPAA compliant telehealth, and those are temporary measures. So we need to expect some stuff to go back to the way it was before, I think, but also, you know, that toothpaste has been squeezed, and I think that some permanent changes are going to be made.
Logan: I think that’s a good pragmatic note to end on. To not have too rosy of a picture to say, you know, this is the way it is; we still have to fight for it. We still have to advocate that in healthcare we believe this is the right way we need to go.
Lisa: Yeah, absolutely.
Logan: Awesome. Well, Lisa, thank you for the time. That’s all the time we have. We will keep an eye on what you’re covering, what you keep writing about, and really wish you a safe and healthy week there in Austin.
Lisa: Thanks, Logan. You too.
Logan: Awesome. Thanks for tuning into this episode of Health Innovation Matters.

How to select telemedicine software

For more information on telemedicine and how it’s being deployed to deal with COVID-19, check out these resources:

You can also refer to the checklist in this article to get help in finding new telemedicine software so that you don’t forget any key steps or considerations.

If you’re ready to get your shortlist of telemedicine providers and begin product demos, schedule a call with our medical software advisors today.

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How Telemedicine Requirements Have Changed to Address COVID-19

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How to Get Started With Telemedicine

Start your search for telemedicine software now.