TELEHEALTH: A REALITY WITH QUARTER-TRILLION-DOLLAR POTENTIAL

One analysis indicates that telehealth use has increased 38-times from the pre-COVID-19 baseline. During the pandemic, telehealth offered a bridge to care, and now offers a chance to re-invent virtual and hybrid virtual/in-person care models, with a goal of improved healthcare access, outcomes, and affordability.

Virtual healthcare models and business models are evolving and proliferating, moving from purely “virtual urgent care” to a range of services enabling longitudinal virtual care, integration of telehealth with other virtual health solutions, and hybrid virtual/in-person care models, with the potential to improve consumer experience/convenience, access, outcomes, and affordability.

Moreover, many of consumers express interest in a set of broader virtual health solutions, such as a “digital front door” or lower-cost virtual-first health plan.

Investment in virtual health continues to accelerate.  The total venture capital investment into the digital health space in the first half of 2021 nearly twice the investment in 2019.

The next chapter of telehealth

Telehealth appears poised to stay a robust option for care. Strong continued uptake, favourable consumer perception, the regulatory environment, and strong investment into this space are all contributing to this rate of adoption.

Innovations around virtual longitudinal care (both primary and specialty), enablement of care at home through remote patient monitoring and self-diagnostics, investment in “digital front doors,” and experimentation with hybrid “online/offline” models will bring new care models for consumers that help achieve healthcare’s “triple aim.”

What is the full potential for telehealth and virtual care?

A few models for virtual or virtually enabled non-acute care and analysed the full potential of healthcare volume and spend that could be delivered this way. These models of virtual care have increasing requirements to engage broader and broader portions of the healthcare delivery system, going from offering one-off urgent visits, to building omnichannel care models that deliver a large portion of office visits virtually or near virtually, to embedding virtual services in home care models.

On-demand virtual urgent care as an alternative to lower acuity emergency department (ED) visits, urgent care visits, and after-hours consultations. These care needs are the most common telehealth use cases today among payers. This allows a consumer to remotely consult on demand with an unknown provider to address immediate concerns (such as an acute sinusitis) and avoid a trip to the ED or an urgent care centre. Such usage could be further scaled to address a larger portion of low acuity visits previously seen in EDs.

Virtual office visits with an established provider for consults that do not require physical exams or concurrent procedures. Such visits can be primary care (such as chronic condition checks, colds, minor skin conditions), behavioural health (such as virtual psychotherapy sessions), and some specialty care (select follow-up visits such as virtual cardiac rehabilitation). An omnichannel care model that fully leverages virtual visits includes a mix of telehealth and in-person care with a consistent set of providers, improving patient convenience, access, and continuity of care. This model also enables clinicians to better manage patients with chronic conditions, with the support of remote patient monitoring, digital therapeutics, and digital coaching, in addition to virtual visits.

Near-virtual office visits extend the opportunity for patients to conveniently access care outside a provider’s office, by combining virtual access to physician consults with “near home” sites for testing and immunizations, such as worksite clinics or retail clinics.

Virtual home health services leverage virtual visits, remote monitoring, and digital patient engagement tools to enable some of these services to be delivered remotely, such as a portion of an evaluation, patient and care giver education, physical therapy, occupational therapy, and speech therapy. Direct services, such as wound care and assistance with daily living routines, would still occur in person, but virtual home health services could enhance the patient’s and caregiver’s experience, extend the reach of home health providers, and improve connectivity with the broader care team.

Tech-enabled home medication administration allows patients to shift receiving some infusible and injectable drugs from the clinic to the home. This shift can happen by leveraging remote monitoring to help manage patients and monitor symptoms, providing self-service tools for patient education, and providing telehealth oversight. This would be coupled with home delivery of the therapeutics.

Telehealth can increase access to necessary care in areas with shortages, such as behavioural health, improve the patient experience, and improve health outcomes. Fundamentally, the integration of fully virtual and near-virtual health solutions brings care closer to home, increasing the convenience for patients to access care when they need it and the likelihood that they will take the right steps to manage their care. The actual opportunity is likely greater once stakeholders embed telehealth as the new normal (for example, driven by improved abilities to manage chronic patients, potential increases in provider productivity).

What actions should healthcare stakeholders take in the near term to shape this opportunity?

Build virtual health into new product designs to meet changing consumer preferences and demand for lower-cost plans. This new design may include virtual-first networks, digital front-door features (for example, E-triage), seamless “plug and play” capabilities to offer innovative digital solutions, and benefit coverage for at-home diagnostic kits.

Integrate virtual health into the care delivery approach. Given the significant disruptions to providers, payers are reassessing their role in care delivery—from ownership of care delivery assets, value-based contracting, or anything in between.

Reinforce the technology and analytics foundation that will be required to achieve the full potential of virtual health.

Consider strategies and rationale to go beyond “tele-health”/clinic visit replacement to drive growth in new markets and populations and scale other applications (for example, tele-ICU, post-acute care integration)