The COVID-19 pandemic has launched healthcare an even higher level of firefighting that ever before. And amid the demands of in-the-moment creative problem solving for challenges that have ranged from equipment shortages and staff shortages to mental health crisis and burnout—questions also arise around what happens next.
Something that we are all beginning to realize is that the world will not simply go back to what it was before. And nowhere is that perhaps more apparent than in healthcare. Organizations and individuals are beginning to ask:
Will our hospitals continue to be safe places during this COVID outbreak, and during the next pandemic to follow? How will the lessons and practices that have helped us navigate this crisis inform how we deliver care in the future?
The events of the last year have renewed public interest in telemedicine. It makes sense. While designed to improve access to care, distance is an obvious byproduct. And distance between patients, healers, and families means fewer infections. For most people, telemedicine means seeing a provider with a laptop or mobile device and skipping a visit to the hospital or a clinic. But there is another opportunity, more urgent now than ever, to use telemedicine in the hospital. Whether separated by 800 miles or 8 floors, telemedicine is an opportunity to bring us together, to look one another in the eye and discuss next steps during this time of great need.
During COVID, the benefits of in-hospital telemedicine are obvious. Each time we enter a patient’s room, the provider has to put on personal protective equipment. Gloves, gowns, and masks are expensive and now in short supply, and at times, providers have had to go without. With new restrictions on visitation policies, families are disconnected from their hospitalized loved ones. Specialists—already in short supply—have to be everywhere at once. Beaming in via telehealth is the next best thing to being there in person.
However, what happens after COVID?
In an industry long struggling with challenges like access, affordability, and collaboration, we have now added additional items like extended isolation strategies and COVID hospitals. For all of these challenges, we will need to reconsider how we build relationships between patients and caregivers. Once in the hospital (and even outside of it), a patient’s journey often feels like the game Mouse Trap—a disconnected series of steps, with different doctors showing up at all hours…or long drives and wait times. Patients, let alone families, often have no idea who is taking care of them. Now imagine replacing pagers and cell phones with video monitors everywhere. Family located thousands of miles away could participate and be brought up to speed on the next steps for their loved one. A specialist can be brought in to consult, or discharge instructions relayed with the PCP digitally present. The physician is down in the ED or clinic? No problem—they can be in the room in as long as it takes to place a phone call. This is not only care, it’s cost-effective care.
Banner Health, one of the leaders in this space, has over 500 patients throughout the US being “watched over” from their command center here in Phoenix. Notably, even a 1-hour decrease in the average length of stay per patient translates into millions of dollars of savings for hospitals. There are many other opportunities—remote (or asymptomatic Covid-positive) experts supporting in-house staff, specialty care and senior nurses from home supporting new graduates, medical device reps remotely present in ORs, chaplain services, translation services—the list of applications is long.
Considering all these benefits, why have hospitals been slow to adopt in-house telehealth? Historical barriers have included both technical and financial issues. First, delivering video in aging buildings and hospitals has posed a challenge. There are thick walls, poor WiFi, and privacy concerns. Typically, a cart (think of it as a TV on wheels) is deployed, but this is expensive and forces people (nurses, doctors, patients, and families) to change their behavior and gather around the cart at an appointed time. Ideally, technology should support humans—not the other way around! Most video infrastructure (that’s the software piece of the solution) is sold like a cell phone contract; that is, on a per-minute or per-person charge. This makes enrolling everyone in the hospital and 24/7 patient monitoring expensive. However, these challenges are not insurmountable.
How we charge for something can be negotiated, how we think about telemedicine delivery can be re-thought. That is why Vitalchat is so exciting for me.
I’ve met a lot of smart engineers—and perhaps none as sharp as Ghafran Abbas. With over 20 years of combined experience and telemedicine implementations into hundreds of organizations—together we have a very good idea of what the future of telemedicine needs to be.
That’s why we built Vitalchat from the ground up, eliminated all third-party reliance (and fees), made it API-rich for quick and easy integration into existing workflows and leverage low-cost hardware (and even repurposed hardware like existing carts and tablets).
On top of that, we added smart video and made the whole experience touchless–requiring zero management from staff and full provider control over the visit.
We believe that this is the path to putting telemedicine everywhere it can add value, affordably.
It is worth a pause to mention that telemedicine should be thought of as supplemental, not as a replacement, for in-person care. Like the EMR, used the wrong way telehealth could become a distraction from care, that sacred human-to-human relationship. Ideally, every service imaginable would be available a few feet away. But this simply isn’t the reality. But used appropriately, telemedicine can save lives and improve the way we care for one another—on the front line fight against Covid and beyond.