The piece you’re about to read is from Klick Health’s Life (Sciences) After COVID-19 series, a collection of expert perspectives designed to inform and inspire the life sciences community for the coming changes and opportunities we anticipate as a result of this global health crisis.
The Insight
If you look at a picture of New York’s Fifth Avenue taken on Easter Sunday in the year 1900, you will see a street jammed with traffic. Every vehicle but one is drawn by horses. The same picture taken on Easter Sunday in 1913 shows the same traffic jam—but conversely, every vehicle but one is motorized. In a very short time, the motor vehicle became the “killer app” of the early 20th century, quickly replacing the technology that came before.
It’s doubtful that those drivers on Fifth Avenue could have glimpsed all the changes that mass-produced motor vehicles would bring—from dispersed suburbs and more deadly forms of warfare to global warming. What they must have known, though, is that motor vehicles had reached a tipping point, and there would be no going back to horse-drawn carriages.
One of the myriad consequences of the coronavirus pandemic may well be to push telehealth past its own tipping point. The odds of returning to the days of largely in-person medicine may be as low as those surrounding the return to horse-drawn carriages.
One of the myriad consequences of the coronavirus pandemic may well be to push telehealth past its own tipping point.
Predicting the immediate consequences of a technological change is important but straightforward—whether that’s smoggier air (but cleaner streets) as cars replace horses, or greater need for broadband as telemedicine increasingly supplants in-person care. What’s more interesting—and much harder—is to speculate on the secondary changes from a technological innovation.
These are notoriously difficult to predict, even by experts. Thomas Edison, for example, thought that the major use of the phonograph would be to record business transactions. Instead, recorded music revolutionized an art form, bringing all kinds of music to billions of people.
This paper looks into an admittedly cloudy crystal ball to try to predict the changes that broader use of telemedicine will bring.
The Evidence
COVID-19 and the need for physical distancing brought enormous pressure on regulators to alter rules that had inhibited the uptake of telehealth services. The changes adopted by regulators in recent months have been profound:
The Centers for Medicare and Medicaid Services (CMS), which sets reimbursement policies for those two federal programs, has begun to pay telemedicine visits at the same rate as in-person visits.
CMS will now pay for services provided in any location, including the home, and has waived the restriction only to “established” patients.
The Department of Health and Human Services will adopt “enforcement discretion” on good faith violations of the HIPAA privacy rules committed while using non-compliant video conferencing platforms.
Several states have relaxed restrictions on the practice of medicine by out-of-state healthcare providers facilitating telehealth.
This more permissive regulatory environment, coupled with the strong drive among patients to avoid going to physical medical facilities, has already produced profound changes in the adoption of geographically distanced medicine.
The Doctor Will Zoom You Now
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Author
David Bowen, PhD
SVP, Policy & Advocacy
David is a specialist in policy and public health with over 20 years of experience leading change in health and health policy in government, at foundations, and in the private sector. As policy director for the US Senate health committee, David had a key role in writing major US health laws, including the Affordable Care Act. David provides insights and strategies for clients based on deep understanding of the public policy context that shapes health and healthcare.
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