Lessons Learned During COVID-19 That Can Move Telehealth in Primary Care Forward

Feb 24, 2021Journal of the American Board of Family Medicine : JABFM

What COVID-19 Taught Us to Improve Telehealth in Primary Care

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Abstract

In April 2020, 73% of all patient visits were conducted virtually, a significant increase from 0.5% in October 2019.

Telehealth implementation began in 2017 but was limited by various barriers until accelerated by the COVID-19 pandemic.
The pandemic prompted insurers to expand reimbursement for telehealth services, facilitating its adoption.
More than 2000 providers received training in virtual health within a two-week period during the pandemic.
The number of virtual visits increased dramatically, with 5293 visits recorded in April 2020, compared to just 2376 in March.
Demand for virtual visits decreased as COVID-19 cases declined, yet 28% of visits in July 2020 remained virtual.

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INTRODUCTION: Our university hospital-based primary care practices transitioned a budding interest in telehealth to a largely telehealth-based approach in the face of the COVID-19 pandemic.

INITIAL WORK: Implementation of telehealth began in 2017. Health system barriers, provider and patient reluctance, and inadequate reimbursement prevented widespread adoption at the time. COVID-19 served as the catalyst to accelerate telehealth efforts.

IMPLEMENTATION: COVID-19 resulted in the need for patient care with "social distancing." In addition, due to the pandemic, the Centers for Medicare and Medicaid Services and other insurers began expanded reimbursement for telehealth. More than 2000 providers received virtual health training in less than 2 weeks. In March 2020, we provided 2376 virtual visits, and in April 5293, which was more than 75 times the number provided in February; 73% of all visits in April were virtual (up from 0.5% in October 2019). As COVID-19 cases receded in May, June, and July, patient demand for virtual visits decreased, but 28% of visits in July were still virtual.

LESSONS LEARNED: Several key lessons are important for future efforts regarding clinical implementation: (1) prepare for innovation, (2) cultivate an innovation mindset, (3) standardize (but not too much), (4) technological innovation is necessary but not sufficient, and (5) communicate widely and often.

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Lessons Learned During COVID-19 That Can Move Telehealth in Primary Care Forward

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