Telehealth has exploded. We’ve written about the explosive telehealth growth multiple times and that’s just a small sample. The number of live video telehealth visits is astounding. It’s pretty rare we get to see this kind of a shift. Plus, we’ve also seen this shift represented in the number of live video telehealth companies that want to be on our telehealth lists. It’s no surprise that the competition for telehealth visits is heating up and we’re just getting started.
While live video telehealth has exploded, not all of telehealth has gone through the same growth cycle. Along with live video telehealth, I think we’ll see similar growth with various telequarantine solutions and virtual rounding options as social distancing becomes a new way of life in healthcare whenever possible. Plus, virtual rounding is exciting because it could make the physician experience more efficient and not just the patient’s experience like other forms of telehealth.
What’s not clear to me is how specialty specific telehealth is going to do. In most cases, I’m talking about a specialist at a larger healthcare organization doing live video telehealth with a smaller, often rural healthcare organization. This area of telehealth had been growing before COVID-19 and so I expect it will see a similar growth, but I’ll be surprised if this explodes the way live video telehealth visits have grown.
The one area that’s trying to ride the wave of telehealth growth has been remote patient monitoring (RPM), but I currently see them getting left behind. Given social distancing, you’d think that remote patient monitoring would make total sense. We don’t want these patients coming to the office or the hospital and so it seems like it would make sense to manage these chronic patients using RPM solutions.
While I don’t want to say that RPM hasn’t benefited at all from the current environment, I haven’t seen it doing the hockey stick like growth that live video telehealth visits has seen. If you know of places that are seeing this, I haven’t seen it and would love to hear. Why isn’t RPM seeing the same growth as telehealth visits?
The answer to this question goes back to our previous article on the telehealth value equation. The value to a healthcare organization and clinician of using RPM solutions hasn’t changed that much. In fact, with all the new telehealth reimbursement that was offered, I never saw any new reimbursement for RPM. There were already a few codes that CMS had recently released before COVID-19, but many I talked to said that those didn’t pay nearly enough for what was required.
Looking at this from an even more cynical viewpoint, doing RPM well will actually cut into healthcare organizations physical and online visit revenue. That’s not a good value equation for explosive growth. As much as clinicians love and care about their patients, adopting new models of care and getting paid less is not a great value proposition. This is why so many telehealth companies are shifting to replacing physical visits (ie. live video telehealth) and away from modifying patient behavior (RPM).
Of course, this story isn’t fully written. Amidst the pandemic, we’ve proven that a lot of things that we previously held as strong beliefs evaporated overnight. CMS and other payers could increase reimbursement for things like RPM and CCM. A significant change there could create the hockey stick like growth of RPM that would benefit the healthcare system as a whole. RPM done right can lower the costs of healthcare. The challenge is that telehealth reimbursement (specifically RPM) gets hard really fast.
As regular readers know, I ask “what do you mean?” whenever someone says “telehealth” now. The same is true when someone says “Telehealth is exploding.” It’s true for some areas of telehealth, but not all areas are created equal. We could also apply it to the question “Is the telehealth genie going back in the bottle?” I might reply, “In some areas of telehealth, the genie is still in the bottle.”