Since the onset of COVID-19, the U.S. healthcare system has been stretched and stressed to a breaking point, facing unprecedented financial pressures, staffing shortages and a decrease in patient satisfaction. Operational and resource issues that percolated under the surface have been laid bare.
The silver lining? The greater embrace of digital health.
Digital health adoption — products, infrastructure, and innovation — had been slowly progressing over the last few decades. However, the pandemic has acted as a springboard, helping to knock down regulatory barriers. Now, as vaccine distribution progresses and widespread access is predicted by the summer, lawmakers and regulators must resist the urge to retreat to their regulatory and reimbursement comfort zone and erase progress as we start heading toward the light at the end of the COVID-19 tunnel.
In other words, we must keep the regulatory ball and care reimbursement parity rolling now that digital health has been more broadly used by consumers and healthcare professionals to great benefit.
Americans have seen the future of healthcare: where more care options are available, diagnoses and health monitoring more convenient and issues of inequality or stigma are reduced. Providers have been able to broaden their patient base, provide more comprehensive care than in the past and create a greater data pool to improve care delivery and operating efficiency.
To bring holistic improvement to our healthcare system, regulators must embrace change and make COVID-driven digital health changes permanent. These include relaxation of U.S. Drug Enforcement Agency restrictions to prescribe certain controlled substances, expedited state licensure for physicians to practice in other states, allowance of high deductible health plan participants to partake in $0 cost-share for telehealth benefits, increased Medicare reimbursements for providers and relaxation of Health Insurance Portability and Accountability Act, or HIPAA, privacy rules — all of which allow brick-and-mortar physicians greater ability to deliver cost-effective healthcare via telehealth.
In addition to holding the line on these regulatory modifications, lawmakers — with the cooperation of providers and payers — must maintain the current momentum and foster further innovation.
How do we do this? First, information is power. Big tech has the potential to be a tremendous partner to our healthcare system, but data interoperability has hindered scaling. While keeping sensitive data safe must remain the number one priority, antiquated regulation and data silos should not be roadblocks. Cloud computing, advanced analytics and business intelligence solutions are building blocks for improved data usage by providers. In addition, patients must be empowered to own and manage their personal data, empowering them in their own health and making the data transportable to other service providers in order to improve their personal healthcare and the entire healthcare system.
Second, digital health as a modality needs to be extended in its application. Looking beyond primary care, behavioral health and the use of fashion and fitness wearables to monitor basic vitals such as heart rate or blood oxygen levels, offer significant opportunities. During the pandemic, we saw a wider scope of telehealth services such as specialized maternity and diabetes care and broader use of wearables like throat patches to monitor respiratory sounds and mobile ECG and EKG devices. Ensuring that digital health tools and care services can be expanded upon by ensuring fair and equitable reimbursement and lowering barriers of use by providers will also be key.
Finally, digital health must not be viewed as a substitute care platform, but rather an innovation-catalyzer that can increase quality outcomes. For instance, Livongo’s merger with Teladoc was considered a disruption of the healthcare status quo as two digital health players would offer greater capabilities focusing not just on ‘sick care,’ but a package providing better disease prevention and management for patients. While this could be considered a threat to traditional providers, the more important lesson within the digital health conversation is the championing of value-based care models that incentivize providers and reduce stress on a system currently treating the sick rather than nurturing the well. Digital health also enables providers to scale up their practices and reach new markets, mitigating disruptive risks presented by new players in adjacent sectors.
As the regulatory environment becomes more favorable, end-to-end digital health innovation will continue to bear fruit for patients, providers and payers. This is a win for all parties and an improvement to the U.S. healthcare system.
Paul Sonnier is an innovation, new ventures and growth leader for PA Consulting
Telehealth – evolving the way we receive care