Industry Voices—Fault lines exposed: 5 things we need to fix in healthcare now

The novel coronavirus was like a magnitude 7.1 earthquake that required our healthcare system to keep going even as the ground continued to shift beneath us.

As we continue to brace for aftershocks, we must sift through the damage and debris to repair what has been broken. COVID-19 exposed our vulnerabilities, the fault lines beneath the surface that can no longer be ignored. 

According to the Centers for Disease Control and Prevention (CDC), there are 50 million Americans, just over 20% of the population, who have chronic pain. About 20 million have pain so severe that it limits their life or work activities. 

During the pandemic, our system was tasked with triaging resources to care for critically ill patients while simultaneously reducing the spread of COVID-19. As a result, elective surgeries, such as those to treat severe back pain, were canceled and physical therapy clinics were closed to flatten the curve. People with chronic pain went without care, and some conditions were exacerbated by sheltering in place.

RELATED: Tech experts: Widespread adoption of telemedicine, remote monitoring 'here to stay'

Here are five changes that industry should make now:

       1. Leverage the technology and tools to deliver care to patients who need it. The CDC recommends exercise therapy, physical therapy’s primary treatment, as the first line of defense for musculoskeletal (MSK) pain, and telehealth is able to offer this care to patients without an in-person visit. In fact, studies have shown that remote physical therapy is just as effective, and in some cases more effective than in person care.

Our strained system needs to activate available care options, whether or not we are dealing with a global crisis. Virtual care solutions can remove the barriers—such as time and distance—that keep people from seeking and receiving care. It is also a tool that can protect patients and healthcare providers in an era of social distancing.

        2. Change regulations to provide and pay for access to telehealth. There is a complicated web of regulations that hinders telehealth providers from delivering care. Fifty state-level boards and one in the District of Columbia regulate the physical therapy practice and require physical therapists to be licensed in each state they may want to deliver care. This antiquated system hinders one of the very benefits of virtual solutions—the ability to deliver care anywhere. In many parts of the country, there is a shortage of providers, and telehealth can be the solution to close the access gap and serve areas with the greatest needs, but our current regulations are an unnecessary barrier to access.

         3. Simplify the care path. The path to access physical therapy can be circuitous and costly. While the CDC recommends physical therapy early in the care journey, PCPs often recommend unnecessary imaging or prescribe injections or addictive opioids for pain management first. MSK patients are also frequently referred to orthopedic specialists that lean toward surgical recommendations that do not resolve many MSK conditions. We must simplify the care path, allowing patients to see MSK care experts as the first line of treatment.

           4. Billing rules must be changed. There is a patchwork of varying state laws that govern the reimbursement of telehealth appointments.  Some states only stipulate that telehealth appointments may be reimbursed, leaving it up to the insurers to decide. In other states, the law states that insurers must cover telehealth and pay the same amount to providers as they do for in-person appointments. We must change these rules and allow physical therapists to be paid for providing telehealth services.

            5. Employers must change how they think about healthcare. With remote work now a reality for large parts of the population, workplace wellness and safety must be redefined. Workplace ergonomics must expand to the home office environment and safety and wellness tips must expand beyond reminders to hydrate and take the stairs.

 COVID-19 has been a wake-up call that we must heed. It is time to embrace and pay for telemedicine fully.

We’ve accelerated more in eight weeks than we have in the last 10 years. The time is now to modernize the way people provide and access care, using virtual solutions.

 Dan Rubinstein is the CEO of Physera, the provider of high quality, evidence-based virtual care for musculoskeletal (MSK) conditions. With a nationwide network of licensed physical therapists, Physera’s  program provides care navigation, MSK triage, diagnosis and personalized guided exercise therapy through the convenience of your smartphone.