The rapid adoption of virtual care during the COVID-19 pandemic may be winding down compared to levels it reached early in the COVID-19 pandemic.
But that shift marked a "sea change" in healthcare that will have a long-term impact on how care is delivered, said Mayo Clinic health IT leader John Halamka.
"Organizations were at 5% telehealth visits and that went up to 95% [early in the pandemic] and now it's down to 25%. Organizations went from 5% to 25% in six months," said Halamka, president of Mayo Clinic Platform, speaking during a virtual roundtable Tuesday hosted by Google Cloud.
Future virtual care growth will be driven by a number of factors including increased patient demand for these services along with permanent regulatory changes supporting telehealth and increased adoption of payment models that focus on cost savings, he said. "What I’m seeing is that this change is here to stay and we'll start at a baseline of 20% to 25% and grow from there," he said.
The buzz around telehealth continues even as some data shows that virtual care usage is dropping after hitting peaks in April.
Recent electronic health record data from Epic indicates that volumes peaked in mid-April when telehealth visits comprised 69% of total visits. Since then, levels have dropped to make up only 21% of total visits, though this is still much higher than the rates seen before the pandemic, less than 0.01%, Epic reported.
As telehealth rates rise and fall, health systems are continuing to invest resources in virtual care solutions, experts say.
"Most CIOs (chief information officers) we talk to say they are looking to invest in these new platforms and are looking for permanent solutions to scale," said Aashima Gupta, director of global healthcare solutions at Google Cloud.
But the uptick in virtual care presents major challenges to provider organizations that have already invested a lot of money into brick-and-mortar facilities, said Medically Home’s CEO Raphael Rakowski.
"These changes are not going to roll back so you will have to rethink how the real estate is used," he said. "A quote that I heard recently is that if you don't have a backfill plan and can't fill those empty beds, then you going to need a backhoe to raze your building."
Future of virtual care
The pandemic has accelerated progress in virtual care more in the past 12 weeks than in the past 12 years, Rakowski said.
Healthcare leaders are recognizing an opportunity to separate medical services from physical assets such as hospital facilities, Rakowski said.
Mayo Clinic scaled up its virtual care services in partnership with Boston-based Medically Home. In July, the two organizations launched an at-home advanced care model for patients in Jacksonville, Florida and Eau Claire, Wisconsin.
Virtual care is helping to increase access to care because providers are not tied to a particular geography, Halamka said.
"The pilot in Wisconsin, it's a rural setting that doesn't have huge access to capital to build more brick and mortar. With Medically at Home, we see twice as many patients using the same expertise and the same staff without having to build new buildings," he said.
Mayo Clinic's partnership with Google Cloud has played a pivotal role in the health system's pivot to virtual care during the pandemic, Halamka said.
In September, Mayo Clinic tapped Google Cloud as a strategic partner to accelerate innovation in artificial intelligence, analytics and digital tools.
The organizations were "well on that journey" when the coronavirus hit the U.S., prompting a quick shift in direction, Gupta said.
Halamka, who joined Mayo Clinic in January, said the health systems' 2030 technology strategy quickly became it's 2020 tech strategy.
"There was a rapid acceleration of virtual care, remote monitoring and bringing in data from multiple disparate sources. That all requires different workflow applications and privacy-protecting data analytics and we could not do that in an agile way without a cloud platform," he said.
Moving forward, organizations will need a hybrid approach that brings physical care and virtual care together in a centralized care model, Rakowski said.
As virtual care and remote monitoring player a bigger role in how care is delivered, AI will be a critical tool to help separate "the signal from the noise" with more health data coming in from disparate sources, Halamka said.
Mayo Clinic is leaning on Google Cloud to develop what Halamka called an "AI factory" that enables any clinician at Mayo to build algorithms using Mayo de-identified data that can be incorporated into clinical workflows.
"I think you’re going to see, in the next several quarters, more automation, more chatbots and more focus on democratizing technology expertise because we’re ready for the change," he said.