When the COVID-19 pandemic hit earlier this year, health system executives had to shift their priorities to fast-track innovations such as virtual care services and artificial intelligence tools.
About a quarter of healthcare executives (26%) said the shift to telehealth and virtual care was a top innovation priority at their organizations prior to the pandemic, according to a survey of 117 executives conducted at the beginning of the year by the Center for Connected Medicine (CCM).
That has now jumped to 49% of executives who say virtual care is a top innovation priority, according to CCM's follow-up survey from this summer.
Prior to the pandemic, executives said their organizations had run into challenges with tight regulations and low reimbursement that made progress in the shift to telehealth difficult. When the pandemic occurred, leaders experienced rapid progress as regulations were loosened and reimbursement was increased.
CCM, in partnership with KLAS Research, surveyed executives from May to August on how innovation priorities shifted in response to COVID-19 and the role of key technologies in managing the pandemic.
Nine out of 10 organizations successfully met increased telehealth demand during the pandemic, according to the survey findings. But the quick implementation of telehealth solutions in response to the pandemic highlighted areas needing improvement—in particular, integration gaps, especially with platforms not built for healthcare workflows, executives said.
While some data show that telehealth visits are beginning to drop as patients return to the doctor's office for in-person appointments, most health system executives said they plan to continue or expand telehealth services in 2021.
One health system CEO said, "We went from almost no telehealth to probably 90% of our visits through telehealth. The increase is exponential and unbelievable. We have learned how to do it, and our patients really like it. If COVID-19 disappeared tomorrow, we would still continue telehealth as much as we could because it is such a patient satisfier."
Executives who implemented quick, short-term solutions are looking forward to improving integration, infrastructure and security for an updated telehealth strategy, according to the survey findings. They also intend to reassess their technology and make long-term decisions about go-forward telehealth platforms.
"We are accelerating our work on digital solutions and telemedicine to improve the patient and provider experience. In some ways, the pandemic helped push through innovation projects that were under consideration and might have taken some time to implement," said Brent Burns, executive vice president of UPMC Enterprises, in the report.
Uncertainty around reimbursement
But post-pandemic regulation and payment remain obstacles. It's not clear whether government and private payers will maintain reimbursement after the pandemic subsides or whether reimbursements will return to prior levels.
The director of population health at one health system said the future of telehealth is "undetermined" as reimbursement is a major variable.
"In the past, payers and the government have usually not paid for telehealth or only paid at a discounted rate for certain services. If that is fixed, I think there can be a pretty healthy ongoing demand for telehealth. If the barriers resume, it becomes harder. When providers get paid less for doing telehealth services or sometimes don’t get paid at all, their incentive to provide those services is reduced," the executive said.
Only 20% of executives said their organizations will continue providing virtual care if reimbursement returns to pre-COVID-19 levels.
Sixteen percent said they would analyze the financial viability of continued telehealth use, 15% said they would lobby for improved regulation, 13% said they would return to face-to-face care and 30% said they were unsure.
What to expect in 2021
A key finding from the survey is that digital health solutions and technology were essential to the COVID-19 response, according to executives, and innovation that seemed to move at a glacial pace pre-pandemic has accelerated.
“Technology has been so essential to the COVID-19 response at UPMC and other health systems that the line now is blurred between traditional health care and digital health. Technology and digital applications that once were not used to their full potential are now a permanent part of providing the best possible care for our patients,” said Rob Bart, M.D., chief medical information officer at UPMC, in a statement.
Health system executives also quickly turned their attention to deploying AI and improving revenue cycle management during the pandemic.
Half of the respondents reported using AI in response to the pandemic for applications such as clinical decision support, management of beds, staffing and devices, and analytics—experience that is boosting interest in the technology and pointing to greater utilization in the year ahead, the survey found.
“COVID-19 has certainly opened our eyes to possibilities about what AI can actually do for us regarding tracking, trending, alerting, and those kinds of things," a director of clinical informatics said.
However, budget constraints as a result of current financial challenges and uncertainty about the future will likely mean top innovation priorities will be put on hold or slowed down.
“Following on the heels of COVID with limited funds, we are probably backing off any type of major project or innovation for the coming fiscal year. We were planning on doing some bigger projects, but I think we will be backing off of pretty much everything now," the vice president of health data support services at one health system said.