Healthcare Design - August 2020 - 41

The

Center

E X PA N D I N G H O R I Z O N

Growing use of telemedicine during the COVID-19
crisis is driving a need for new research on
impacts to care outcomes and brick-and-mortar
spaces By Debra Levin

OR YEARS, this industry has been talking about how
telemedicine was going to move a significant amount
of outpatient care from the traditional healthcare
setting into a "care anywhere" model. Discussions
considered the impact that an uptick in telemedicine
would have on access to care and care delivery and how
this would affect the buildings where healthcare is
delivered. Yet, over all of these years, only incremental progress was made to truly incorporate telemedicine into practice.
There were constant hurdles, ranging from regulations to reimbursement to the comfort level of patients and care teams adapting to a new
way of doing things. Then the COVID-19 pandemic hit and, overnight,
mountains were moved.
By the end of 2020, virtual care visits are expected to soar to more
than 1 billion, according to Forrester Research. Yet, the research states,
only 24 percent of U.S. healthcare organizations had an existing virtual
care program in place at the start of the year.
Though telemedicine has its limitations that come from not physically being in the same room as the patient, such as taking vitals and
listening to a patient's heart and lungs, the challenge of providing outpatient care during a pandemic served to heighten the benefits it has
to offer, as well. Some systems credit the
rapid adoption of telemedicine with allowTHE CHALLENGE OF
ing them to work quickly through large backPROVIDING CARE DURING
logs of patients who had been waiting for
in-person visits. It's also been a critical tool
A PANDEMIC HEIGHTENED
to help slow the spread of COVID-19 by limitTHE BENEFITS THAT
ing caregivers' and patients' exposure to inTELEMEDICINE OFFERS.
fectious diseases including COVID-19; lower
the cost of cleaning between patients; and
provide an easier and safer way for frail, elderly, less-mobile, and highrisk patients to receive care. Telemedicine has also served as a helpful tool for screening and triage, with nearly 900 million of the more
than 1 billion telemedicine visits expected this year to be related to
COVID-19, according to Forrester.
What isn't known yet is the quality of these virtual visits and the impact they may have on long-term outcomes versus in-person care. University of California San Francisco Health (UCSF) has been providing
telemedicine services since 2015 but saw a dramatic uptick in participation with the onset of COVID-19, jumping from 3,600 visits in February to more than 50,000 in April. Seeing an opportunity, UCSF is in the

process of analyzing data collected during these visits to ascertain if its platform is
improving access to services for those who
weren't previously receiving care. Other
healthcare systems, like Geisinger Health, are
working to uncover if certain conditions are
more easily addressed through a virtual platform than others. They're also embarking on
a study to see if readmission rates and emergency room visits are impacted differently for
patients who saw their care providers virtually.
From a design standpoint, we need to better
understand how aspects of the physical space,
such as lighting and camera placement, affect
outcomes, especially around critical issues like
diagnostic clarity. We also need to understand
what the long-term impact of telemedicine
might be on brick-and-mortar real estate dedicated to in-person visits. The Centers for Medicare & Medicaid Services is currently providing
reimbursement flexibility during the pandemic, allowing telemedicine to be more financially
feasible. Whether that will be a permanent
change is still to be seen.
In September, The Center will be holding
a day-long virtual workshop, "Telemedicine:
The Genie's Out of the Bottle," that will feature
what we've learned to date, including policy
changes, design best practices, and relevant research, and will spotlight innovative new models that are starting to emerge. Because the
workshop will be limited in size, we'll have the
opportunity to break into small virtual groups
to problem solve and learn from one another.
For more information, visit healthdesign.org.
Just a few months ago, telemedicine was on
the "near horizon." Now, with a worldwide pandemic, we've been pushed to learn quickly how
to produce the same level of care as in-person
visits when it comes to patient experience, quality of care, and privacy in telemedicine. The consensus of opinion is that we likely won't stay at
the level of visits that we're at now, but it's clear
we've hit a watershed moment and telemedicine
will continue to be a more integral part of our
care system moving forward. It's important that
we spend the time now to get it right. 
Debra Levin is president and CEO of The Center for
Health Design. She can be reached at D L E V I N @
H E A LT H D E S I G N . O R G .

AUGUST 2020

http://www.healthdesign.org

Healthcare Design - August 2020

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