Successful technologies have their big adoption moment — the event that pushes them past the “tipping point” and across the chasm to become a part of everyday life. The COVID-19 pandemic and the corresponding reduced barriers to virtual care are pushing telehealth further into the mainstream, as many health care providers are moving quickly to implement or expand telehealth capabilities.
As of mid-March, almost 80% of hospitals in the U.S. offered some sort of telehealth service, according to the Wall Street Journal. Yet, until now, consumer demand has lagged. Currently, health systems and direct-to-consumer telemedicine apps are reporting huge spikes in use of these services, as both consumers and providers are embracing their utility.
University of Pittsburgh Medical Center’s urgent care telehealth platform, AnywhereCare, has seen a six-fold increase in visits, from an average of 80 visits per day to 500. At the same time, the system’s ambulatory care telehealth platform saw visit volume in one 48-hour period equal to the telemedicine visits performed in the entire year of 2019. Atrium Health, based in Charlotte, North Carolina, experienced a 500% increase in telehealth usage.
Amwell confirmed that since January, usage of their app has grown by 158%, with 650% growth in Washington state. Teladoc Health’s patient visit volume spiked by 50% in one week in mid-March. I could go on and on with examples, but you get the point: telehealth is booming — and it’s crucial to slowing the spread and flattening the curve.
Systems without telehealth programs at this time — or that need additional resources — can contract with national telehealth companies including Amwell, MDLive, Teledoc and others. When possible, use your own physicians; patients — especially in rural markets — will prefer to be connected with their physician or someone in their community.
Some systems are utilizing physicians who are quarantined and still healthy enough to give care to conduct telehealth visits, to free up other physicians to perform in-person care and overcome workforce capacity issues. If it’s not possible to use your own physicians, it’s definitely better to outsource than to not offer this service that is so critical to consumer access to care and social distancing at this time.
In early March, The New England Journal of Medicine proclaimed telemedicine “virtually perfect” for COVID-19 care, highlighting a variety of different crisis applications. Numerous other sources have also documented the wide-ranging uses of telehealth during this crisis.
Telehealth has become a critical tool for sorting patients before they arrive in the ED, thereby protecting patients, clinicians and the community from exposure. More than 50 U.S. health systems had such programs as of early March, according to the journal, which noted that in ambulatory care settings, patients screening positive can be given a tablet while isolated in an exam room.
NYU Langone Health is one system using telehealth in this way, according to American Journal of Managed Care (AJMC). The system is encouraging patients with flu-like symptoms to utilize their Virtual Urgent Care services, enabling the system to rapidly scale up care. Similarly, the Ascension system offers an online 24/7 urgent care option for patients in all 50 states, no insurance required, according to DocASAP. NYU Langone Health is also reportedly allowing clinicians to use their iPhones, or “clinical mobile companions,” to conduct a telehealth visit into a patient’s room without potentially being exposed to the virus.
According to Fierce Healthcare, University of Pittsburgh Medical Center (UPMC) has pivoted its consumer telehealth services to focus on onboarding primary care physicians to address the flood of patients with potential COVID-19 symptoms. Some health systems are rapidly setting up telecommute capabilities to enable physicians to do virtual visits from their homes. Geisinger Health System, for example, is working to onboard 1,000 physicians for virtual visits by providing devices, cameras and headsets to physicians at their homes.
As part of its program, Geisinger Health System has also developed a chatbot to help triage and screen patients remotely, as reported by Fierce Healthcare. Systems are implementing such bots to further streamline video visits and manage the increased demand. As Alan Pitt, MD, professor of neuroradiology at Barrow Neurological Institute and Chief Medical Officer at CloudMedx stated to HealthLeaders: “The next phase of telemedicine is having an AI bot in front of that encounter where basically the patient can enter information while they are waiting.”
According to The New England Journal of Medicine, Avera health is preparing to send mobile home health care units directly to patients and coordinating home-based COVID-19 testing. Houston’s Project ETHAN (Emergency Telehealth and Navigation) has used telemedical oversight by physicians to supplement care offered in person by 911 responders. UPMC is also implementing telemedicine on EMS ambulances to decide whether patients need to come to the ER or not.
As reported in American Journal of Managed Care, Telemedicine carts have been deployed across all of NYU Langone Health’s Emergency Departments to aid emergency physicians in handling surges. Paul Testa, MD, Chief Medical Information Officer for the system, said: “ED has a set number of physicians, nurses and clinicians in it. If they get hit with an extra 50 patients who are complaining of similar symptoms, we now have telemedicine capabilities to magnify the clinical team in the ED to take care of those patients.”
E-ICU programs allow care teams to remotely monitor the status of numerous patients in ICUs in multiple hospitals. Mercy Virtual Care Center, Sutter Health and Sentara Healthcare are offering such services to monitor sicker patients. Geisinger Health is also using its existing e-ICU tools to manage patients across its campuses. The New England Journal of Medicine notes that it would be impossible to create such a program on short notice; however, rapid deployment of a two-tablet approach can reduce ICU caregivers’ contact with infected patients.
Telehealth technology is also playing an important role in supporting patient and family health by maintaining their connectedness. Geisinger Health is reportedly setting up video chat for admitted patients to be able to connect with their families at home. And, sadly, when necessary visitor restrictions make it impossible for people to say goodbye to their loved one in person, video visits are often fulfilling that need, to the extent possible. If this is something your system is considering, I can tell you firsthand that this is an absolute blessing for family members grieving both an illness or loss and the ability to be there in person.
Systems such as Jefferson Health are also deploying telehealth to enable clinicians to continue to care for established, non-COVID-19 patients, by converting scheduled office visits to telemedicine visits, according to HealthLeaders. These visits can be conducted with both patient and provider in the safety and comfort of their own homes. Importantly, the system makes online training modules and remote training available for clinicians or patients who require assistance.
Many systems are of course so overwhelmed with COVID-19 surge preparation and care that mental and behavioral health are not top service delivery priorities. Yet mental and behavioral health specialty providers have gone virtual to support patients while maintaining social distancing. As the crisis goes on, we hope to see more providers making mental and behavioral telehealth readily available, as it will be desperately needed.
As Ann Mond Johhson, CEO of the American Telemedicine Association recently said in a Healthgrades webinar on this topic: “Telehealth is really the ultimate expression of consumerism in healthcare. And so it’s really great to see it being deployed in a way that is benefiting so many people, both patients as well as clinicians.”
We know you are running yourself ragged, doing all you can to meet a million urgent COVID-19 communication needs. We see you. We appreciate your hard work and absolute dedication. You are making a difference.
In hopes of making things even a tiny bit easier, here are a few recommendations to effectively support your telehealth initiatives, across all of your marketing channels. If your team is overwhelmed and you need support, we are here to immediately assist you on any of these efforts.
As explained in more detail in my recent article “How to communicate with frightened healthcare consumers during the COVID-19 crisis,” consumers are in a state of greatly heightened fear and anxiety. So while we need to create a sense of urgency around social distancing and taking proper COVID-19 protection measures, it is not helpful to fuel a sense of discomfort or even panic with giant red banners and large photos of the virus. Instead, calm patients’ fears by leading with safety, security and comfort. Support these emotional benefits with telehealth’s functional benefits (e.g. convenience) and features (e.g. available 24/7), rather than meeting them with a barrage of features first.
Geisinger leads with a “comfort” message and a calm, cozy image. Even their “COVID-19” button is a nice, soothing blue.
A picture is, as they say, worth 1,000 words. Resist the temptation to use 1,000 words when describing your telehealth services. A wall of words is among the fastest ways to make telehealth look complicated and intimidating. Keep it simple. Use simple graphics and icons to support key message points. For the web, make an investment in excellent information architecture to ensure great user experience. After all, if your web page is complicated, people are going to assume that your telehealth service is complicated.
Advocate Aurora Health’s simple, short message callouts and icons make telehealth feel very friendly and accessible.
Treat telehealth as a technological vehicle for facilitating human connection. In other words, remember it’s not as much about the technology as it is about the people giving and receiving the care. Rural healthcare consumers in particular often have some resistance to using telemedicine due to concerns that they will miss out on personal relationships. In a January 2019 Gartner study, three out of five rural consumers said they would not like to try telemedicine. Obviously life has changed since then; however, it’s reasonable to assume there may still be some hesitance. The urgent need of care during COVID-19 may overcome that, in part; yet the onus is on us to make sure that community members do not put off seeking care because telehealth appears intimidating or unfriendly. Demonstrate that telehealth can actually be quite personal by putting a warm and welcoming physician front and center.
Core Health client Riverside Healthcare emphasizes that the patient’s telehealth visit will be with their Riverside Medical Group provider, which offers reassurance to potentially reluctant telehealth consumers.
Make it easy for patients to find, understand and especially use your telehealth services. Remove every barrier or complexity that you possibly can. This will be increasingly necessary to gain a competitive edge as consumers become more and more familiar with the numerous available alternatives, including national telehealth brands that offer very easy user experiences.
Support accessibility messaging across your communication channels. Actually, go beyond messaging to embody accessibility in your communications. Some systems and providers that have outdated web platforms have rapidly launched new microsites or landing pages to support COVID-19 resources and telehealth accessibility.
Cleveland Clinic uses a short explanatory video to demonstrate the ease of their Express Care Online app, messaging that care is “just a click away.” They are also waiving copays and pre-payments for COVID-19 screening to maximize accessibility.
Recent policy changes have made telehealth more accessible to encourage its use for COVID-19 screening and support social distancing. Some private insurers have said that telehealth screenings for the virus will be covered for free under their plans. The Centers for Medicare and Medicaid Services expanded Medicare coverage for telehealth visits. Medicaid reimbursement varies by state, with almost all states having some form of coverage.
Still, even pre-COVID-19, healthcare costs were the biggest driver of consumers’ financial uncertainty, and have caused many consumers to delay care, according to Gartner research. While telehealth reimbursement may not be simple for systems to navigate, we must make the consumer pricing of it transparent and easy to understand. This is the right thing to do during this crisis. It’s also the necessary thing to do to be competitive. Some systems, like Prevea Health, are waiving the fee for virtual visits related to the screening and evaluation of Coronavirus. Others are offering discounts, like Ascension’s $20 online urgent care visit offer.
Ascension is promoting $20 online urgent care visits for COVID-19 care.
Non-digital advertising can cross-promote your telehealth services, when appropriate. And, being an inherently digital service, it’s most important to cover your digital marketing bases thoroughly.
Whatever digital home you are using for your COVID-19 and telehealth information, support it well with paid search campaigns to ensure you are found and in the consideration set. Paid search on this topic is ramping up and becoming more competitive, and this is the best way to get found quickly in the moment of need.
Advocate Aurora Health and Ascension are competing for virtual visit business via paid search advertising.
We know it’s hard to think past COVID-19 right now. Just know that every step you take to implement, enhance and market telehealth now is a step towards a future in which telehealth plays a larger role.
Ann Mond Johnson, CEO of the American Telemedicine Association, indicates in a HealthLeaders report that now that more consumers have experienced the benefits of telehealth, the landscape will permanently change after the pandemic. “I think consumer expectations and consumers’ perceptions of what can happen are going to change and therefore, it’s going to be hard to go back. Once you give people something, it’s really difficult to take it away.”
We’re not going back. Virtual care will be part of healthcare delivery, not as a 'nice to have.' It is how care will be delivered post COVID-19. How are you going to think about it, and how are you going to create a great patient experience and provider experience so it’s sustainable?
We agree that thinking through both patient and provider experience is essential. Health systems should work to continue to improve the ease of accessing and using their telehealth services for both consumers and providers. The aforementioned Healthgrades webinar included an interesting discussion regarding the many benefits of telehealth not only for consumers, but also for combatting provider burnout. That alone offers an incredibly compelling reason to continue pushing forward in a continuous improvement effort.
We also agree that Telehealth will very likely “cross the chasm” to widespread, routine consumer and physician adoption. For healthcare marketers, gaining market share in virtual visits will be an increased focus. The time to enhance your marketing around this essential service is now.