Credit Suisse https://www.credit-suisse.com hosted the 3rd “Healthcare Disruptive Technologies & Innovation” (HCDT&I) day virtually with Dr. Sylvia Romm CIO, Atlantic Health System https://atlantichealth.org as one of the keynote speakers. She reported on how Atlantic Health System an integrated healthcare system, operates with a workforce comprised of 16K team members working in 350 sites including six hospitals, is currently responding to COVID-19.
To help relieve the anxiety and stress in the community, the Atlantic Health set up a hotline where a patient facing a nurse/physician can discuss health issues strictly related to COVID-19. The hotline was originally staffed with up to eight nurses and three physicians to accommodate the high volume of calls.
Dr. Romm reports that the system was overwhelmed almost immediately by the number of people calling in with many questions. However, Atlantic Health has allocated staff to accommodate the large volume of calls.
The health system has also started to move to chat bots to help with assessments, to guide people around symptoms and exposure to COVID-19, and to emphasize the importance of social distancing etc. The health system has also set up a drive-through sample collection centers for COVID-19 testing.
According to Dr. Romm, “Although telehealth can be an extremely valuable resource in the current environment, telehealth has been burdened by regulations which have hampered the adoption curve in recent years. For instance, up until recently providers needed to be licensed not only in the state where they are located but also in the state where the patient is located. If a physician wants to be licensed in 50 states, it will cost the physician $40-$50K even before considering ongoing renewal fees.”
However, both regulators and those practicing medicine now realize that many of the geographical boundaries don’t make sense. In response to the coronavirus outbreak, regulations around geographic, reimbursement, and privacy regulations have all been relaxed. Also, in terms of HIPAA, regulations have also become less strict on enforcement of procedures on some platforms. Since the loosening of regulations, Atlantic Health has increased the number of physicians practicing for the past two weeks which is more than the previous year combined.
Dr. Romm questions whether physicians being forced to use telehealth solutions during the coronavirus outbreak will stand up to keep the regulations relaxed once the outbreak ends or regulations revert to pre-COVID-19 levels.
Atlantic Health uses a combination of telehealth solutions. MDLive is used for their direct-to-consumer urgent care. However, because of the recent surge in volumes, Atlantic Health is also setting up a second platform which is adding video technology to the EHR platform Epic.
As for telehealth companies to be ready for the surge in demand, Dr. Romm notes that it would have been nearly impossible for them to have been prepared for such an event. She clarifies that urgent care telemedicine companies can generally be split into two categories. 1) Companies that provide technology solutions to physicians, who see their own patients, and 2) Companies that provide clinical services that are technology-enabled.
For example Teladoc Health sells clinical services that are technology-enabled to health plans and employers which may be by phone and video. However other companies such as Zoom sell their technology to physicians who see their own patients.
As Dr. Romm sees the situation “Right now, companies providing technology-enabled services are on a physician recruiting binge as they have way more patients than the number of physicians typically kept on staff are able to provide care. Physicians with telehealth companies report seeing ten times the number of patients they normally see.”
Dr. Romm emphasized, “Initially, companies ramping up capacity levels to meet demands will see volume levels come down post outbreak. However, the new improved infrastructure will still be there and the situation will be similar to how the lead-up to the Dot-Com bubble resulted in an immense array of telecommunications networks to be built which enabled the maturation of the internet as we know today.”
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