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In the wake of a nationwide stay-at-home order, healthcare providers swiftly made financial and technological adjustments to deliver care to patients virtually. Several new surveys suggest this trend is likely to continue, with more patients and healthcare providers embracing telehealth than ever before. The use of telehealth for dialysis patients has been especially important as providers worked to protect patients from the risks of COVID-19.
The Renal Physician's Association recently conducted a survey to examine the use of telehealth by nephrologists to provide kidney care to their patients during the pandemic. While 74 percent of nephrologists surveyed had not used telehealth prior to the public health emergency, the findings show that the use of telehealth in kidney care has grown exponentially. It also showed overall satisfaction with the quality of the patient-physician encounters that took place via telehealth.
“Providers feel that if they can structure their day better, they can provide better care and have more engagement with their patient,” said Dr. Ahmad Sharif, Chief Medical Information Officer for Fresenius Medical Care North America (FMCNA), during an episode of the company's podcast,Field Notes. “At the same time, the reimbursements for these interactions have been brought up to par of an in-person visit.”
In the two weeks following national stay-at-home orders in March, Fresenius Medical Care North America (FMCNA) implemented telehealth across its more than 2,600 in-center and home dialysis facilities nationwide. This resulted in a dramatic uptick in telehealth appointments between patients, care teams, and physicians. Almost 400,000 telehealth visits were logged in the company’s electronic health records by the end June.
Government and private insurers are adjusting towards the rapid adoption of telehealth. Before the spread of the virus, insurers often paid less than half the amount paid for in-person visits for telehealth visits, discouraging doctors from offering telehealth services. In response to the pandemic, payment for telehealth visits are now often equal to in-person visits, removing a barrier to wider adoption of the technology.
“I think that we will see a lot of new paradigms emerge out of this experience,” Dr. Sharif predicted. “I think we’ll see these technologies evolve pretty rapidly to make it as close to in-person visits as possible.”
In a survey conducted by Sermo, a private social network for physicians, 85 percent of physicians reported that they are now conducting virtual visits with patients, and 68 percent said they believe telehealth will have a lasting impact on how doctors see patients, indicating a desire for increased telehealth use in the future among both patients and care providers.
A study out of Duke University School of Medicine confirmed the rapid adoption of telehealth at the onset of the COVID-19 outbreak. Telehealth appointments at Duke University Hospital reached more than 1,000 video visits per day. Before the COVID-19 outbreak, health systems with high telehealth adoption performed less than 100 video visits a day.
Advances in telehealth and connected health technologies such as theHub, FMCNA’s own connected health platform, have been shown in a recent study to improve engagement and clinical outcomes for home dialysis patients. FMCNA has also been working on expanding telehealth and connected health technologies to better monitor home treatments remotely.
These advances can work in combination with new predictive tools such as the Imminent Hospitalization Predictive Model (IHPM), which uses machine learning to identify unseen risk factors that may require intervention, preventing potential hospitalizations before they happen.
“By using machine learning and advanced analytics and artificial intelligence, we will see a lot of improvements and refinements within these telehealth tools, all of which will combine to help us be more effective and efficient in care delivery,” said Dr. Sharif.