Becker's Hospital Review

22 Executive Briefing SPONSORED BY T elehealth is here to stay. In 2020, virtual health solutions and stopgaps were sped into place to enable the delivery of healthcare during the COVID-19 pandemic. These solutions — which provide important benefits for patients and providers — have now become a permanent fixture in healthcare. However, as hospitals, health systems and health plans contemplate their future digital care strategies and investments, they are realizing they must pursue a more strategic and integrated approach to ensure that virtual care continues to fuel a higher quality and more seamless care experience. To better understand the virtual care landscape, the barriers that remain and the outlook for the future, Amwell partnered with HIMSS Analytics on a survey of 100 front-line clinicians and support staff, 102 senior leaders at hospitals and health systems, and 100 health plan executives. The results were reported in Building the Future of Virtual Care: Streamlined, Scalable, Sustainable. This article is based on the Amwell survey, research included in the report and conversations with Amwell executives Ali Hyatt, Vice President of Marketing, Jamile Mack, Sr. Account Director, Provider Solutions, and Jalpa Sheth, Account Director, Health Plan Solutions. They shared their observations and insights about the future of telehealth. During the peak of the COVID-19 crisis, telehealth became mainstream Prior to the pandemic, telehealth was in phase 1 — a decades- long incubation period in which telehealth users and use cases increased incrementally over decades. But overnight, due to the COVID-19 pandemic, that slow, incremental progress turned into explosive growth, ushering in phase 2 of telehealth. The data tells the story. In the fourth quarter of 2019, there were 1 million telehealth visits, representing just 1 percent of all healthcare visits, according to the COVID-19 Healthcare Coalition Telehealth Impact Study. Then, in the first quarter of 2020, there were 5 million telehealth visits, accounting for 5 percent of all healthcare visits. The number grew to 33 million in the second quarter of 2020, representing 37 percent of all health visits. Throughout the early and most intense periods of the pandemic, telehealth was the only game in town. It proved to be a lifeline for many patients and providers. For many provider organizations and clinicians, the immediate focus during this time was launching and scaling telehealth solutions as quickly as possible to meet the overwhelming demand. "Often times in a matter of days, clinicians had to figure out how to see their patients," Hyatt observed. "As a result, 2020 was understandably about speed, not strategy." Making telehealth a more sustainable part of care delivery In the second half of 2020 the percentage of virtual visits has stabilized at around 22 percent of visits, below the peak in the early days of COVID-19, but still far above the level prior to the pandemic. "We're entering a new phase of telehealth," Hyatt said. In Mack's view, "As telehealth enters a new phase, healthcare leaders are reconsidering the role that it will and should play in care delivery and in their organizational strategy over the long term." In this new phase, the emphasis has shifted from reacting amid a crisis to proactively and strategically adapting for the longer term. Key drivers of this new phase include: • Patient demand for telehealth. By now, almost all patients have had a telehealth visit. During their last telehealth visit, 8 in 10 consumers had a positive experience, per a recent report from the COVID-19 Healthcare Coalition. Hyatt pointed out that 41 percent of patients said they would have chosen telehealth over an in-person visit for their most recent appointment and another 26 percent viewed telehealth as interchangeable with an in-person visit. • Clinicians see benefits in telehealth. Virtually every clinician has had experience with telehealth, and most have a favorable view, citing benefits of improved patient access (82 percent), increased efficiency (52 percent), improved patient experience (51 percent) and a more flexible work-life balance for themselves (43 percent). Clinicians don't see the use of telehealth declining. For their own practices, a majority expect telehealth to either increase or remain at its current level. • Use cases are diversifying. The use cases for virtual care are expanding beyond the most common initial use cases of urgent care and behavioral health to primary care, chronic care management, follow-up visits after surgery or hospital stays, specialty care and more. As telehealth use cases broaden, telehealth volume will continue to grow. Despite telehealth's positive momentum, challenges and barriers remain While consumers and providers are enthusiastic about telehealth, and the benefits are clear, long-standing barriers to adoption and use remain. However, those barriers vary among clinicians, hospitals and health systems and health plans. Telehealth 3.0: Advancing from sprawl to smart, strategic growth

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