Written by: Ibani Kapur
Medically reviewed by: Rob Philibert MD PhD
“Virtual” or telemedicine healthcare visits have become the new norm for many patients. Telehealth (TH), which includes health services provided through telecommunication and digital technologies, is a form of virtual healthcare. TH is not restricted to one type of service and includes several types such as patient education, diagnostics, health monitoring, and health information services. The use of TH has been expanded from initial applications that focussed on disease screening to include chronic disease monitoring and management.
Even prior to the pandemic, TH was a rapidly growing model of healthcare delivery. The pandemic has only strengthened its growth with the utilization of TH facilities increasing nearly 40-fold over the course of the pandemic. There are several factors that have led to this surge in the usage of TH services. Initially, many providers and patients were leery of the confidentiality and the quality of TH services. However, with time and the adoption of secure, easy-to-use TH platforms, these concerns have largely eroded. Reimbursement issues are still a challenge for many of these services. However, there is considerable pressure from consumers, who value the convenience of TH services, and employers, who no longer have to lose the productivity of their employees spent on traveling to and from appointments, to bring reimbursement of TH services on par with those provided in person.
Telehealth approaches offer a number of advantages that have led many to opt for TH services over traditional in-person provider visits. These advantages include easy access to specialists, markedly enhanced convenience, and occasionally, lower patient costs. It has also eased the burden on already strained healthcare systems by allowing lower-risk patients to stay at home and avoid the risk of accidental exposure to COVID-19. Higher-risk patients also can benefit. By improving chronic disease management, high-risk adults can have reduced serious relapse and re-hospitalization rates. Although infection from COVID-19 dominates concerns, the use of TH also prevents exposure to other pathogens. Whereas it is sad to note that nearly 700,000 Americans have died over the past 18 months from COVID, the risk from other infectious diseases cannot be ignored. In prior years, influenza often killed over 50,000 people annually. As a result, even prior to the pandemic, patients were often reluctant to go to provider offices. Instead, when available, they chose a TH option. This choice was beneficial for many of those with cardiovascular disease. According to a 2017 meta-analysis, heart failure patients that were managed via telemedicine as well as in-person visit experienced a reduction in heart failure admission rate as well as lower mortality rate. Could TH be the reason for the better outcomes? The authors speculated that the early intervention fostered by TH led to early recognition of relapse and the resulting decrease in morbidity and mortality.
The advantages of TH are being increasingly recognized by both employers and employees. According to a recent report from Mercer Consultancy, 75% of employees who had used TH plan over the past year use TH even after the pandemic. Conversely, a survey conducted by a global professional services company has reported more than one-third of US employers offering telehealth services to their employees and about 12% are looking at ways to incorporate it into their wellness initiatives in the coming years.
Employer demands may be key to resolving the roadblocks in reimbursement of TH services. US employers are very concerned with the costs associated with chronic disease in maintaining our increasingly aging workforce. But costs are not the only driver for employers. Employee health impacts their morale as well as productivity. The convenient access to healthcare professionals via TH can encourage employees to address their health concerns easily, without taking time off from work or other daily activities. By incorporating remote biometric monitoring, employees can also share detailed information with their healthcare professionals.
One of those biometric monitoring approaches may be through the use of new epigenetic tools such as Epi+Gen CHD. Epi+Gen CHD uses the latest in Precision Medicine and Artificial Intelligence technologies to prevent the risk of coronary heart disease (CHD). Screening with this new method is very convenient and the test can be conducted in the privacy of one’s home. The subsequent test interpretation and prevention planning are conducted via convenient TH follow-up. Best yet, this method is effective. In direct head-to-head testing, Epi+Gen CHD markedly outperforms conventional lipid-based approaches, particularly for women for whom it is 40% more sensitive in detecting risk.
As TH continues to be incorporated into the provision of health services, it is imperative to continuously adjust corporate strategies to optimize the mix of in-person and TH technologies for employee healthcare and wellness programs. An adroit continuum of both of these types of services that includes education, motivational training, and health support can be critical in maintaining the competitive edge for both employees and employers.