The COVID-19 pandemic created a sudden need for virtual health care for patients and prompted regulators to drop stricter regulation of what could be provided.
Now, four years later, giant retailers are offering consumers direct access to services while traditional providers adapt and partner to meet patient needs, particularly for rural patients like many across South Carolina.
The future of health care for many patients and providers could be a mix of both virtual and face-to-face care, experts said.
Telemedicine, providing an exam via an interactive video system, has been around for decades, but it was limited by acceptance, traditional regulation and reimbursement to limited uses, such as in a stroke. Hooking up a rural emergency room that lacked specialists to a larger medical center meant patients with a suspected stroke could be evaluated remotely, and after a neurologist read a CT scan of their brains, offered clot-busting drugs that improved outcomes and survival.
Stroke was one of the first ways the technology showed it was better than the traditional approach, said Brandon Welch, CEO of telemedicine company Doxy.me and author of “Telehealth Success: How to Thrive in the New Age of Remote Care.”
“Telemedicine really proved itself in the stroke use case because it was a very clear path to success,” he said. But outside of that, and some limited use in psychiatry, the industry “was kind of treading water,” Welch said.
That is until COVID-19 hit in early 2020. Suddenly, hospitals and clinics were limiting who could be seen, while many patients feared leaving the safety of their homes, even when sick. Federal regulators like the Centers for Medicare and Medicaid Services quickly loosened the reins on what care could be provided virtually and also reimbursed, and many others followed suit.
Those flexibilities were meant to be temporary, and technically still are, with the latest expiration on Dec. 31. But most believe they will be made permanent soon. Congress has been trying in various bills, and the South Carolina Legislature recently passed new regulations codifying remote care standards.
The changes are here to stay, Welch said.
“They’ve been threatening to end it for the last four years, and every time the time comes, they extend it for another year or two,” he said. Members of Congress don’t agree on much, but “what they can agree on is telemedicine should be here to stay,” Welch said.
Big companies already believe that. Amazon purchased virtual-care provider One Medical; Costco members in South Carolina can use its provider, Sesame; and other big retailers have followed suit or soon will.
That kind of access is what many patients want, said Kaitlyn Torrence, executive director of MUSC Health Solutions. She gets it — she uses One Medical herself at times.
“I demand access. I want it quickly,” Torrence said. “And yet, I still want that continuum of care when I need to go to a higher level (of treatment).”
It poses a dilemma for MUSC Health and other providers in South Carolina and across the country: How do you compete with that? Or do you even try?
It’s something MUSC Health is thinking a lot about, whether to continue building its own or partner with a provider like One Medical to provide care that it can’t, Torrence said. For instance, one of those quick-access providers might be the first to see a patient, but MUSC Health becomes the provider for more acute care or for patient management.
One Medical is already a provider for 8,500 employers and partners with 18 health systems across the country, the American Hospital Association noted.
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