Updated: Jul 5, 2020
In today's world, it seems all graphs describing our lives and the fundamental changes happening right now in society and with our healthcare system are exponential; voters' net support for the Black Lives Matter movement, unemployment rate, new confirmed cases of COVID-19 and the utilization of telemedicine and video calls.
The American health system is witnessing an all-time high demand for behavioral health services, with an early April poll showing that nearly half (45%) of all U.S. adults say the COVID-19 pandemic has affected their mental health, while 19% say it has had a “major impact.” Telemedicine companies are seeing this spike as well, as Doctor on Demand, for example, had a 130% increase in behavioral health visits and Ginger saw a nearly 50% increase in active users on its platform. In our previous blog post from early March ("The Mental Health Ripple Effect of the Coronavirus"), we anticipated that these phenomena would only increase, while COVID-19 continues to rage across the country and telemedicine enjoys its time in the spotlight.
A few innovative providers have taken this to a whole new level, with fast deployment among clinicians and consumers in order to reduce barriers to care, such as the Cohen Veterans Network, which achieved greater than 90% conversion rate of all clinical services to telemedicine by the end of March. Behavioral health and telemedicine function hand in hand, as "providers usually do not need to physically touch patients, and because patients may prefer to access behavioral health services discretely, using virtual care technologies to deliver behavioral health services is one of the best and most impactful use cases", according to a recent report on the state of telemedicine by Zeigler.
So, will telemedicine solve the problem of access to quality care, one that many Americans face while seeking behavioral and mental health treatment? As America is in a mental health crisis - with more than 60 million people currently suffering from mental illness, and with a chronic shortage of behavioral health clinicians - a drastic change is required to level the playing field.
Shifting from Securing Access to Ensuring Quality of Care
Although it might seem like an ancient tale from the past, 82% of consumers did not use telemedicine pre-COVID (https://medcitynews.com/2017/12/consumers-telehealth/). However today, companies such as Teladoc and AmWell have had a whopping 159% increase in utilization (https://qz.com/1821549/telemedicine-faces-unprecedented-demand-in-the-wake-of-coronavirus/). Changes in regulations have allowed millions to receive access to behavioral healthcare, and telemedicine is to thank. Telehealth is the exciting future of healthcare, and how it is delivered should become an integral part of our behavioral healthcare system. However, the shortage of clinicians is still prominent; telemedicine does not create new clinicians, but it is improving the way existing resources are utilized. In order to dramatically influence these "economies of care," we need to improve treatment outcomes and maximize the value of every session delivered.
"Telehealth has great promise, but it is important that in introducing it, we do not digitize the same flawed and overcrowded health care system that struggles to meet the needs of patients today. The solution is not to bring in episodic, disconnected telehealth, and assume it will fix our problems. Rather, we must experiment with more comprehensive strategies that combine telehealth and the necessary in-person care so that we are digitizing a better, more efficient, and more equitable health care system."
According to Lori Uscher-Pines and Dr. Ateev Mehrotra from RAND Corporation.
By providing better and more efficient care to people, we can alter the scale entirely. We need to make sure the care that people receive results in improved outcomes and long-lasting treatment effects, otherwise we will find ourselves in a vicious cycle that will continue to increase the cost of care and inefficiencies within our system.
The rise of telemedicine must be leveraged to generate clinical, administrative, and financial benefits for healthcare providers and consumers. The COVID pandemic has demonstrated, across the board, that telemedicine is here to stay, and we must now look beyond the "is it working?" phase and view telemedicine as an infrastructure for further applications.
By augmenting telemedicine with advanced technologies such as artificial intelligence, voice analysis, natural language processing, and image recognition we can not only improve access to care but also impact the outcomes that this care facilitates:
Clinical value - improve treatment outcomes by empowering clinicians to follow evidence-based practice and standardizing the level of care across one's network, triage patients more effectively with early-prevention, drive personalized treatment and relapse plans, support decision-making with real-time data and analytics.
Administrative value - use automation to streamline the clinician's workflow, improve care coordination, and integrated care models, improve data capture and compliance.
Financial value - use predictive analytics to reduce no-shows and drop-outs while increasing engagement with consumers, use remote-patient monitoring to automatically track at-risk patients, demonstrate outcomes to outside stakeholders to attract new business and clients.
Mental illnesses are projected to cost $16 trillion globally by 2030, with 60% of all medical costs associated with mental health conditions. Social workers, psychologists, psychiatrists, nurses, and all behavioral health professionals are doing their ultimate best to tackle this pandemic head-on, however, most of the time with not enough resources compared to the enormous need in the population.
The growing adoption of remote care over the past few months brings an opportunity to maximize the clinical value of each session and improve treatment outcomes at scale. We are witnessing "the perfect storm:" the growing number of people suffering from mental health issues, shortage of clinicians, growth in value-based care and alternative payment models, matureness of AI-based technologies, and professional community openness to new technologies and change.
If we intend to provide care to a growing number of people, we are going to need to radically improve the efficacy of treatments and speed up remission.