The ongoing coronavirus pandemic has forced healthcare providers to rethink the way they offer their services. Since older adults are among the most vulnerable groups to contracting the virus and developing serious complications, their access to medical care is especially important. To address this issue, federal regulations have been revised to ease restrictions and enable providers to use telehealth services.
Telehealth is a form of technology-enabled health care that involves electronic communication and remote patient monitoring. Telehealth services were used even before the pandemic as a result of advances in telecommunication technology. However, starting from March 2020, when the pandemic hit the U.S., their use rose from 0.15% of claims to 13.0%.
Policy changes
The magnitude of this public health crisis is reflected in recent policy reforms. The Centers for Medicare & Medicaid Services (CMS) have increased access to telehealth services as of March 6, 2020. Before that, although available through Medicare, they were restricted to people who lived in designated rural areas.
To prevent the virus from spreading between patients and caregivers, the Centers for Disease Control and Prevention (CDC) recommends looking for alternatives to face-to-face triage in ambulatory care settings.
With the 1135 waiver, telehealth visits from a variety of providers can be reimbursed. This includes physicians, nurse practitioners, clinical psychologists, dieticians, and certified clinical social workers, as long as an audiovisual telecommunication device is used in real-time. Health Insurance Portability and Accountability Act (HIPAA) restrictions have also been eased to allow communication through video conferencing platforms like Zoom, FaceTime, and Skype.
Challenges
Advancements like telehealth, remote monitoring devices, or medical transcription services have always had the same goal: to improve the medical system's performance while lowering costs and increasing accessibility. And although telehealth does bring some significant benefits to the elderly, there are, of course, some challenges.
First of all, Patients need to have broadband internet and an audiovisual device such as a smartphone, tablet, or a computer equipped with a webcam. They also require a certain degree of digital literacy in order to use them. This can be resolved if they can get support from someone who does have digital literacy, such as a family member of designated health care professionals.
Another problem might be that elderly patients with hearing impairment may have trouble using telehealth services since many of the current platforms don't have closed captioning or other options to mitigate this issue.
Some medical problems will still require in-person examinations but, once again, telehealth services can be very useful for triage and reducing the spread of the virus. The medical professionals providing these services will have to use their expertise to determine whether telehealth is suitable for a particular patient or a face-to-face consultation is required.
Lastly, elderly health care involves additional resources like home care, nutritious food, toiletries, social support, and accurate information on how to protect their health and what they need to do if they get sick. Policymakers and medical professionals will have to develop programs that address all of these needs in the context of the ongoing pandemic.