Aside from the obvious threats of COVID, the world faced several side effects from sheltering at home and social distancing, such as the loneliness from isolation. However, technology provided several work-arounds to the isolation, and has resulted in a permanent shift in the healthcare industry that will endure even after the pandemic subsides for good.
Telehealth or telemedicine, when a patient speaks to a healthcare professional via technology, is nothing new. But the demand and necessity of social distancing has resulted in the remodeling of entire hospital networks. Across the world, hospitals now have entire staffs dedicated to telehealth, and some patients even prefer it to their standard doctor’s visits.
Prior to COVID, MHC Healthcare in Marana had a small telehealth program mainly used for two patient groups: behavioral health patients who were in residential treatment facilities out of town, and for substance abuse treatment to further develop a network of support. However, these constituted less than 1% of their overall business, according to Jon Reardon, chief behavioral health officer for MHC Healthcare.
“In March 2020 when the Governor declared a state of emergency, we sprang into action. We worked with training departments and designated time. Because at that point only essential workers would be out and about, and our immediate concern was the continuity of care for the patient population. We had to bridge that gap,” Reardon said. “It went from 0 to 60 in no time at all. By the next week, our staff was actively providing telehealth services, and by the following month in April, we were providing as much service delivery as we had previously, all via telehealth.”
Aside from rapidly expanding their system by purchasing new webcams and laptops for staff, MHC Healthcare also had to introduce the system to many patients and employees. While Reardon admits there was a learning curve, he says patients also saw some unexpected benefits, such as not having to worry about childcare, transportation or commute time for their appointments.
“The willingness of the state of Arizona to temporarily allow us to provide services via telephone as well as audio/video did allow us to bridge more gaps,” Reardon said. “There were some folks who, regardless of how much effort you put in to provide training, were really going to struggle. It might be because of a lack of knowledge or access to technology, and the ability for us to have a telephonic code set as well as audio/video, allowed us to provide care that we otherwise would have struggled with.”
Telehealth was also especially important in Reardon’s field of behavioral health. With primary care doctors, patients may only visit the hospital for an annual wellness check or when they’re feeling sick. But behavioral health is often based around continual treatment courses.
“Before COVID hit, there was an understandable reluctance to using telehealth. It seemed new or awkward. The traditional model is you get to know your doctor and get that service directly,” Reardon said. “But what we found out is you can get the majority of that work via telehealth, and still establish very effective relationships. It really was pushed by necessity, but once they tried this out, it was a positive experience.”
Reardon says MHC’s biggest concerns for telehealth were around their substance abuse treatments, which can take place in group formats. However, he says they did see success with telehealth groups. However, some patients did request to be back in person, which MHC accommodated, with masking and temperature checks in place.
At their peak, MHC saw more than 80% of their behavioral health services conducted via telehealth. This has since dropped down to around 50%, with a slight increase since the Delta variant began spreading.
Of course, there are many hospital procedures that can’t be conducted via telehealth. But telehealth can still benefit these by freeing up time and hospital space for those who do need to go in for surgeries and more precise consultations.
According to Banner Health CEO Sarah Frost, from March 2020 through March 2021, 27% of Banner University Medicine Tucson’s ambulatory visits were via telehealth, with most online visit volumes coinciding with COVID-19 surges. This was of particular success in Banner’s Tucson locations, as Banner University Medicine Tucson accounted for 44% of all telehealth visits across the entire Banner Health system, which spans six states.
In May 2021, Gov. Ducey signed House Bill 2454, which expands access to telemedicine for patients, ensures doctors receive equal compensation from insurance companies for telemedicine services, and allows out-of-state health care professionals to provide telemedicine in Arizona.
“Even as COVID-19 cases start to decline, our telehealth visits are still steadily increasing, forcing us to reevaluate how we deliver care to this vulnerable population,” Frost said. “As it’s currently trending, we will continue to encourage telehealth visits for our behavioral health population in Tucson, so long as it is appropriate for the patient and they meet specific criteria.”
MHC Healthcare has even created a permanent work-from-home workforce. In the past, they had to create additional buildings or expanded spaces in response to higher demand, but now a portion of that new demand can be satisfied via telehealth. Reardon says there are even members of the staff who have found they prefer to provide help this way.
“We’ve always thought about this and wanted to address those gaps in care. Obviously when the pandemic hit it maximized demand, but even going forward we are seeing this is a very effective way to deliver service,” Reardon said. “For most populations, it is as efficient as face-to-face, and in fact it is a form of face-to-face, just through a screen. We believe it’s here to stay.”