Remote patient monitoring, technological advances that impact the balance of where and how care happens, and temporary reimbursement enacted by government and payers for the sake of the pandemic are three hot topics in telemedicine today.

To get an idea of where these areas of telehealth will evolve in 2022 and beyond, Healthcare IT News interviewed a heavy hitter in the realm of virtual care, Roy Schoenberg, president and CEO of Amwell, a telemedicine technology and services company.

Q. Remote patient monitoring and automation are areas of telehealth that are of growing interest to healthcare provider organizations. What do you see happening with RPM and automation in 2022?

A. We need to understand the motivation for remote patient monitoring, which is the understanding that patients are spending most of their time at home. The ability to increase our level of medical oversight and potentially act on that oversight at the home level will not only make people's lives better, but also help us prevent patients from relying on care in more costly settings.

RPM technologies play an important role, but they are only a very small piece of the healthcare puzzle. Said another way – for RPM to truly live up to its promise, we need to focus less on the devices themselves and more on what they connect to.

Automation is in many ways the connector and I believe care automation will be what moves the needle on healthcare even more than the EHR revolution. If we were aspiring for the best care of a patient, we would be with them all of the time, but the problem with that model is that it's not financially viable.

With automation, we can establish a presence of healthcare that is "always on" and never goes to sleep – that is always responsive and interactive with a patient in a way that doesn't break the bank. Moreover, it will be a presence that is very knowledgeable about an individual's medical condition and challenges, and it will engage, inform and support individuals throughout their health journey in a highly economical way.

Digital automated companionship for patients is right in front of us, and it's going to start with patients who require more intense support and who need to be watched very carefully. It will be powered by a combination of artificial intelligence, machine learning and natural language processing, and it will be built with escalation paths into higher (and more costly) levels of telehealth and physical care when needed.

This is one of the most exciting advancements we'll see emerge in 2022, and it will make a deep impact on care delivery, care outcomes and healthcare costs.

Q. What do you see in the realm of technological advances in telemedicine in 2022, and how will these impact the balance of where and how care happens in the year ahead?

A. This year, we saw hybrid care models that combine in-person and virtual care begin to reshape care delivery across the healthcare industry. Today, accelerated in large part by the pandemic, there is an understanding that patients will be interacting with healthcare both physically and through technology – it's inevitable.

Now that we've accepted that some of our healthcare will happen via technology, there's a whole new world of opportunity in front of us that we'll begin to see take hold in the year ahead. Specifically, we're seeing a new breed of digital technologies powered by automation emerging and finding their place as a meaningful part of the care journey. When I think about technological advancements in the year ahead, it's less about what else telemedicine will be able to do and more about how it will work with and be integrated with these new technologies to create a seamless, yet always-on healthcare experience.

In fact, the ability to tie together in-person care, virtual care and technology-driven care is a completely new model for healthcare and, when done right, presents a much more economical experience for all. With the influx of various technologies and the plethora of use cases that virtual care is now being used for, however, we've put ourselves at risk of having a very disjointed healthcare experience.

Our recent survey of health systems, health plans and clinicians found the vast majority of healthcare organizations are using at least three telehealth platforms or systems – and more than a quarter have five or more platforms in place.

All groups reported a lack of integration and interoperability as a major pain point. In 2022, we will see a streamlining of various virtual care systems boiled down into a single platform that not only allows for all the new technological capabilities and devices to plug into it, but also for the seamless handoff between care settings.

Q. All the temporary reimbursement moves enacted by government and payers for the sake of the pandemic really pushed telehealth into the mainstream. What do you foresee happening with these regulations for virtual care in 2022? Will they become permanent? Will they be expanded?

A. When we start thinking about how individuals can coordinate their care – not with the people who are next to them, but with the people who are right for them – we have to create a vehicle that will allow healthcare to travel over technology without breaking everything else in the system.

In any other industry, the notion of creating restrictions around access at the state line is unheard of. We've never had to think about healthcare in this way because we've tended to think of care as being very physical and very proximal to where we live.

As more care is rendered through technology, however, we need to change how we think about accessing it. There is a lot to be gained by the opportunity to pool care resources together virtually.

Relaxation of state licensure requirements during the pandemic facilitated access to care providers in geographies where specialists are few and far between. The reality is that access to care is thwarted because the distribution of specialty care is not equal in all regions, cities and geographies. That's a scenario that existed long before the pandemic.

The notion of a state structure for healthcare is embedded everywhere, both on the delivery side and the insurance side. Even large commercial plans are state-specific, and there are agreements between these plans not to interfere with one another when it comes to coverage.

This is an area that is going to be tested in the very immediate future, and I think it's likely to happen in 2022 at the state level, the insurance level and the federal level.

Local medical boards – which have an important role to play in ensuring that the care provided locally is high in quality – would do well to proactively consider how to allow healthcare to travel over technology while still protecting the quality and experience of care.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.