In the months and years to come, as we reflect on all that has changed in our lives due to the pandemic, patient engagement and telehealth will be among top subjects for healthcare.

Multi-year studies published between 2017 and 2019 showed that telehealth, while definitely a welcomed concept for home-bound or time-constrained patients, clinicians managing chronic diseases, and/or payers and providers looking to mitigate population health incentives, was still very much in its infancy.¹

Prior to the pandemic, an analysis of claims data showed that only about 2.4% of enrollees in large employer health plans had used a telehealth service.²

A report published by the U.S. Department of Health and Human Services on July 28, 2020, indicates that in April 2020, 43.5% (average across both rural and urban areas) of Medicare primary care visits were provided via telehealth as compared to 0.1% in February 2020.³

In-person, patient-clinician engagement for the management of complex diseases, such as cardiovascular disease and oncology drastically declined starting the end of March 2020. Cardiology in-person visits reached lows of 10% in April, and as of August 7, 2020, have only rebounded to about 48%.⁴  However, oncology in-person visits sustained the greatest decrease, hitting as low as 2% and only rebounding to about 15% of as of August 7, 2020.⁴

While reimbursement for telehealth services has facilitated adoption especially in primary care settings, a chasm prevails when we look at the use of telehealth services in complex specialties, such as cardiology and oncology.  And the answer to bridging this chasm may be clinical decision support solutions (CDSS).

Today’s patients and their families and/or caregivers want more than just treatment for the disease. They want their clinicians to:

• Include them in and personalize the decision-making process
• Educate them about treatment options
• Update them on the progress of their care
• Provide them with respect and dignity throughout their disease journey⁵

Clinical decision support solutions, powered by artificial intelligence  techniques, facilitate the clinician’s ability to have these in-depth and personalized discussions about the decision-making process.

By accessing the comprehensive CDSS that are now available in the market, clinicians can:

• Fully engage their patients virtually via a telehealth consultation
• Show them exactly the status of their condition based on diagnostic information
• Show them the options for treatment based on their condition
• Arrive at a decision together

As treatment progresses, clinicians can virtually update patients on progress and present options if treatment needs to be adjusted.  

In addition to offering the ability to engage in personalized treatment decisions and management, virtually accessing CDSS via a telehealth service allows clinicians to reinstate complex disease care for the patients while addressing the mutual concern of virus exposure. 

More importantly, with studies estimating tens of thousands of excess cancer deaths due to missed screenings, delays in diagnosis and reductions in cancer care due to the pandemic, it is critical that clinicians take action and lobby through advocacy associations, the Centers for Medicare and Medicaid Services and private insurers for reimbursement for virtual use of CDSS in patient-clinician treatment decision-making. ^4,6 

The ideal synergy of telehealth and CDSS could be a true game-changer, enabling patients and clinicians to make decisions together along the care continuum of complex diseases while ensuring clinicians continue to provide the quality of care and outcomes patients expect and deserve. 

For more information on how telehealth and AI-powered clinical decision support solutions can enable personalized patient-clinician engagement, visit Siemens Healthineers Digital Health Solutions.

About the Author

Liana Romero, PhD, MBA, MT (ASCP), is the Head of Global Marketing, Clinical Decision Solutions, Digital Health, for Siemens Healthineers GmbH.

References

1.Harvey, J. B. et al. (2019) Utilization of Outpatient Telehealth Services in Parity and Nonparity States 2010-2015. Telemed J E Health. doi: 10.1089/tmj.2017.0265

2.Rae, Matthew et al. (2020, March 3). Overage and utilization of telemedicine services by enrollees in large employer plans. Peterson-KFF Health System Tracker. https://www.iqvia.com/-/media/iqvia/pdfs/files/iqvia-covid-19-market-tracking-us.pdf?_=1598288823560

3.Assistant Secretary of Planning and Evaluation (ASPE). (2020, July 28). Medicare Beneficiary use of telehealth visits: Early data from the start of the COVID-19 pandemic. U.S. Dept. of Health and Human Services. https://aspe.hhs.gov/system/files/pdf/263866/HP_IssueBrief_MedicareTelehealth_final7.29.20.pdf

4.IQVIA. (2020, August 14). Monitoring the impact of COVID-19 on the pharmaceutical market. https://www.iqvia.com/-/media/iqvia/pdfs/files/iqvia-covid-19-market-tracking-us.pdf?_=1598288823560

5.Schaeffer, C. (2016).  Talk to me. Improve patient engagement; improve your cancer program. https://www.accc-cancer.org/docs/Documents/oncology-issues/articles/JF16/jf16-talk-to-me

6.Nelson, R. (2020). More Than 10,000 Excess Cancer Deaths due to COVID-19 Delays. https://www.medscape.com/viewarticle/932858