From the distant past of the 1990s up to just a few years ago, many healthcare technologists have predicted that telemedicine would make it into the mainstream of healthcare delivery.

Today, thanks to many factors surrounding the COVID-19 pandemic, telemedicine has finally made it into the mainstream. And now that it is being so robustly used across the country, the big question is: What's next?

We spoke with a heavy hitter in the world of telehealth, Dr. Roy Schoenberg, president and CEO of Amwell, one of the big players in telemedicine technology and services, to get his views on how his predictions from last year turned out and where virtual care is headed in 2023.

Q. You predicted last year that in 2022 we'd see exciting advancements in remote patient monitoring and automation powered by the patients who need them most. How did that prediction turn out?

A. Not only has the technology for remote patient monitoring and care automation become more advanced, but the use cases they are powering are maturing rapidly. Today, we're seeing applications of automation that go beyond mimicking clinicians and instead are being used to help patients manage the reality they face in the moments in between visits when they are not in front of clinicians.

It's this area that I predict will grow more rapidly in the years ahead as it means that technology can actually assist clinicians in being there for their patients more frequently in a cost-effective way. As the industry struggles to keep up with workforce shortages and deal with financial constraints, technology that can serve clinicians and patients, while being financially viable, will become pervasive.

Still, we've only just begun to scratch the surface of what RPM and automated care programs can do to drive more patient-centric, value-driven care. We can transform lives and quality of life by extending the reach of clinicians through digital technology and empowering people to live their healthiest life.

Q. You also predicted that in 2022 patients will be interacting with healthcare both physically and through technology – hybrid care. How did that turn out?

A. 2022 was a year of advancing the understanding that digital care is much more than videoconferencing. People now are coming to terms with the fact digital care is not just about changing where care happens but how care happens.

By thinking about it as a true distribution arm, you can see how you can manage patient conditions differently, you can reach customers differently, you can motivate patients to play a more active role in their healthcare – this is a powerful reimagination of traditional care models.

Hybrid care models that combine physical and virtual interactions was the first iteration of seeing this understanding play out, and we saw these models accelerate significantly. The next phase is hybrid care models that combine physical, virtual and automated interactions.

It's this type of digital care delivery that we are focused on enabling our clients to achieve through an integrated platform approach that allows for a well-coordinated, seamless care experience across all settings.

Q. What are two predictions you have for 2023 on technological advances in telemedicine?

A. In 2023, we'll continue to see digital health's influence in completely reimagining how care is accessed and delivered. It's a transformation that will be sparked not just by consumer demand for digital care, but also by clinician preference.

In fact, clinician-initiated digital care will far outpace patient-initiated virtual interactions going forward, with clinicians becoming the top utilization driver. It's a trend we've already started to see.

We've reached a point where physicians and nurses are prescribing virtual care. Within physician practices, medical assistants are triaging patients for virtual encounters when the manner in which they are seen – in person or virtually – is less important than the need for speedy access to care.

In an era when patients are surrounded by devices, we'll not only gain greater knowledge of potential use cases for RPM and automated care, but also a wealth of data around which approaches work best in specific circumstances. These findings will further advance digital care from a "nice to have," convenient feature to an integral aspect of the continuum of care.

Additionally, I predict digital care will continue to shift from transactional to transformational. Virtual primary care is becoming ubiquitous, however the opportunity for virtual primary care is dramatically extended when it's tightly integrated with escalation paths to create a more comprehensive care experience.

Discussions around digital care's trajectory will increasingly examine how to more tightly integrate virtual care and digital health within the complete patient journey. It will be a time of reinvigoration around the power of what is still a relatively new component of care.

Some of our best learnings around digital health will take place in this space where the immediate pressures of COVID-19 have passed, and clinicians feel more free to imagine: "What's next?"

Q. What's a prediction you have for 2023 regarding telemedicine public policy?

A. One of the biggest challenges for the digital care industry continues to be around state licensure. It's clear we need to allow healthcare to be distributed around the country through technology – the internet does not stop at state lines.

What's less clear, however, is who on Capitol Hill will be the one to say, "We have to find another way." Change must occur in partnership with medical boards that will continue to play an important role in enabling the safe practice of medicine. It's inevitable this will be the biggest war we'll see play out over the next few years and it will greatly impact the future of care distribution.

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Email the writer: bsiwicki@himss.org
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