The pandemic forced providers into online care. Will they stay logged in once they can see patients in person?

The coronavirus pandemic has changed nearly every facet of how hospice care is delivered during this time. But when it comes to hospices adopting telehealth in response to the virus, many are wondering if care delivery online will carry into the future. Historically it has been difficult for hospices to establish strong telehealth programs, but now that COVID-19 has forced the issue, what does the path forward look like?

Hospice has long been a prime spot for telehealth due to the home-based care design, the access issues inherent for hospice patients, the remoteness of some coverage areas and the need to check in often on seriously ill patients. However, the utilization of telehealth by hospices has been surprisingly low,” said Robin Stawasz, Program Development Executive at Acclivity Health.

Telemedicine has been technologically available for some time, but often under-utilized by hospice, palliative care, and other health care providers. So, what are the barriers to using telemedicine for patient visits?

“This could be attributed to the sense that the power and intimacy of a hospice intervention is somehow diminished by not being there in person,” Stawasz said. “Also, an often-overburdened staff is understandably reluctant to take on more demand, and establishing telehealth does require some work and advocacy. But again, once it becomes routine for an organization, the gains in effectiveness and efficiency outweigh the effort.”

When the coronavirus reached the U.S., COVID-19 made telehealth a necessity despite the difficulties of establishing a program. With staff numbers down, the need to limit exposure, and families requesting that no one visit in-home, hospices have had to find ways to safely deliver care while decreasing face-to-face interactions. Now that providers are experiencing the flexibility remote health care offers, they may choose to continue after restrictions are lifted.

“Now that this genie is out of the bottle and the benefits of remote care have been realized, there will be little going back. Even CMS has acknowledged that telehealth will continue to be supported even after the state of emergency is lifted,” said Stawasz.

Many hospice advocates are already calling for Congress to allow telehealth to be used for recertification and other visits after the COVID-19 crisis ends. Many feel CMS is likely to continue supporting telehealth use in hospice, and Stawasz agrees.

“As hospices, along with many other health care providers, are going to be faced with even greater staffing, funding and demand challenges, the efficiency and flexibility that telehealth provides will be a necessary part of the new normal. Also, as patients and families learn what is possible and what value they can gain through telehealth, there will be increasing consumer demand for telehealth, which providers will be called upon to provide.”

Regardless of how quickly hospices had to take their services online, Stawasz foresees many opting to keep at least some telehealth services available going forward. They’ll likely make improvements to the platforms or security of communications as they go.

“While the need for in-person care will always exist, the gain of more frequent communication, increased accessibility, and greater patient and family input from telehealth should not be ignored,” she said. “Of course, continual attention must be paid on whether telehealth is a safe and appropriate alternative for each patient’s unique situation.”

You can read the full summary of waivers from CMS here. 

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