As little as 10 % of patients in the US reported using telehealth before the emergence of the novel coronavirus. However, as the world battles to contain the spread of Covid-19, the concept of digital healthcare is becoming an imminent reality. The Cleveland Clinic reported a dramatic increase in remote outpatient visits from a 2% low, to a colossal 75% over the period of March 7 to April 11. And we are witnessing comparable trends with digital health platforms across the board. The burning question is; is telehealth here to stay? Or is it a transient silver lining here to serve the healthcare communities during Covid-19?

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Telehealth is not a new phenomenon. However, there has been widespread resistance to its adoption and momentum has been slow. The WHO broadly define Telehealth as the "delivery of health care services, where patients and providers are separated by distance”.  Sounds familiar, doesn’t it? At a time where being “separated by distance” proves paramount to the protection of our communities, it is no wonder that the telehealth epoch has finally arrived. 

The rigor of regulatory and legal frameworks, combined with lack of reimbursements glare with notoriety when we consider the barriers to telehealth adoption. However, they are not the only ones. Prior to Covid-19, HCPs were typically not compensated for providing telehealth consultations the same way they were for face-to-face consultations. Many doctors and patients have also been reticent to revoke the traditional philosophies of medicine, which deem human touch essential. 

So, what has changed? Covid-19 is cutting through the red tape that initially restricted adoption of telehealth. It has forced the healthcare world to do a 180° on digital health, welcoming it with open arms. In the wake of Covid-19 telehealth is being leveraged to manage challenges facing healthcare systems, from mitigating hospital and emergency department overcrowding, to providing high quality medical consultations and monitoring to patients. The vast majority of hospitals in the US report a surge in the use and reliance on telehealth and expect to sustain increased levels of usage post-Covid.

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Both the CDC and WHO endorse the use of telehealth in official guidance addressing healthcare system operations during Covid-19. While telehealth historically faced myriad legal and regulatory challenges, emergency policy changes have been introduced to support its adoption. The US has seen an expansion in coverage across settings, waiving of co-payments and loosening of HIPAA requirements as part of its emergency response (coronavirus emergency legislation and CARES Act). Patients can now use telehealth services at any location, and physicians can now take on new patients in any state remotely. Loosening of privacy restrictions allow standard video conferencing apps such as FaceTime, Zoom and Skype to be used for telehealth, while they become compliant for health applications making them long term options. Prescribing guidelines for controlled substances have also been redacted so they can be prescribed during telehealth visits. Equipment for non-urgent injuries can also be prescribed remotely and shipped to patients with follow-up fitting consultations arranged online. 

Similar trends are happening across Europe. In France, reimbursement rules have been eased, and in Germany, the Health Innovation Hub has published a list of trusted telehealth providers. Having enacted its ‘just-in-time’ DVG (Digital Health Act) late last year, Germany was quick to lift restrictions on video consultations and allow more possibilities for psychotherapy video consultations, as well as the issuing of sick certificates without personal contact. In 2019 the British government unveiled its first long-term digital health plan proposing free mHealth to all UK citizens by 2023. In response to Covid-19 the NHS has requested GP surgeries to conduct as many remote consultations as possible.
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In line with this seismic shift towards digital health it is of little surprise that there is strong investment in this area. Digital health venture funding documented a record $3.1 billion investment during the first quarter of 2020, according to Rock Health.

Among the many interesting and exciting moves in this space include:

• The acquisition of the Finnish startup Kaiku by the publicly-traded Sweedish company Elekta. Elekta is one of the global market leaders in precision radiation medicine. Kaiku specialises in digital solutions for improved patient outcomes and this move will allow over 4000 cancer patients access the startups’ novel digital patient monitoring platform.
• The acquisition of the virtual physical therapy startup Physera by the digital chronic-disease-program Omada Health. Omada provides behavior-changing tools such as smartphone-based coaches and wireless weight scales to its customers digitally. This exciting move accelerates Omada Health's progression toward a fully integrated care experience on its premise that “Telehealth is here to stay,”.
• New York-headquartered start-up Tyto Care, has recently received $50 million to grow its telehealth examination and diagnostic platform. 
• British digital health company Babylon sealed a $550 million investment last year marking the largest ever digital health fundraise in European or US digital health. It has recently launched a Covid-19 care assistant which offers treatment to people who are ill and self-isolating, and triaging patients in accordance with NHS guidelines. The company is also offering Covid-19 antibody tests and allowing users to share results in support of national research. 
• The French healthtech giant Doctolib recently announced its 4-year vision to expand telehealth services and sustain it as a future standard of care. Last month the number of video consultations jumped from 1,000 to 100,000 per day and one survey carried out by the company reported that 74% of doctors, and 80% of patients say they will continue to use video consultation after the pandemic.  

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For more information on this space check out our Covid-19 digital solutions map, which is updated daily for more news and companies working to leverage telehealth as remote medicine becomes normality. https://www.healthxl.com/covid19.

Until a vaccine is developed, it’s likely that all of us will continue to proceed with caution, preferring services that mitigate risk and social interactions. As the industry begins to look forward to a world beyond (or alongside) the coronavirus, we envisage that healthcare will experience a "hybrid" reopening with urgent and essential services backtracking towards pre-Covid normality. The balance of in-person care and telecare is what we need to work out.

Telehealth is one of the rare sectors reaping a net positive effect of Covid-19. They say that “In the midst of every crisis lies a great opportunity” - Could Covid-19 be the opportunity telehealth has been waiting for?