Last year, as cases of a new virus forced hospitals and clinics to close their doors as a protective measure, facilities across Iowa were forced to instead offer many of their services virtually.
In Cedar Rapids, Mercy Medical Center reported its providers connected with patients on more than 49,000 telehealth visits between March and December 2020, said Dr. Tim Sagers, a family medicine physician who spearheads the hospital’s telehealth initiatives. In 2019, that total had been less than 1,000 telehealth visits.
At UnityPoint Health locations across Iowa, which includes its health system in Cedar Rapids, telehealth visits rose from 6,700 before COVID-19 to more than 174,000 in the pandemic, officials stated.
And that was true for health care providers across the United States. According to a U.S. Centers for Disease Control and Prevention study, the number of telehealth visits at the nation’s four largest service providers increased up to 154 percent between January and March 2020 when compared with the previous year.
“I think the numbers speak for themselves,” Sagers said.
What’s Happened Since
The demand for telehealth remains much higher than it ever has before. But at this stage of the pandemic, unlike in its earliest days when fear of the virus was driving use, telehealth now is consumer driven.
Though clinics throughout Cedar Rapids are open and able to see patients in person again, many providers still are scheduling telehealth visits throughout the day because it is the patients’ preferred delivery of service, said Dr. Alecia Allen, a family medicine physician at UnityPoint Health.
Patients have embraced appointments from the comfort of their own home, no longer having to risk exposure to COVID-19 in order to maintain their care plan. For those who do schedule appointments during their work hours, a virtual visit can mean they don’t need to take time from work. Instead, Allen said some of her patients have joined a video chat from the car.
Specialties at both health care systems have seen a surge in use among their population, particularly among patients that live outside of Cedar Rapids and have to travel some distance to see a specialist.
“Where we are now with telehealth virtual visits is the beginning of a new standard of care delivery,” Allen said.
Utilization of telehealth services did fall during the summer months when COVID-19 cases remained steady across Iowa, and rose again in November when new cases surged.
It’s still unclear whether telehealth is helping to capture people who otherwise would not be engaged with health care, Allen said.
However, providers have pointed out that cancellation rates have decreased over the past several months, most likely because many patients are instead opting to switch their appointments to telehealth.
Advocates have long pointed to telehealth as a solution for improving access to medical and behavioral health services, especially in rural areas with limited resources.
But despite the benefits it poses, telemedicine has historically struggled to gain traction because insurance reimburses telehealth visits at a lower rate than in-person visits.
The pandemic has put a renewed focus on the issue around payment parity for virtual health care. If that happened, Sagers predicted health systems would be more liberal with their use of telehealth, even offering appointments beyond daytime hours.
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“The application of telemedicine is growing,” Sagers said. “Patients are more accepting of it and providers are more accepting of it. All of the pieces are in place, but the last thing is we need is to get true long-term buy in from payers and the government to build telemedicine parity. When that happens, it’s a big win for patients.”
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