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The Positive Impact of Telehealth on Senior Housing and Professional Services

The practice of using online services for medical purposes (broadly referred to as telehealth) is nothing new — the earliest use of this form of technology dates back to the late 1950s and early 1960s. But when the coronavirus swept the nation, logging onto our computers to take part in medical appointments quickly became ubiquitous, whether we were ready for it or not.

According to data collected from FAIR Health’s monthly telehealth regional tracker, telehealth claim lines increased 8,336 percent nationally in one year, up from 0.15 percent in April of 2019 to 13 percent in April of 2020. Additionally, the percentage of older adults who had ever participated in a telehealth visit rose from 4 percent in May of 2019 to 30 percent in June of 2020, according to a poll by the University of Michigan.

Although it hasn’t been without its complications, the proliferation of telehealth use has generally had several positive effects for most users, not the least of which includes the senior population. Although providers were forced to quickly adapt to telehealth systems when shelter-in-place orders went into effect earlier this year, the outcome has been, for the most part, a shift for the better.  Telehealth services clearly streamlined and increased access and delivery method of healthcare services for all – especially the vulnerable and the senior population.

The easing of previous restrictions helped usher in new ways to provide expanded medical care

For telehealth to work — and for medical providers to shift so quickly to their new virtual roles — some changes had to take place at the governmental level. Although the technology that makes virtual doctor visits possible hasn’t necessarily changed over the past few years, previous restrictions drastically limited doctors' ability to receive Medicare reimbursement (or payment for) for virtual telehealth visits. Since the inception of telehealth, Medicare and some private insurance companies only reimbursed doctors for virtual visits in designated underserved and rural markets, limiting the access and potential payments for these services to more populated urban areas. Additionally, before the pandemic, users were required to have an in-person meeting with a doctor before being able to utilize telehealth in the future. Since the COVID-19 pandemic, the government has eliminated the requirement for an initial in-personal doctor visit and relaxed the geographic restrictions, making it significantly easier for senior living residents or patients to access telehealth visits whenever the situation warranted.

Another notable area of change has been the ease of regulations pertaining to the Health Insurance Portability and Accountability Act (or HIPAA). This law instituted national standards developed to help protect the privacy and sensitive patient health information in the past. Adhering to all HIPPA requirements during a virtual healthcare visit can be challenging for staff and residents in congregate living situations, such as nursing homes and assisted living. In the wake of the pandemic, the government has opted not to impose penalties for non-compliance with certain HIPPA regulations for telehealth visits, making it easier for senior housing and professional services workers to help facilitate online appointments for their patients.

Major benefits of telehealth for seniors and those in senior housing
The convenience of telehealth appointments can’t be understated, particularly as it relates to our aging family and friends. For senior citizens, virtual doctor appointments allow them to maintain their essential medical appointments while avoiding exposure to an outside world that has become increasingly dangerous over the past few months due to the pandemic. Likewise, seniors that may have limited mobility are provided easier access to the same level of care, without the need to be transported from a senior living facility to multiple doctors at different locations. Access to telehealth services brings a level of comfort and ease of access that’s especially important for the senior population, particularly the most vulnerable and most immobile.

An important measure of the quality of care provided by a nursing home is the rate of hospital readmissions for residents in skilled nursing facilities. With the increased use of telehealth visits, nursing home operators have been able to materially reduce their readmission rates thanks to quick and easy access to virtual meetings that allow a doctor to assess the situation and, hopefully, provide a preventative treatment or a course of action that doesn't require a new hospital visit. Hospital readmissions cost facilities in terms of the staffing hours necessary to transport residents back to the hospital and negatively impact census in their nursing home. With the option for easy access to telehealth, a quick meeting, combined with an assessment for a proper care plan, can be handled more succinctly.

The future of telehealth: Technology that’s here to stay, with some caveats
There’s much to celebrate when it comes to advantages associated with virtual health appointments, but that doesn’t mean that it comes without challenges. For an aging population, or for anyone that may not be as well-versed in technology, accessing telehealth services may come with challenges, anxiety, and a steep learning curve.   

From the senior living prospective, clinics and senior housing facilities have also had to ensure that they have the technology available for virtual visits, which may include multiple software platforms for different healthcare providers, as well as staff that’s able to work the systems and physically help patients with their appointments as needed. Additionally, although relaxing the HIPAA regulations has been necessary in a world where telehealth became a necessity virtually overnight, to see this form of medical communication through into the future will require adjustments. For example, any issues associated with privacy — as well as the technology that provides this form of medical access — will need to be fine-tuned.

The hesitations that may have accompanied the initial settling into a virtual health atmosphere seem to have subsided. Patients logging on for mental health appointments, for example, may have originally worried about the loss of personal connection that having a conversation over a computer might bring. As our comfort with this form of virtual medical care has grown over the last several months, a general gratitude for the ability to still connect with our care providers and have quick access to professional services when necessary — seems to have become the predominant takeaway.

According to the same University of Michigan [MM1] poll from above, adults aged 50-80 reported that telehealth visits are more convenient than office visits. While some concerns over certain telehealth issues do still exist, over the past year, older adults’ concerns about privacy in telehealth visits decreased from 49 percent in May 2019 to 24 percent in June 2020, and concerns about having difficulty seeing or hearing health care providers in telehealth visits decreased from 39 percent in May 2019 to 25 percent in June 2020. Over the past year, older adults have also felt more comfortable using the technology that enables these virtual visits, as 91 percent of current or experienced telehealth users now consider the level of difficulty using telehealth technology as low or easy.  

It’s impossible to predict exactly what a post-pandemic future might hold, but based on the quick adoption of telehealth during the pandemic, and all of the perks it provides, it’s fair to assume that some version of this virtual medical care will be around to stay. With issues like privacy, integration with medical records and ease-of-use in mind, it’s easy to imagine a future where virtual medical visits — particularly for certain needs like follow ups, mental health and less complex medical issues — is commonplace. As long as Medicare and private insurance continue to cover these virtual visits, telehealth appears to be a positive solution for everyone involved, particularly for senior care facilities.

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1 National Poll on Healthy Aging, August 2020; University of Michigan Institute for Healthcare Policy & Innovation, ©2020 The Regents of the University of Michigan.

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