Healthcare has a long tradition of providing telehealth and telemedicine solutions, but COVID-19 has accelerated the practice into the future. Moving from convenience to necessity, modern telehealth solutions have saved countless lives during the worst pandemic of our generation. Organizations are now moving beyond telehealth deployment to sustainable, long term practices. Telehealth today offers an unprecedented insight into our clinical practices and efficiency, while answering the challenges of compliance and patient satisfaction.
In this blog, we take a look at the evolution of telehealth and the COVID-19 pandemic’s role in transforming our relationship to it. Then, we dive into how AWS and Veritas, an AWS Advanced Technology, Storage, and Government competency Partner, can ensure the continuity of telehealth beyond the pandemic, helping healthcare providers, payors, and healthcare IT ISVs with secure, compliant, and private telehealth video recordings to facilitate billing, risk mitigation, and support compliance reporting.
The evolution of telehealth: keeping up with patients
An important place to start is there is a difference between telehealth and telemedicine. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Telemedicine, a subset of telehealth, is the practice of medicine using technology to deliver care at a distance. Innovation in healthcare is constantly changing and evolving to meet patients’ needs. Although healthcare practiced remotely has a long history. As far back as 1879, an article published in the Lancet, the authors envisioned the usage of telephone to reduce unnecessary office visits1. Since the 1920s, the radio has been used to give medical advice to clinics on ships. Home monitoring developed with the space race and the Mercury space program when the National Aeronautics and Space Administration (NASA) began performing physiologic monitoring of astronauts during space flight. NASA brought this to terrestrial healthcare for a pilot with the Papago Indians, the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) project. COVID-19 has created a fast lane for deeper and wider adoption of telehealth solutions.
Impact of COVID-19 on telehealth
COVID-19) has fundamentally changed our relationship to telehealth. Since the declaration of a public health emergency on January 27, 2020, federal regulatory bodies have instituted many emergency changes. The most impactful for telehealth and telemedicine was the allowance for Medicaid and Medicare reimbursement, so that providers can be reimbursed for these services. While this is a temporary measure, going back to practices prior to January 27, 2020 is unlikely.
The rapid spread of COVID-19 in the United States made the implementation steps for telehealth very challenging to the health care system. According to Healthcare IT News, telehealth visits grew 100,000% between 2019 and 2020. Hospitals had to adapt to remote work overnight by buying thousands of laptops, headsets, and cameras to implement telehealth practices rapidly. They also had to deploy telehealth very rapidly. Some went with well-known telemedicine platforms like Teladoc or Amwell, while others went with commercially available solutions such as Zoom, Amazon Chime, Microsoft Teams, Webex, and the like. These were relatively easy to deploy and most patients could navigate the applications. The next challenge was actually billing for the visits. Some organizations had to provide telehealth for free for up to two months before they could figure out how to capture the revenue cycle.
Challenges of managing telehealth at system level
Healthcare organizations are finding it challenging to have an effective and sustainable telehealth practice. First, they have to protect new remote workers, who may be targeted by ransomware groups because they are new to remote work. Healthcare systems are also being targeted by state sponsored hackers with the sole task of stealing data, formularies, treatments, and vaccines. HIPAA (Health Insurance Portability and Accountability Act) and other global compliance standards require that we protect PHI (Protect Health Information) at all times and in all forms.
These healthcare systems also face challenges around treatment protocols. This includes ensuring that every caregiver is following our documented protocol for treatment. Healthcare organizations are financially motivated to follow quality protocols and measures. Measuring training quality as well as continuously evolving guidance from CDC, WHO, and state medical boards adds further complexities to the situation.
Patient satisfaction is also a primary concern for hospitals. Healthcare organizations are measured for HCAP scores that reflect overall patient satisfaction. Ensuring the maintenance or improvement of these scores are important to a hospital’s bottom line.
In addition to new challenges, healthcare organizations continued to struggle with existing ones, such as physician burnout and productivity. Even prior to COVID, caregivers report that they were spending half of their time documenting engagements and only half their time providing patient care.
Veritas telehealth solution for ensuring security and compliance while reducing risks
Now that telehealth has been adopted, it’s time to make it secure and compliant with the proper data privacy control to ensure a sustainable future. Large healthcare systems are reporting that they do more than 47,000 telehealth visits per day. From these initial implementations we are starting to see telehealth for what it really is – a comprehensive capture of the entire patient physician relationship. Using modern day technology, we can harness that information. This is not the data within the structured EMR we are used to, but the entire conversation including sentiment analysis, transcription, and machine learning. Organizations can now learn from their entire practice to identify trends, effective treatments, and early risks.
The following Veritas telehealth solution on AWS enables simplification of telehealth engagements, assistance in capturing all telehealth revenue and deliver supervision to ensure patient satisfaction, treatment protocol compliance and required HIPAA security:
Figure 1: Veritas and AWS solution reference architecture
Providers can use the video conferencing platform of their choice to provide telehealth visits. The video conferencing platform needs to have the ability record the session. Veritas Enterprise Vault (EV) will protect PHI data as per HIPAA regulations on AWS. The solution provides flexibility and lower costs than purpose-built telehealth systems.
Each patient visit or session is then translated to a transcript using Amazon Transcribe Medical. The transcript and session is then run through the Veritas classification engine where policies are applied to determine which sessions need to be reviewed for patient satisfaction, protocol compliance or billing optimization. The technology allows reviewers to focus on just the sessions of interest, filtering out the thousands of sessions based on the chosen criteria. The classification and transcript engine with Veritas EV provide a method to rapidly review the session of interest, but also provides a hotlink to areas of interest. These hotlinks jump directly to the part of the video of interest so the reviewer can see the points of concern. All telehealth sessions can be centrally and safely stored on AWS. In addition, the rules engine on EV will only keep the parts of the session for the duration determined by the organization. For example, the video may be important for a short time, while the transcript may provide for advance learning and new protocol creation. Finally, the rules engine can anonymize the transcript and delete the video by policy, reducing any litigation risk while preserving what can be learned.
Just as we have embraced the “new normal” of remote working, healthcare must also embrace telehealth as a mainstream offering and competitive advantage. Telehealth has unlocked incredible benefits to serve underprivileged and remote patients, improve patient satisfaction, reduce hospital borne infections, reduce inpatient treatments, and improving continuity of care. Telehealth and telemedicine have changed the way we practice medicine and will usher in another age of digital maturity for healthcare. Veritas and AWS are committed to partnering with healthcare to assist in this adoption.
The Veritas Enterprise Vault solution on AWS makes telehealth practices sustainable for medical institutions, such as hospitals and doctor offices, who need to protect video recordings to facilitate billing, risk mitigation, and support for compliance reporting. For more information, watch the on-demand webinar Beyond TeleHealth: The future of remote care and visit www.veritas.com/aws to learn about the Veritas telehealth solution on AWS.
To learn more about healthcare and life sciences on AWS, see aws.amazon.com/health.