Digital perspective: COVID and the need for healthcare without walls

August 1, 2021 Providence Digital Innovation Group

Key takeaways:

The Digital Innovation Group at Providence is providing perspectives on how healthcare can be improved for everyone through technology.
Digital Perspective reports outline goals for improved care options and strategies to make them possible.
Providence has learned many lessons from the pandemic about delivering care without walls.

[3 MIN READ]

Providence was the first health system in the nation to care for a coronavirus (COVID-19) patient. From the earliest stages of the pandemic, our leaders worked together to develop innovative digital solutions that would meet the growing health needs of the communities we serve. Along the way, we’ve learned valuable lessons and gained insight into what’s broken in the healthcare system and what we can do to fix it.

The Providence Digital Innovation Group is sharing its deep research and knowledge around how digital technology can help transform the care we provide. Within our Resource Center, you can access our Digital Perspectives that cover a wide range of topics in four main categories:

Distributed care for access and convenience
Navigation and personalization
Helping marginal and underserved populations
Scaling behavioral health

We’ve put together a series that highlights our recent reports and explains why we feel the topics addressed are vital to improving care for everyone. The first Digital Perspective, “Where Does Health Happen?” looks at distributed care and how it’s changing traditional healthcare rules.

Healthcare without walls

In the past, when you got sick, you went to the doctor, the hospital or another healthcare facility to receive the care you were looking for. With distributed care, many of the services you need come to you instead.

Distributed care is about decentralizing healthcare services—such as monitoring vital signs or diagnostic testing—and putting them closer to you, the patient. In some cases, that may mean adding virtual or telehealth capabilities. In others, treatment is available at convenient locations such as pharmacy-based clinics or urgent care centers. Innovative technology that lets you monitor and test from nearly any location also plays a vital role in making distributed care a reality.

The basic concept of distributed care is that historically care has been locked inside the hospital and inside the clinical office. We know, however, that the healthcare facility is not where health happens.

“The basic concept of distributed care is that historically care has been locked inside the hospital and inside the clinical office. That’s where all care, more or less, takes place,” said Matt Cohlmia, Executive Director of Digital Strategy at Providence. Cohlmia is the editor of the Digital Perspective “Where Does Health Happen?”.

“We know, however, that the healthcare facility is not where health happens,” Cohlmia writes in his report. “If the healthcare system is going to transition away from being a ‘sick care’ system, care must extend beyond the four walls of the clinic to become Distributed Care.”

Removing the barriers to care

The trend towards distributed care began long before COVID-19 made an appearance, but the pandemic dramatically shortened the timeline for adopting new ways to deliver and access care.

As the healthcare industry struggled to balance the ever-growing demand for services with shelter-in-place requirements and social distancing, several of the barriers to distributed care began to crumble, according to Cohlmia.

Changes to insurance reimbursement policies

Pre-pandemic, most insurance companies either didn’t reimburse or reimbursed at a different rate for care that happened outside a traditional healthcare setting.

“That changed during COVID,” said Cohlmia. "People did video visits and virtual visits. And health insurance companies said, 'Not only will we cover those visits in a way that we didn't use to, we will pay you the same amount that we would've paid you if your patient had come into your clinic."

State-to-state, any location

Changes to payment reimbursement weren't the only change prompted by the pandemic. Traditionally, physicians can only practice medicine in the state in which they are licensed. During COVID, those regulations were relaxed to allow virtual care to occur across state lines as needed to handle the demand.

Traditionally, physicians can only practice medicine in the state in which they are licensed. During COVID, those regulations were relaxed to allow virtual care to occur across state lines as needed to handle the demand.

Before the pandemic, insurance companies typically required that patients be in a clinical facility to receive services. Virtual visits were primarily held to connect specialists with physicians in facilities that did not have access to their type of expertise. Devices used to transmit any kind of telehealth or virtual service had to meet such a restrictive security level it was impossible to meet for the average patient.

“With COVID, all of that broke wide open,” said Cohlmia. “You could get care from anywhere from any device. It was transformative.”

What’s next?

It’s difficult to predict which changes healthcare will keep and which will be discarded or adapted once the pandemic is over. Reimbursement rates, methods and requirements will have a tremendous impact on how the industry moves forward. Convenience, affordability and accessibility are likely to keep virtual visits and telehealth options a permanent part of the healthcare landscape. However, other changes, like care that crosses state lines regardless of licensing, are likely to revert to pre-pandemic use.

Convenience, affordability and accessibility are likely to keep virtual visits and telehealth options a permanent part of the healthcare landscape.

“We need to be prepared for a world in which care isn’t just bottled up inside the clinic or the hospital,” said Cohlmia. “If patients and doctors have all gotten comfortable with this, and if businesses have been able to build themselves up and grow and invest in technology in this window of opportunity, all of that will create an ecosystem where distributed care becomes much more of an inevitability. We’ll get there.”

Have you tried #VirtualVisits or #telehealth options during the pandemic to get the care you need? Share your experience with readers @providence.

Find a doctor

The technology pioneers at the Digital Innovation Group are dedicated to making healthcare accessible, equitable, and available. Through Providence Express Care Virtual, you can access a full range of healthcare services. If you need to find a doctor, you can use our provider directory or search for one in your area.