By Finn Ryan
The medical market is a constantly evolving field – subject to the changing needs and demographics of patients, along with the developments of technology. As health environments change, so too must the solutions designed to prevent, relieve, and remedy. One prominent branch of medicine’s long and intricate history is telehealth, the distribution and use of remote medical services, instruction, and other care.
History of Telehealth
The development of telehealth and remote devices corresponds with that of communicative technology. In 1895, when the first radio transmission was made by the Italian inventor Gugliemo Marconi’s “wireless telegraph,” global communication changed forever. The routines that governed modern medicine – the annual well-visit, for example – were seemingly threatened by the rapidly advancing machinery. But as some retreated in fear or defiance, others jumped towards the new horizon. In their 1924 issue, the cover of the American magazine Radio News depicted an imagined medical apparatus with the text “THE RADIO DOCTOR – Maybe!” Another magazine, Science and Invention, illustrated in 1925 the concept of the “radio doctor” with a similarly fanciful instrument.
The visions of remote medicine were cemented into reality when hospitals and laboratories began transmitting images and data between locations. In 1948, radiologic images were delivered a distance of 24 miles between West Chester and Philadelphia, Pennsylvania. In reference to the event, now widespread terminology was first used. Indeed, the words “telemedicine” and “telognosis” surged in popularity in the years following these initial inventions.
Two-way television systems were used in 1959 by the University of Nebraska to send neurological information across campus. This, along with the increased transmission of ECGs and X-Ray scans in the next decade, stitched telehealth in the fabric of modern medicine. Projects, like INTERACT in Vermont and New Hampshire, catered to hospitals and offered a combined network of telemedicine, education, and training.
NASA joined the conversation in the early 1960s. Eager to facilitate the “man-in-space” process, NASA engineers identified the need for remote medical aid. The team, working with the Lockheed Corporation, devised a satellite-based system and, to test the technology, they offered it to the Arizonan population of Papago Indians. The project, referred to as the STARPAHC (Space Technology Applied to Rural Papago Advanced Health Care), resulted in the use of telemedical communication with NASA’s 1972 Applications Technology Satellite (ATS-1).
Despite rising transmission costs, telehealth persisted as a growing sector of medicine into the 1990s, when it eventually entered the mainstream. Investments expanded during the decade as experts lauded the industry as the future of medicine.
Telehealth Before COVID-19
But the so-called architect of the future soon plateaued, growing only in tucked-away corners of the market. Aside from high prices, the failure to integrate telehealth into medical routines rendered a transition into complete electronic care difficult. Although the American public no longer saw telehealth as an impending and radical technology (think the RADIO DOCTOR), its implementation would disrupt many lives.
This disturbance extended to clinicians as well; reimbursement rates and assurances for virtual consultations were either unsettled or in flux, leaving many physicians uneasy about the transition. The quality of care was also a point of contention, as issues of transparency and data security were slow to resolve.
Telehealth During COVID-19
The gray areas of telehealth were forced into elucidation with the onset of the pandemic. As apprehension flooded the halls of hospitals and homes alike, many in-person PCP visits were canceled. Both patients and providers were left helpless. As the National Cancer Institute noted, “in March 2020 alone, COVID-19 forced the postponement of more than 800 appointments for lung cancer screening.” While some patients could independently monitor and abate their conditions, others – namely those with heart difficulties and diabetes – required consistent and comprehensive care.
The delays in visits also signaled the loss of significant reimbursement options, leading many small, local offices down the path of bankruptcy or suspended practice. According to the Association of American Medical Colleges, “the COVID-19 pandemic has only exacerbated our nation’s doctor shortages.” The upheaval revealed not only the lack of emergency infrastructure, but the systemic inequalities infecting even the surviving systems. Black patients and practitioners were disproportionately affected by the pandemic. As AAMC mentioned, the inaccessibility of resources, as well as the pressure to provide for their communities, struck minority physicians remarkably hard.
In March of 2020, the Centers for Medicare and Medicaid Services (CMS) issued the emergency expansion of telehealth benefits and reimbursement options. The flexibility of the PHE, public health emergency, allowed for the use of telehealth services without geographical limits. These waivers, along with audio-only visits, were extended through December 31, 2024 under the Consolidated Appropriations Act, 2023.
Billing options for providers also evolved with the pandemic, expanding payment policies for virtual visits.
How Impilo Can Help
Impilo empowers healthcare companies to start connected device and virtual care operations. Our patient engagement and activation systems are embedded into your existing workflows. RPM programs and other telehealth services can be maximized with Impilo’s help.