Christian Williams|10/20/2020|4 min read

4 Ways Coronavirus Is Shaping Telehealth

What we've learned from 20 telehealth executives


What we've learned in The Techstars Accelerator From Interviewing Twenty Telehealth Executive's in the past two weeks.

2020 has been a volatile year for telehealth executives. Some networks have experienced over 8000% growth in Telehealth use caused by the COVID-19 pandemic. Projections in January are now remnants of excel charts in a world changed.

For the last two weeks we've interviewed telehealth executives at the leading edge of the industry's growth. These leaders shared key insights on how the COVID-19 pandemic has shaped their care delivery models. Also, the teams took time to speculate on what the future of telehealth will look like. Here are 4 key takeaways from our in depth discussions with telehealth executives.

1. The thing about licenses

Before the outbreak in March, strict laws were in place regarding the practice of telemedicine. When practicing in a state, Clinicians had to maintain the state license associated with patients they serviced. There were different processes in place for physicians, advanced practice providers and nurses. Logistics of each are discussed in this section.

Physicians (MD/DO's) have to maintain a state license to practice telemedicine. For example, a physician in Maine could only service patients within Maine. If the physician wanted to deliver care to a patient in Missouri, they would then need to register for a state license in Missouri. This process can take up to six months from application.

In 2013, as an effort to reduce these care limitations, the state medical licensure boards created the Interstate Medical Licensure Compact (IMLC). Over 29 states now recognize the license, but physician adoption rates are low. As of July 2019, only 5,000 of the 985,000 physicians in the US had applied and received the IMLC.

Nurses (RN, LVN, etc.) have a similar compact that allows practice across state lines. In 1999 the National Council of State Boards of Nursing (NCSBN) created the Nurse Licensure Compact The first organization to reduce the regulatory barriers for nursing across state lines. In the twenty years since, 34 states have enacted the NLC as a way to increase the total nurses available to practice within their state.

Advanced practice providers (NP, APRN, PA's, etc.) face a greater challenge. Before this year, there was no compact license in place for clinicians. In August of 2020, in the midst of the coronavirus pandemic, the NCSBN put to motion a new license, The APRN Compact. This license has yet to be adopted and APP's are still limited to single state applications.

2. The future of the COVID-19 telehealth license waivers will impact operations

As the need for telehealth patient demand spiked, so did the need for evolution within physical and virtual practices. State governments responded to the virus by waiving previous practice license limitations discussed above.

These waivers created practice opportunities for all clinician types. With restrictions removed, the world of telehealth opened for business.

Clinicians power telehealth companies. And these waivers gave companies like Teladoc and MDLive the ability to onboard clinicians from different states faster than ever into their care network.

We spoke about these waivers with executive teams delivering a variety of care models. These companies specialize in primary care, chronic care management, long-term care monitoring and a range of other services. All teams working with many clinicians in multiple states.

The flexibility of waivers allowed the companies to spin up service lines quickly, but the new normal is around the corner. In 2021 as we near a vaccine or herd immunity for Coronavirus, there will be a need to review the waivers in place for clinicians.

The executives we spoke with believe it is likely that waivers will be reversed or applications made more difficult. Companies using providers across state lines will have to apply for individual state licenses; or the compact options.

This complex credentialing landscape is top of mind for teams delivering telehealth during the pandemic.

3. Technology will be audited as the pandemic slows

In March, when Coronavirus first emerged in the U.S., HIPAA privacy and security rules were relaxed. Telehealth was the clear solution for patient services but the rules were too stringent. To increase adoption, The Department of Health and Human Services announced it would not impose penalties for lack of HIPAA compliance in telehealth.

This led to the use of Zoom, FaceTime and other non-HIPAA compliant conferencing tools as a means for delivering telehealth.

Like the changes in medical waivers, this is expected to reverse in 2020. HIPAA policies are in place to keep patient data secure and protect health care coverage for individuals who lose and change jobs. Maintaining this security will be a top-priority as Telehealth continues its expansion.

Jeff Urdan, CFO/COO of swyMed, a secure telemedicine platform that specializes in providing connectivity in areas with low bandwidth, states, "Doctors used whatever they could when the pandemic started. As the industry looks forward, we're seeing broad desire for a telemedicine service delivery capability, and planning for implementation of a secure platform like ours."

4. Business-to-Business solutions show signs of large revenue opportunities

The giants are already betting on telehealth. Two-weeks ago Best Buy announced its partnership with Amazon to create a new flip phone that connects seniors to on-demand providers. These major players are capturing the attention of the aging population through technology. Companies with related services are supporting this growth.

As part of the Techstars accelerator program we have met several startup teams making recent pivots from Direct to Consumer models, into scalable Business to Business solutions. With insurance providers like Humana and Aetna focusing on preventative care solutions and value based care There is an increased amount of opportunities for business creating integrated care solutions.

The teams we've met with are finding unique care models within these networks' patient populations. We spoke with founders of companies in addiction medicine, mental health therapy and speech pathology. All repositioning from subscription charges to their customers, to insurance backed payments.

What will be left standing.

The only thing for certain is that telehealth is going to be ever present in the news cycles next year. If adoption remains as high it has been during the COVID-19 pandemic, laws and regulations will be reviewed. The thought leaders of the industry are all positioning for tighter controls and compliance.

At OpenLoop, we're working with partners in multiple states to plan for changes in 2021. We'll continue to share insights as trends emerge in the Telehealth and post-COVID-19 world.