During the COVID-19 pandemic, health care providers have faced unique challenges in the delivery of health care. As COVID-19 began to spread across the United States, the CDC advised health care providers, especially in areas with widespread COVID-19 transmission, to offer care via telemedicine technologies where appropriate. As a result, although telemedicine has been emerging as an important player in the delivery of health care over the past several years, the pandemic has caused the use of and access to telemedicine to grow to an unprecedented scale. During the pandemic, telemedicine has materialized as an especially useful tool in triaging patients in emergency care settings. This “tele-triage” model provides significant opportunity for the health care industry.
Delivering care through telemedicine modalities has helped providers address several important barriers to accessing health care during the pandemic. At the start of the pandemic, the nation faced an unprecedented shortage of personal protective equipment (PPE), such as masks and gowns. Front-line providers working in hospitals and other emergency care settings faced significantly increased risk of catching and spreading COVID-19, which became especially important as asymptomatic transmission became a significant concern. Moreover, as lockdowns were enforced and individuals were asked to stay home as much as possible, patients began delaying or avoiding health care. By June 30, 2020, the CDC reports that as many as 41% of adults in the United States had “delayed or avoided” routine or emergency medical care. Moreover, emergency departments and urgent care centers saw record levels of overcrowding as COVID-19 spread, causing the need for makeshift hospitals and care below usual standards. As providers began offering telemedicine as an alternative to in-person care, telemedicine emerged as an important tool to conserve the short supply of PPE, keep patients and providers safe, and minimize unnecessary overcrowding of emergency care spaces, all while maintaining continuity of care.
Perhaps one of the most important areas of telemedicine growth has been in the emergency care space. The pandemic has certainly caused emergency department capacities to reach crisis levels nationwide, but even before 2020, overcrowding of emergency departments due to their overuse for primary care is a well-studied phenomenon. It is caused by various factors such as lack of access to primary care, lack of access to health insurance, and the promise of 24/7 care at an emergency department. Use of the emergency department for non-urgent conditions has been proven to drive up national health care spending, contribute to poor care management and continuity for patients, and generate prolonged wait times that ultimately increase patient morbidity and mortality and decrease overall health outcomes. During the pandemic, overuse of the emergency department also became downright dangerous, as emergency departments struggled to develop processes to separate patients who were suspected to have an active COVID-19 infection from those who were not.
To combat these problems, hospitals and other emergency care settings began offering virtual encounters to provide safe and timely care. Providers also used telemedicine to triage patients, providing clarity on whether patients really needed to visit an emergency care setting or if a telemedicine or other office visit would suffice. These “tele-triage” encounters have helped providers quickly and efficiently direct patients to the appropriate care setting, while limiting the overcrowding of emergency departments at a time when emergency department resources had to be preserved for treatment of severely ill COVID-positive patients. Tele-triage also emerged as an important tool for identifying patients who may have been infected with COVID-19, but who did not need emergency care and could remain isolated at home,…