The COVID-19 pandemic unfolded with a shift in health care delivery in Massachusetts: a dramatic uptick in telehealth services. In just five short months, Mass General Brigham clinicians completed more than one million telehealth visits.
Telehealth encompasses a broad range of services, but generally means using electronic information and telecommunications technologies to support long-distance clinical health care. By leveraging secure email platforms, video-chat services, texting, and phone calls, clinicians are able to connect with patients remotely without having to meet in an office.
While many of these virtual technologies existed prior to COVID-19, they were often vastly underutilized. Champions of telehealth services were surprised as programs that had historically struggled to get adopted—such as video calls— grew exponentially.
“Telehealth visits were only a tiny fraction of our clinical care,” says Tim Ferris, MD, a primary care physician at Massachusetts General Hospital and CEO of the Mass General Physicians Organization. “If you look at the numbers—not just at Mass General but across our entire system—there were maybe 1,200-1,500 visits a month, on average.”
In February, prior to the pandemic, telehealth accounted for only 0.2 percent of all outpatient visits across the Mass General Brigham system. By April, at the height of the pandemic, virtual appointments skyrocketed to 62 percent of all outpatient care. Clinicians were seeing hundreds of thousands of patients a month.
Though telehealth can ease the burden of frequent visits required for certain patients, Leonard Finn, MD, a family medicine physician affiliated with Newton-Wellesley Hospital, explained in a recent interview that the industry should be careful not to pigeonhole the definition of telehealth—especially when it comes to reimbursements. Telephones, though not as flashy as some new innovations, are critical for reaching many underserved populations.
“Elderly, frail patients sometimes don’t have the technology, and we’re still doing the serious work with them,” he said.
Additionally, Dr. Finn explains that as we ramp up telehealth services, it’s important to remember that not all patients have access to new computers, smartphones, or reliable wi-fi.
Mass General Brigham is committed to making healthcare equitable for all the patients we serve. Teams are exploring creative solutions, advocating for technology upgrades with some of our vendors, and working with leaders in the community to shape a telehealth strategy that meets people where they are.
“The growth and adoption of telehealth technologies has been a surprisingly positive outcome of the pandemic,” says Tom Sequist, MD, Chief Quality, Patient Experience, and Equity Officer for Mass General Brigham. “Our system is looking inward during this rapid expansion and using quality metrics to show us where these inequities may be popping up. We’re trying to shape a future where everyone is supported by these advancements in care delivery.”
This huge increase in virtual visits is only one facet of telehealth related services. Clinicians have developed creative ways to minimize exposure to COVID-19, conserve personal protective equipment (PPE) and help patients and families remain connected while most visitors were prohibited.
A video intercom system enabled hospitalized patients with COVID-19 and their providers to interact via secure video conferencing. Through a bedside iPad in the patient’s room, clinicians could initiate a video chat using a computer or mobile device — relieving providers from needing to enter patient rooms for every routine question or conversation.
“A silver lining of the COVID-19 pandemic has been the rapid adoption of new technology. We have achieved years of digital transformation in just a few months,” said Adam Landman, MD, vice president and chief information and digital innovation officer at Brigham Health.