• Leah Hess

COVID-19 Could Change the Future of Chronic Disease Management

Updated: Jul 20, 2021

There aren’t many areas of life that the COVID-19 pandemic hasn’t touched. Individuals around the world have dealt with school and office closures, travel interruptions, and housing issues. The pandemic, unsurprisingly, has also affected the healthcare industry. As the disease spread and stay-at-home orders were issued, many providers began to make the necessary shift to telemedicine. Telemedicine is a subset of telehealth (which involves providing health care services over the internet) that refers to the provision of remote clinical services using telecommunications technology. With this change, patient care has also been affected for better or for worse, and those living with chronic diseases that require frequent doctor’s visits may be disproportionately affected. Now, even as lockdowns are lifted, the extent to which virtual care delivery will prevail is uncertain.

Telehealth existed before 2020 but was not by any means the standard. Medical licensure policies, lack of insurance coverage, and eligibility obstacles barred many from utilizing telehealth services, putting a damper on its widespread adoption. Policy changes like those outlined in the Coronavirus Preparedness and Response Supplemental Appropriations Act largely waived Medicare payment requirements for telehealth, loosened HIPAA (a set of standards that serve to protect privacy regarding health information) requirements for virtual care, and set telehealth pricing to rates comparable to in-person medical services.


For many, the use of telehealth has been a welcomed change of pace. Nearly half of all Americans suffer from at least one chronic disease, many of which require stringent management and doctor supervision. For example, the CDC reports that there are 34.2 million people living with diabetes in the US alone, many of which are required to visit an endocrinologist (a doctor that treats conditions relating to the glands and organs that make hormones) as often as once every three months to receive their necessary prescriptions. For those without reliable transportation, busy work schedules, or families to care for, this can be a challenge. In addition, the US has experienced a wave of hospital closures, with 64 rural hospitals shut down between 2013 and 2017 according to a 2018 report by the U.S. Government Accountability Office. For people who require specialized care, traveling to the proper facilities may be unrealistic, and telemedicine may encourage more frequent doctor’s visits. In fact, a survey by Updox found that 51% of respondents said they would continue using telemedicine post-COVID-19 due to the convenience it offers.


Patients with chronic illness may also benefit from aspects of telehealth other than virtual appointments. Applications like Dexcom, Medisafe, Manage My Pain, and Qardio allows patients with chronic conditions to stay connected with their doctors between appointments, track new symptoms, and manage their lifestyle. Although consumer-focused health apps like these were around before the telehealth boom, they are now gaining more attention from investors (digital health investments reached $3.1 billion during the first quarter of 2020 according to Rock Health) and doctors, who aim to keep a competitive edge in the changing industry.


Although some individuals with chronic disease may welcome the change, not everyone is benefiting from virtual medicine. Chronic conditions take a toll on those living with them, even pre-COVID. To make matters worse, in a 2020 survey of healthcare professionals, 67% reported moderate or severe effects on their patients’ abilities to manage their illnesses due to changes in healthcare services since the outbreak. It is also worth noting that with the increased use of technology in healthcare comes the potential for the growth of disparities among income levels.


Policymakers had to quickly respond to the need for telehealth at the beginning of the pandemic; now they must work to address its issues in order to cement its standing in the health industry. Funding combined with laws that offer financial incentives to adopt telehealth, further expand the services covered by Medicare, increase privacy regulation, and prioritize the quality of patient care, may do just that. The Coronavirus Aid, Relief, and Economic Security (CARES) Act has already awarded additional funding to the Telehealth Network Grant Program, which serves to provide telehealth technologies to those in medically underserved areas. Moreover, lawmakers are proposing bills like the Telehealth Modernization Act, which aim to continue telehealth’s momentum. Those living with chronic illnesses or anyone who has an opinion about the direction of telehealth are encouraged to contact their representatives about what they’d like to see going forward.


The favor telemedicine has gained with patients, its ability to improve patient outcomes, and the past and proposed legislation to make it more accessible begs the question: Can those with chronic illness expect telemedicine to be a regular part of their care going forward? Getting an answer to this burning question will require the cooperation of health care providers and lawmakers, and the careful consideration of patient needs.

 

Speaking Plainly:

  • The COVID-19 pandemic has changed the way healthcare is delivered, with increasing reliance on telemedicine.

  • People living with chronic medical conditions such as diabetes, COPD, hypertension, heart disease, and cancer are disproportionately affected by these changes.

  • Many people with chronic diseases feel they are benefitting, noting the ease of access to care and medications that comes with virtual doctor’s appointments.

  • Others feel as if the pandemic has lessened their access to care, and there is evidence that telehealth may not be the right option for everyone.

  • Policy changes are necessary and expected as healthcare moves towards an increasingly technological direction.