How Telehealth Has Changed American Patient Care

COVID-19 significantly accelerated digital transformations in virtually all industries, and when it comes to telehealth, both the adoption of and investment in telemedicine has increased significantly. This continued digital transformation in healthcare has worked to make essential medical services more accessible to all segments of the population, regardless of where they live.

Usage of telehealth technology has increased by a factor of 38 compared to its pre-COVID baseline. From March 2019 to March 2020, telehealth visits in the US increased by 154 percent. In the first half of 2021 alone, venture capitalist investment in digital health reached US$14.7 billion, double the amount for all of 2019.

What is driving telehealth investment in the US?

There can be little doubt that quarantine measures were the original driver of telehealth's recent surge. This is no longer the case, however. Telehealth adoption has now stabilized, and attitudes towards virtual care continue to change, according to a survey that states 74.2 percent of patients expect virtual care to be a standard part of healthcare moving forward, and 50 percent would even switch providers if they could have regular virtual visits.

This ongoing market shift represents a considerable opportunity for investors, and one that extends post-pandemic. The third quarter of 2020 alone saw US$4 billion in investment in digital health startups in the US. Major investments by non-healthcare companies are also on the rise — in January 2020, Microsoft (NASDAQ:MSFT) launched a US$40 million healthcare-focused artificial intelligence initiative, and in August 2020, Google invested US$100 million in telehealth provider Amwell.

Telemedicine's compound annual growth rate is projected at 21.4 percent through 2025. This is unsurprising, considering that virtual care has broad applications across multiple healthcare disciplines, and it benefits both patients and providers.

How is telehealth used in the US?

In the US, 30.1 percent of all patient visits during the pandemic's early months were done via telemedicine. Adoption was highest among endocrinologists (67.7 percent used telemedicine at least once), gastroenterologists (57 percent) neurologists (56 percent) and pain management specialists (50 percent). Optometrists (3.3 percent) and physiotherapists (6.6 percent) saw the lowest uptake. Telecare provider Athenahealth (NASDAQ:ATHN) reported that 33 percent of mental health and 17 percent of primary care appointments leveraged telehealth.

There are many use cases for telemedicine, one of which is patient monitoring. This is often done by recording data such as blood pressure, food/calorie intake, heart rate and blood sugar levels, either manually or through a wearable device, such as those offered by Garmin (NASDAQ:GRMN). It also applies to monitoring medication compliance and sleep.

Other applications include self-service use, such as allowing patients to check test results, schedule appointments and manage their prescriptions. Notably, 93 percent of patients have expressed an interest in the latter. Telehealth platforms such as IQVIA's (NYSE:IQV) Orchestrated Patient Engagement software can be used for that purpose.

Another popular use is for coordination and collaboration to enable information sharing between family physicians and specialized practitioners, including test results, allergies and diagnostic data. Teleradiology technology such as that provided by Leveljump Healthcare (TSXV:JUMP) is one prominent example of this. Leveljump offers teleradiology solutions, and is set to acquire telehealth business Targetco, a Midwest US-based telehealth business focused on remote medical care for rural and underserviced communities.

What are the main advantages of telemedicine?

Telemedicine offers interconnected benefits for both patients and care providers. Top benefits include improved care for rural communities. Prior to the pandemic, extending care to rural and underserved patients was one of the primary use cases of telehealth. In a 2019 survey, 93 percent of physicians noted that telehealth improves patient access to care.

Convenience and comfort also top the list. In addition to enabling a patient to manage care entirely from home, telemedicine streamlines both paperwork and appointment management. Per analyst firm Deloitte, there is every indication that patients will continue to expect this level of convenience after the pandemic.

In some cases, patients may even achieve higher quality of care. Over 75 percent of physicians feel that telemedicine helps them provide better care for patients. When you couple that with the general affordability of this technology, telemedicine has the potential to reduce the cost of a doctor visit by as much as 15 percent. Estimates made pre-pandemic showed that telehealth could potentially save the US healthcare industry as much as US$305 billion a year. One ambulatory care program reduced costs by 34.5 percent in the first year of adoption, while another hospital's virtual care program lowered the cost of patient care by 50 percent.

Lastly, healthcare providers are noticing increases in revenue. This is because of the new revenue streams, improved efficiency, reduction in no-shows and increased reach enabled by virtual care, which can be expected to have a net positive impact on healthcare revenue. Telehealth can also increase a practice's billable hours and improve patient loyalty.

What opportunity does telehealth represent for investors?

We are still in the early stages of telemedicine adoption. The market is rich with potential investments, ranging from stock in established companies to capital for startups.

These investments are incredibly diverse, and it all starts with making telemedicine more accessible to the general population. For example, further development of technology to help hearing-impaired, vision-impaired and mobility-impaired patients enjoy the same benefits from virtual care. This gives investors access to a much broader healthcare market through accessibility services.

Cutting-edge innovations are also another reason to invest sooner rather than later. New innovations may include artificial intelligence, further integration with wearable/Internet of Things technology, digital access control and remote surgery.

There's also the infrastructure play. While some telehealth solutions require little beyond a webcam and an internet connection, as telemedicine continues to proliferate, certain disciplines will require specialized hardware and tools to provide the best care possible.

Lastly, ongoing treatments made available through teletherapy cannot be ignored. Teletherapy coaching and management accounted for nearly 40 percent of telehealth investments in Q2 2020, and with renewed interest in health and wellness, this could continue to increase.

The takeaway

The pandemic significantly accelerated the adoption of telemedicine. With the industry's rapid growth, telehealth is still very much in its nascent stages and early investors are well positioned to benefit from this growth trajectory. By the time the pandemic ends, it is projected that up to US$250 billion of US health spending could shift to virtual care, another reason to invest in this sector sooner rather than later.

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