NIC Notes

Insights in Seniors Housing & Care


By: NIC  |  April 22, 2020

Telehealth Emerges as Lasting Care Solution Amid Disease Outbreak

Business Environment  |  Senior Housing  |  Skilled Nursing

Interest in telehealth shifted into high gear over the last month as senior living providers quickly recognized the benefits of caring for residents with virtual visits as the COVID-19 pandemic unfolds.

Residents do not have to take the risk of leaving their apartments to see healthcare professionals. Visits can instead be conducted online. Timely consultations help prevent later, more costly interventions.

In a big step toward more widespread adoption, Medicare recently announced that it will reimburse for telehealth provided services for the duration of the COVID-19 public health emergency. The change covers providers such as doctors, nurse practitioners and other clinicians. The visits are paid at the same rate as in-person visits.

Telehealth companies are now fielding more requests for services from senior living providers. The use of telehealth is expected only to grow, becoming a standard tool for resident care across the senior living spectrum.

“Remote healthcare has helped us manage through this crisis,” said Richard Nolden, health center administrator at Monarch Landing, a continuing care community in Naperville, Illinois. “Telehealth is not going away.”

The growing value of telehealth was highlighted at the 2020 NIC Spring Conference.

A session titled, “Telehealth: Boon or Threat to Senior Care,” brought together experts who discussed how the technology will impact staffing, cost of care, site of care, and investment returns.

The category of telehealth covers a broad swath of interventions, noted session moderator Kelsey Mellard, CEO at Sitka, a digital healthcare solutions company. These interventions can include everything from remote monitoring of residents via wearable devices to virtual consultations with doctors who can prescribe treatments and medications.

Telehealth can reduce costs and improve care. Peer-reviewed and anecdotal evidence show up to a 40% reduction in hospital admissions with the use of telehealth in post-acute care settings, according to NIC session panelist Michael Kurliand, director of telehealth and process improvement at West Health, a nonprofit focused on lowering healthcare costs for seniors.

The panel was also joined by Robin Glass, president and chief commercial officer at Doctor on Demand, a virtual care provider.

The timing is right

The overall adoption of telehealth services is surging in the aftermath of the COVID-19 outbreak.

  • Virtual health-care interactions are on pace to top 1 billion by year’s end, according to a report by Forrester Research.
  • Non-COVID related medical visits are expected to reach 200 million this year, up from an original forecast of 36 million visits, said Forrester.
  • March telehealth visits rose 50%, according to research by consultancy Frost & Sullivan.
  • Virtual care provider Teladoc reported April 18 that it is providing more than 20,000 virtual medical visits per day in the U.S., more than double the volume of the first week of March as the coronavirus outbreak continues to drive telehealth implementation.

Senior living communities are adopting telehealth solutions.

Holiday Retirement announced in March that it is providing 24/7 telehealth access and services to the residents of its 261 communities through MeMD’s national network of healthcare providers.

Monarch Landing’s health center has been using Third Eye Health, an on-call physician service, for about a year now. Third Eye physicians are available virtually during off-hours.

The care provider or nurse on staff connects via iPad to a Third Eye doctor, available within minutes. The software is integrated with electronic health record systems, including PointClickCare and MatrixCare. Both Third Eye and primary care doctors have access to the medical records.

The doctor conducts a live video visit, assisted by the on-site provider. “Telehealth helps us manage resident care,” said Nolden. The service does not replace the primary care physician, he added, but it does help minimize emergency room visits at times when the primary care physician is not readily available.

With a current census of 74 residents, Monarch Landing is also using the iPad platform to virtually connect with specialists, such as psychiatrists and wound care nurses. These practitioners who visit multiple facilities can be a potential source of new infection during the pandemic. “We can provide service but minimize our exposure,” said Nolden.

Prior to the COVID-19 outbreak, Third Eye technology was in use at about 400 nursing homes. “Now we are doubling our business,” said Dan Herbstman, CEO and co-founder of Third Eye. The service is available nationwide. Assisted living facilities with high-acuity residents are using the service too. “Providers are accepting telehealth,” said Herbstman. “The skeptics are coming around.”

How do residents react?

“The residents are fine with it,” said Deborah Hart, CEO at Montgomery Place, a continuing care community in Chicago. “They think it’s cool.”

Montgomery Place uses Third Eye in its skilled nursing center and sometimes with independent and assisted living residents. “It doesn’t cost them anything, so they like that,” said Hart. She moved on to the campus herself in mid-March, a change that has been well received by residents. Several staffers also stay overnight in case of emergencies. “Residents feel comfort knowing that someone is here. I am one of them,” said Hart.

Communities are adopting other telehealth platforms.

Belmont Village Senior Living established new protocols in the wake of the pandemic. Routine off-site doctor visits were discouraged early on.

The company contacted residents’ physicians to ask how best to establish a virtual connection, either by Zoom, Skype, FaceTime, or some other method. The effort coincided with the change in Medicare rules that allowed for the reimbursement of virtual visits.

Belmont distributed iPads to its communities to connect residents with their healthcare providers remotely. Disposable anti-microbial iPad pouches were included to reduce contamination. “We are exercising extreme caution,” said Belmont President Mercedes Kerr.

Like other senior living providers finding success with telehealth services, Belmont is now expanding its offerings.

The company plans to roll out a virtual, after-hours physician service this May. The service will be phased in gradually at Belmont communities. And as with other providers, the service is not meant to replace primary care physicians. “It is a supplement for urgent care,” said Kerr. “We hope to reduce transfers to hospitals.”

Telehealth adoption is expected to accelerate as companies forge partnerships with large healthcare systems, insurers, and information technology companies. These big stakeholders share the goals to reduce costs and improve care.

VitalTech, for example, offers a virtual care platform. It has formed alliances with AT&T Business, the American Hospital Association, physician groups and other providers.

The VitalTech service includes wearable devices that monitor the vital signs of residents. Results are delivered via a smart phone application to the resident’s personal healthcare provider or the provider in the building. The company does not employ physicians but facilitates the connection between residents and healthcare providers.

The application includes medication management as well as a video connection to family and friends. VitalTech is a subscription service but it is being offered free for 90 days to senior living providers during the COVID-19 crisis.

Senior communities are stretched very thin, observed Ernie Ianace, executive vice president at VitalTech. He thinks senior living communities were a little behind the curve in terms of adopting new technology, but the unfortunate event of the COVID-19 outbreak is speeding acceptance of virtual care technology. “So many seniors need care,” said Ianace. “Without technology it will be impossible to serve them.”

About NIC

The National Investment Center for Seniors Housing & Care (NIC) is a nonprofit 501(c)(3) organization whose mission is to support access and choice for America’s seniors by providing data, analytics, and connections that bring together investors and providers.

Connect with NIC

Read More by NIC