Point of Care Changed in 2020…Will there be a New Normal?
Authored by Augie Caruso, Health Monitor Network and
William Lief, Accelerated Rx Analytics, LLC
Of the many aspects of pre-COVID life that changed during the pandemic, one to which health care professionals and brand marketers continue to pay close attention is Point of Care. As patient visits to physician offices dropped by around 60% in the early weeks of COVID, several things occurred simultaneously. First, new prescriptions dropped precipitously, and patients sought mail order Rx’s and larger prescription sizes for fear that COVID restrictions would interrupt their existing treatments. Second, chronic and other non-emergency conditions were ignored as people were isolating, physician practices were shuttered, and media focused almost exclusively on COVID symptoms, testing and case numbers across the nation. Finally, telemedicine, long an alternative with which certain clinical specialties as well as primary care had been tinkering, suddenly became a significant factor in how healthcare practitioners and their patients interacted.
The Evolution of Telemedicine
It became immediately apparent that telemedicine could serve as a potential stopgap replacement for in-office visits in a COVID environment, and it was certainly better than ignoring non-COVID health issues which could lead to delayed diagnoses and treatment. Telemedicine grew to represent over one-fifth of medical visits for a short period of time in the early weeks of the pandemic. However, as physicians gained more experience with the medium, its limitations also became more evident. You can’t conduct in-office diagnostics during a telemedicine visit and doctors found that the medium was limiting in terms of visually examining as well as “bonding” with patients. Moreover, physicians didn’t like having to be the “IT guy” when they or their patients experienced technical difficulties with their respective devices. As a result, our research shows that for most specialties, telemedicine is preferred for “check-in” or “follow-up” visits with existing patients where the expectation is to confirm how the patient is doing rather than to initiate or switch therapies.
There are exceptions of course. With respect to telemedicine, one specialty – psychiatry – has truly embraced the medium which continues to account for a very high percentage of their patients. It may be that the verbal nature of the psychiatrist’s interaction with the patient is especially suited to telemedicine. In other specialties, IQVIA has shown a large drop off in telemedicine visitation from mid-April 2020 when the pandemic was new vs. the second half of 2020. We also see in these data that the rate of NBRx productivity is lower for telemedicine visits than in-office visits which suggests that telemedicine visits offer less value to Pharma. Looking to the future, our research shows that most practitioners expect telemedicine to remain a valuable secondary option for interacting with patients, but not a replacement for in-person care once COVID-19 ceases to be a clinical consideration.
Other COVID-related Trends
Beyond the boost in telemedicine usage, it’s important to note that patient isolation, COVID anxiety and office practice restrictions led to the cancellation of many elective health procedures and exams. Health concerns such as Type 2 diabetes, cardiovascular disease and oncology screenings were put on hold, increasing risk to the patient. And for some, that period of “waiting until later” could be permanently detrimental.
Our Role as Educator in a Changing Environment
As a company that's been at the center of patient education for nearly 40 years, historically serving patients and families through the physician’s office, how do we help patients get back on track when it comes to paying attention to their health and wellness? We need to be very direct in our educational efforts to address the potential impact of loss of six months to a year or more of “letting things go,” and encouraging an immediate return to attending to oneself – mind, body and spirit. We need to ensure that we are collaborating and partnering with HCPs to deliver those educational tools to patients wherever they may be, and in whatever manner works for them – at home, in office, in a different remote location due to changing work or living circumstances, etc.
One thing we know from recent studies is that disease types impact patient reach, connection and access to health information. For example, the typical Parkinson’s patient is age 60 or older, suggesting they are less likely to be tech savvy than say, a younger multiple sclerosis patient, on average. As educators, we must be ever cognizant to not presume that technology advancements provide the same opportunities for health information for all. Health information access and health literacy remain societally inequitable to this day, and the pandemic only served to compound these differences.
Turning the Corner…What’s on the Horizon?
Thankfully, as approaching 70% of the nation’s adults become fully vaccinated, we have seen a return to pre-COVID prescription writing and fulfillment, in some cases surpassing Rx levels prior to the pandemic. And in-office patient visits are getting closer to what they were prior to the pandemic.
As technological advancements continue to provide new inroads in health care delivery, information access, and informed health and wellness management, it is safe to assume there will be increasing interest in identifying patient- and physician-friendly ways of melding at-home convenience with personal touch. That said, patient-centric education delivered in the most individually accessible manner will always be critical to enabling informed patient decision-making and better health outcomes as a result.
Sources: IQVIA, Symphony Health, a PRA Health Sciences Company and Health Monitor Network