Ask the Experts: The changing landscape of healthcare

As we adjust how we work and live, the healthcare industry is adapting to an entirely new set of policies and how it treats patients.

We reached out to two of New Hampshire’s largest healthcare authorities to learn more about how normal processes have changed and how it can affect you and your needs.

Our experts:

William C. Brewster MD, FACP, CHIE, Vice President, Harvard Pilgrim Health Care – New Hampshire Market.

Mary Oseid, Senior Vice President Regional Strategy and Operations, Dartmouth-Hitchcock Health, Connected Care – Center for Telehealth.

William Brewster, Harvard Pilgrim Health Care

Q. How is technology playing a role in medicine, and how has it changed normal processes lately?

Brewster: “We’re currently living in unprecedented times. Having made it through the first month or so of our new normal, I can’t imagine the difficulty and disruption to life during the 1918 pandemic. While it has taken a little getting used to, I’m able to do everything that I did in the office — just from my home — all thanks to technology. Between video conferencing, teleconferences and a strong VPN, our business operations have not stopped. With just a few clicks of their smartphone, my team can get necessary supplies and have them delivered to their front doors. Our members can contact us as they normally would and have the same great experience as always, even with the team working remotely. And last but not least, we have been able to access medical care without having to leave home. As telemedicine visits may help limit the spread of the disease, Harvard Pilgrim is emphasizing telemedicine services at no cost to our members and expanding the scope of our telemedicine coverage for telephone only, audio/video and e-visits.”

Q. What policies have changed in light of the current health situation?

Brewster: “It’s clear that the situation continues to change daily. With that in mind, we have ongoing cross-functional meetings to discuss the situation and make sure we are addressing them from all areas of the business, with a focus on our members, our broker partners and our provider network.

“To help remove any potential barriers to care for our members, Harvard Pilgrim waived member cost sharing (deductibles, copays, coinsurance) for COVID-19 testing and treatment provided by in-network providers. Costs will also be waived for out-of-network providers when an in-network provider is not available for testing and for any emergency services related to COVID-19 treatment administered by out-of-network providers.  We have also removed the member cost sharing for all telemedicine appointments, regardless of whether they are COVID-19 related or not, and are allowing members to receive a one-time early refill of covered maintenance prescription medications (up to a 90-day supply) at usual cost sharing. We want to provide every opportunity for our members to get the care they need without having to leave their homes, and implementing these changes does just that.

“During this time, we have also put many policies in place that help relieve some of the day-to-day stressors for healthcare providers. Things like removing usual precertification requirements — such as those related to the transfer of patients to less acute settings like rehab hospitals — not only allow providers to focus on continuing to provide quality care but can also free up limited bed space more quickly.”

Q. What information do you want to share with the public?

Brewster: “This is a challenging time for everyone. We are all dealing with this new normal and worry is at an all-time high. While it is difficult, maintaining social distancing (staying at home other than for essential trips out) and following all local public health mandates is vital. We want to thank all of the essential workers keeping us safe, stocked with groceries and connected. No matter what your role is, one thing is clear: We are in this together. And Harvard Pilgrim is no different. While so much has changed, our commitment to our members and community has not. We are in regular contact with the NH Hospital Association, NH Insurance Department, NH Medical Society as well as other partners within the state and country to ensure that you can count on us when you need us. Oh, and wash your hands.

Mary Oseid, Dartmouth-Hitchcock Health

Q. How is technology playing a role in medicine, and how has it changed normal processes lately?

Oseid: “The delivery of healthcare remotely, often called telehealth or virtual care, is one of the most important and innovative changes that technology has brought about in healthcare in recent history. Today, physicians and other providers across a broad range of healthcare services are using video technology and digital information to assess, diagnose and treat patients remotely. Using telehealth, patients are able to remain in their communities to get the care that they need from their local hospital. Patients, particularly in rural regions, no longer have the burden of traveling long distances to access specialty healthcare.

“Dartmouth-Hitchcock (D-H) Center for Connected Care’s Tele-Intensive Care Unit (TeleICU) is one such program that provides care for patients remotely. The Dartmouth-Hitchcock TeleICU program, launched in 2019, is staffed with board-certified intensivists (physicians who have undergone advanced training in providing care for critically ill patients) and critical care nurses. The TeleICU team collaborates with bedside clinicians in rural hospitals to provide re-al-time care, support, monitoring and clinical consultations, allowing even the most critically ill patients the ability to receive care close to home. The clinicians communicate with patients and providers using state-of-the-art, two-way, interactive audiovisual technology, enabling the critical care team to talk with providers at the bedside while seeing the patient in real-time.

“To assist during this time of crisis, the Dartmouth-Hitchcock TeleICU team expanded its coverage to 20 hospitals across the region, offering critical care consults for COVID-19 patients in all of these locations.

Q. What policies have changed in light of the current health situation?

Oseid: “Dartmouth-Hitchcock Health has been investing in telehealth since 2012. The D-H Center for Connected Care provides telehealth services to more than 20 hospitals in the region and serves patients across five states. Our program provides telehealth care that spans the full continuum of healthcare services. When the COVID-19 pandemic hit, we were ready. We knew that expanding telehealth services was critical in addressing the challenges of caring for patients while maintaining social distance, protecting healthcare workers and preserving important personal protective equipment.

“Fortunately, federal and state governments agreed. As part of their emergency orders in response to COVID-19, they put in place policies requiring that telehealth services be paid at rates consistent with traditional, in-person appointments. Video technology applications have also been expanded to provide remote care to patients. And physicians are able to practice in bordering states without going through state licensing procedures. These new policies allow us to take advantage of our experience in telehealth, expand our programs quickly, and provide needed healthcare services to patients and hospitals in our region.”

Q. What information do you want to share with the public?

Oseid: “We want our patients, our communities and our regional healthcare partners to know that Dartmouth-Hitchcock Health is here to support you — just as we’ve always been. During this crisis, we are doing everything we can to leverage our telehealth technology and expertise, to provide care remotely and limit your exposure to others.

“We believe that strategies to maintain social distance will continue to be essential, even as the threat of a significant COVID-19 surge passes. Telehealth is here to stay and our commitment to and investments in telehealth will remain strong. We are building on a solid foundation of success in telehealth and will continue to offer services that provide patients with access to specialty healthcare services closer to home.”

For more information about telehealth and virtual visits, visit

Categories: Health