Telehealth is here to stay

But as things return to normal, its use is waning, despite benefits

Asian Doctor And Nurse Team Making Video Call For Discussing, Consulting For Pandemic Virus Together Via Internet And Wireless Technology With Laptop Computer On Wood Table In Meeting At Medical Room Of HospitalNew technology that allowed doctors and patients to interact through video screens exploded at the start of the pandemic. Now that many facets of life return to normal, interest in telehealth is waning, and Concord Hospital officials are wrestling with how to keep it as a permanent fixture.

Last spring, Concord Hospital went from offering virtually no telehealth services to shifting 60% of their appointments online almost overnight. Since then, telehealth has comprised a smaller portion of the hospital’s total appointments — today, it comprises about 16% of all appointments.

Matthew Gibb, chief clinical officer of Concord Hospital, said this is mostly attributed to in-person services opening back up. Many of the services patients delayed during the pandemic require elements of in-person care.

Still, advocates of telehealth say virtual healthcare fills in gaps for patients who have trouble getting access to care.

Telemedicine has the potential to change the way health care operates in a variety of settings, such as nursing homes, prisons, and rural areas. Patients who have historically had difficulty accessing health care could be instantly connected to a specialist who is hundreds of miles away. Drive to far away medical facilities are eliminated.

Those seeking second opinions are no longer limited by their geography – a patient in Concord could send their scans to a doctor at Johns Hopkins in Maryland or even Dartmouth-Hitchcock Medical Center in Lebanon.

Several mental-health care providers in New Hampshire have reported seeing patients who previously struggled to hold appointment times, consistently show up for video calls in the convenience of their home.

Gibb said he doesn’t know where the number of virtual appointments will level out. The availability of these services depends on a number of factors, like how insurance companies resolve to reimburse virtual services.

Slow to realize

Gov. Chris Sununu signed a bill in July that requires Medicaid and private insurers to pay the same for telehealth services as they would for in-person services. However, the law does not apply to more common Medicare reimbursements. While the Centers for Medicare & Medicaid is currently covering select telehealth services, these policies are set to expire when the federal public health emergency declaration expires.

The shift to telehealth hasn’t been all rosy. During a Monitor interview in Mau with several of Concord Hospital’s top executives, Gibb said some providers have had a difficult time adjusting to interacting with their patients through the computer screen.

“The interpersonal piece of care is as important as technical pieces of it,” he said. “It’s been a disruption for physicians in general to adapt and feel like you’re accomplishing what you feel like you could generally do at a face-to-face visit.”

Robert Steigmeyer, Concord Hospital’s CEO, said the shift to virtual medicine has been long anticipated but slow to realize. The pandemic has pushed slow-moving bureaucracies to make large, but necessary changes.

Before the pandemic, providers had to jump through a multitude of hoops to provide medical care remotely. They couldn’t prescribe medications unless they met with the patient face to face. They couldn’t call a patient in another state because of state limitations on malpractice insurance. Even if they did meet all of these requirements, insurers usually reimbursed providers for just a fraction of what they would get from in-person appointments.

However, relaxed restrictions have sparked a telehealth golden era that providers hope will outlast the pandemic.

“It’s been a jumpstart to things that we’ve all believed are necessary,” he said. “Many systems struggled with bringing up telehealth and then many systems got it done within 48 hours. And now we find that consumers, patients, communities, appreciate that in a certain way. It needs to be a part of what we do permanently.”

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