With major vaccination programs completed and visitation restrictions easing, life at long-term care facilities across the country is inching toward looking more like its pre-pandemic self. But even when COVID-19 is not a daily threat anymore, its effects will linger — in a positive way — through the use of technology that will change the industry forever.
Those changes roughly fall into three categories — telemedicine/telehealth, social connectedness and engagement, and infection control — according to Majd Alwan, Ph.D., senior vice president of technology and business strategy for LeadingAge and executive director of the LeadingAge Center for Aging Services Technologies.
Telemedicine, “the traditional computer on wheels or telemedicine cart that has sophisticated equipment,” and telehealth, “simpler modalities for two-way virtual visits,” Alwan said, have provided important access to healthcare for residents who were confined to their senior living communities or nursing homes or who wished to minimize their risk of being exposed to or exposing others to the coronavirus.
“I firmly believe that telehealth is here to stay,” he said. “The end users, whether it’s older adults or clinicians who were not familiar with and uncomfortable with telehealth, have had to use it and have been baptized by fire, so to speak, during the pandemic and have become a lot more comfortable with it.”
Assisted living, nursing home and perhaps even independent living residents will demand telehealth going forward, Alwan said. “They may find a lot of time efficiency and convenience in seeing their physician, especially for routine or simple things,” he said.
Society as a whole has come to value telehealth, too, Alwan added.
“We probably would have had a lot higher infection rates, and a lot higher hospitalization costs and death rates as well, because of people having to either forego receiving healthcare services or expose themselves to potential infection with the COVID virus or others by going into healthcare provider clinics or hospitals, especially if they didn’t have to,” he said.
The use of telehealth also received a boost due to flexibilities from the Centers for Medicare & Medicaid Services, Alwan noted.
“For example, they waived the requirement for the platform to be HIPAA-compliant, and a lot of people used general-purpose video conferencing applications, from Viber to WhatsApp all the way to Skype and Zoom, in addition to the clinical version of Zoom, which is compliant,” he said.
CMS also expanded the number of places where clinicians could be reimbursed for providing telehealth services. “Now physicians were able to be reimbursed regardless of where the patient was in terms of originating site,” Alwan noted.
He also said he has heard that “CMS is seriously considering extending or making some of the telehealth flexibilities permanent.”
Such a change would incentivize clinicians to accept telehealth calls from nursing homes in urban areas, as well as in senior living, Alwan added, “because that’s where the patients live, especially if CMS continues with the flexibility around the patient’s home.”
The majority of telehealth reimbursements related to older adults have been either audio-only or two-way audio–video conferencing virtual visits, he estimated.
Alwan expects HIPAA-compliance requirements to return.
2. Social connectedness and engagement
Interest in social connectedness and engagement technologies has been significant, “from Skype applications for video conferencing … all the way to classes over Zoom for yoga,” Alwan said.
The trend started well before COVID but has seen a step increase during the pandemic, he said, predicting that the use of such technologies will not level off when this coronavirus is a fading memory, “because it’s based on what the residents want rather than what they need, and it’s fun. Everybody gravitates toward those kinds of solutions, and they do not push back against them.”
Alwan said he foresees a continued convergence between social connectedness and telehealth technology, with an increasing number of social connectedness platforms having dual application.
“As with telehealth, I believe it’s going to continue to grow, for the similar reasons, without the reimbursement aspect,” he said. “But the reimbursement aspect is also a contributing factor when it comes to social connectedness.
“For example, you can use a computer that is enabled with video-conferencing capabilities, especially if it’s HIPAA-compliant, to connect with your physician and have a virtual visit, and you also can use it to connect with family members and continue to attend classes and participate in activities remotely.”
3. Infection control
Not surprisingly, providers also have shown a significant interest in infection control technologies during the pandemic, Alwan said. The category, he added, includes tech such as that used to help screen residents and staff members for signs of COVID, perform hand hygiene, and disinfect — UV light disinfection and foggers as well as HVAC systems to help control air quality.
Providers also have welcomed simple solutions to help them manage COVID-19.
“There was a lot of demand and questions regarding automating the pre-registration and the pre-consent forms for vaccination when the vaccine came about,” Alwan said.
Among the many resources LeadingAge CAST provided operators, he added, was an article about how tools such as mail merge in Microsoft could be used to auto-populate the consent form as well as the pre-registration form needed for the federal Pharmacy Partnership for Long-Term Care program.
Infection control wasn’t as big of a focus in senior living before the pandemic as it was in skilled nursing, but Alwan said he believes that high interest will continue in both settings, although it will “level off.”
“We learned that infection control is important, and we need to be ready for the virus du jour,” he said.
“Today, it’s COVID. God knows next year if there are going to be strains, whether it’s COVID or another virus or a mutation of viruses … that would require more stringent hand hygiene and infection control strategies in general, and screening of residents and staff and visitors and so on and so forth.”
Editor’s Note: This article appears in 2021 McKnight’s Technology Supplement. To read additional content, click here.