COVID-19 ISO Insights

COVID-19 Tests Telehealth and the Internet

March 30, 2020

By: Christopher Sirota, CPCU

The global spread of SARS-CoV-2, which causes COVID-19, appears to call attention to an increased need for virtual medical visits (telemedicine or telehealth), as well as increased dependency on the internet needed for that service: remote working, e-learning and streaming entertainment (videos and gaming).

Internet Use Increases

The COVID-19 outbreak has reportedly forced millions of people to stay at home and work from home in many countries, especially, according to Business Insider, in countries with strict quarantines, including: China, Denmark, El Salvador, France, Ireland, Italy, New Zealand, Poland, and Spain.

According to CNN, to keep working (and stay entertained), millions of people have been relying on the internet more than ever, potentially straining network capacity in some places. For example, per the article:

  • Use of Webex in China has reportedly increased by 22 times and doubled worldwide.
  • Seattle internet usage at night has increased by 40%.
  • Internet usage in Italy has increased by 70%, and in France by 30%.
  • In South Korea, online gaming has increased by 30%.

One expert reportedly opined that urbanites may face fewer issues with their internet service than residents of small towns and rural areas where fiber optic capacity may be less.

A related CNN article also reported that since about 60% of consumer internet usage is for streaming videos, Netflix has decided to temporarily reduce data quality by 25% to reduce the strain on the internet in Europe during the COVID-19 outbreak.

Telehealth Systems Overwhelmed

In addition to an increased use of the internet, the New York Times has also reported that some emergency rooms are leveraging teleheath systems to triage patients before they arrive to a hospital or clinic. For example, the article noted that one patient was consulted via a tablet. Such triage reportedly allowed the healthcare workers to diagnose him as a potential COVID-19 case and thus they were "able to prepare for his arrival by clearing the ambulance bay of people and vehicles to protect patients and hospital staff from possible infection."

That said, STAT News has reported that the sudden increase in the use of telehealth systems resulting from the COVID-19 outbreak has led to some consequences.

According to the article, such systems have been slowed down by the aforementioned internet issues and online platform issues. In addition, the online platforms used by some hospitals reportedly now require more staff to address the increase in telehealth consultations, and more training for that staff for specific protocols related to COVID-19 that are themselves reportedly changing often. Regarding that training, one online telehealth provider reportedly noted that it has been "constantly updating" its training videos for COVID-19, which is comprising nearly 95% of its telehealth calls.

Per the article, some examples of implementations of telehealth and responses to the COVID-19 outbreak include the following:

  • "Cleveland Clinic is onboarding its entire workforce of 4,000 physicians to deliver remote consultations via video, and the system is also adding registered nurses and others who can help with the workload."
  • [Instead of using a telehealth online provider] "Penn Medicine has built its own technical infrastructure which, until two weeks ago, was used primarily to serve employees of the health system […]the health system is providing consultations via video and chatbot, as well as telephone […]the number of telehealth visits increased from about 40 a day to more than 120…" [due to the COVID-19 outbreak].
  • [Regarding the] "University of Pennsylvania in Philadelphia, requests for virtual visits are coming in faster than clinicians can handle them. The hospital system has increased the number of practitioners delivering remote consults from six to 60, but it is being forced to schedule telehealth visits several days out to spread the workload"

The article also explained that one online telehealth platform that has 10,000 clinicians has experienced platform issues that have caused patients to wait 30 minutes or more to log in.

Of note, the recent Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 will reportedly support the expansion of teleheath usage by Medicare patients to millions, rather just "seniors living in rural areas." (See this Lexology article for more details), potentially straining teleheath providers even further.