Many years ago, I was one of the early pioneers of telemedicine. I and others firmly believed that telemedicine had so much promise that if people would accept it as a mainstream way of delivering health care, the skilled nursing industry would be forever changed for the better. That was why I become one of those pioneers.

Telemedicine has come a long way since then. In many ways, it took a pandemic to gain that level of mainstream acceptance, but by then there were very few similarities between the telemedicine I helped to introduce and what we practice today. Telemedicine has opened the door to even newer technologies and opened the eyes of the industry to possibilities that were never contemplated just a few short years ago.

Let me use one of the facilities we partner with an example. It's a 75-bed Midwest skilled nursing facility (SNF). Like thousands of other post-acute care facilities, it is part of the national health care infrastructure. But it, like all nursing homes today big and small, is expected to deliver far more advanced health care than what was expected when they accepted their first residents back in the late 1970s.

The facility is reimbursed under the same Centers for Medicare & Medicaid Services (CMS) guidelines as their big-city counterparts with far more capacity and capability. It deals with the same handful of global insurance companies whose mission to uniformly “even out" health care by providing for the best possible care at the lowest possible cost suits the insurer far more than it suits the needs of the SNF or its patients.

Patients really became the focus during the pandemic, CMS and big insurers notwithstanding. If there were a silver lining to that catastrophic event, it is this: medical care delivered using high-tech means is accepted, expected, and is now a critical part of our national health care infrastructure. Having patients seen by a doctor at their bedside, without having to transport to a hospital, saved countless lives. It brought talented, skilled, and dedicated clinicians to every corner of the country. It made treatment by a specialist more practical, and it leveled a very uneven playing field so that small Midwest facilities were immediately as capable and as highly regarded as any facility in any of America's biggest cities.

Much of this care was rooted in the pandemic, as were the necessary permissions and reimbursements, but now that the genie is out of the bottle, that level of care is still expected. Prior to this event, the owners of facilities, especially smaller ones, were never going to be able to afford a medical director or an on-site clinician who would make daily rounds and see patients on demand. Today, not only is that affordable for those owners, it's an additional profit center, all thanks to advanced technology.

The acceptance of such technologies has led to the development and deployment of a host of other technology-based advances. In thousands of SNFs nationwide, patients' vital signs are being measured and recorded digitally, with guaranteed accuracy and results uploaded automatically in real time into the facility's electronic medical record (EMR). And they do it in about two-thirds of the time it would take a nurse.

Partners like Saiva are continually refining and reinventing the technology we use and the way we use clinical intelligence to be more efficient and effective. Neteera and others are deploying technologies that use radar waves and vibration detection to continually measure respiration and heart rate. Neteera is using the same technology to track behavioral functions, specifically bed exits.

Medical practices like TapestryHealth are coordinating all of those technologies and putting them at the fingertips of trained clinicians, essentially making that clinician on-site equal to that of any major medical center. Enhancing all of that are the behind-the-scenes artificial intelligence (AI) technologies that turn tens of millions of bits of data into an early warning system so that facilities like those that partner with TapestryHealth can get an invaluable heads-up before the next outbreak or the next emergency hospitalization hits while there's time to act, maybe even to save a life.

And the patient? The patient has a relationship with his or her own doctor, one they see regularly, sometimes standing in the room and sometimes visiting over a computer monitor, but connecting with the patient nonetheless. It has taken many years, untold effort in research and development by some of the best minds in the world, and a global pandemic, but we're finally effectively blending leading-edge computer technology with old-fashioned doctoring to create a better health care environment than we've ever known.

Until next year.

David Chess, MDBecause companies like TapestryHealth are already testing robotic delivery of these technologies so that they can perform their respective functions with no human intervention at all, freeing doctors, nurses, and other clinicians to spend more of their time providing hands-on care. The technologies of tomorrow are being built on the on the foundational technologies of today. The only way to be ready and not be left behind is to embrace the future by bringing it into your facility today.

Dr. David Chess is a geriatrician who pioneered the original concept of telemedicine in the SNF setting. He has spent much of his career since then advancing the use of technology to improve both patient care and profitability in SNFs. He is the founder of TapestryHealth, one of the nation's leading providers of health care in skilled nursing facilities.​