Telehealth & COVID-19: Key Areas Primed for Impact

Michelle Baker

Telemedicine or telehealth has become a popular tool to help stem the spread of COVID-19 and address other health issues during these challenging times.

COVID-19 has disrupted lives and economies worldwide. During this pandemic we are facing challenges and disruptions in how we work, shop, learn, socialize – and get health care. Going to the doctor’s office or hospital has become a health hazard in and of itself with people home sick, often scared and desperately seeking medical guidance.
 
Telemedicine or telehealth has become a popular tool to help stem the spread of COVID-19 and address other health issues during these challenging times. Physicians are seeing a surge in on-demand care requests. In fact, it is estimated that majority of patient consultations in the United States right now are now happening virtually.
 
Now that is a major shift! Physicians who previously avoided telehealth or dismissed it altogether are now reliant on it to keep practices afloat and manage patient care. Health systems with underutilized telemedicine programs are now scrambling to staff up and manage virtual visit loads. In addition, patients who were reluctant to even try telemedicine are now trying to figure out how to schedule appointments for the whole household.
 
The federal government –having long touted telemedicine as a panacea for physician shortages, rural care challenges, high costs, and access issues – is breaking down some long-standing barriers to delivering virtual care, and at mass scale. For example, state and federal laws and regulations have become more flexible relaxing limits on scope of practice, covered conditions, site of service, and many other parameters. Additionally, the Centers for Medicare and Medicaid Services (CMS) has expanded reimbursement for telehealth services, which is key to patient access.
 
But even better than that, many federal agencies are putting significant funding behind programs to help equip new entrants in telehealth, or to help shore up existing programs to provide high-quality, safe telemedicine services. The reason that the federal government is putting so many resources into telehealth now is obviously the immediate health needs associated with the COVID-19 crisis. Telehealth is central to the COVID-19 Outbreak Response System helping to stem the tide of the virus.
 
We have heard a lot about “social distancing” but with “medical distancing” telehealth allows health care providers to triage patients with cold or flu-like symptoms – screening virtually rather than have them enter a physician’s office or hospital. So, if each infected person is expected to infect two or three additional people, then telehealth helps keeps patients and health care providers safer.
 
Some COVID-19 patients leave the hospital with digital thermometers attached to their fingers to provide remote physicians with real-time information, including blood pressure and oxygen levels. Electronic ICUs allow nurses and physicians to remotely monitor as many as 100 patients across many different hospitals. Of note, in many instances quarantined doctors are the one providing remote care for patients – something that is essential when you consider that one hospital had more than 100 care providers quarantined at a time.
 
Remote care is also saving lives by mitigating the mental health toll social isolation has caused via mental health telemedicine services. Social distancing has isolated patients with serious mental health issues, exacerbated by the extreme stress and uncertainty of the pandemic itself. Telehealth has been a lifeline for many patients in need of care for anxiety, depression, or other conditions.
 
In addition to helping manage COVID-19, the other key role for telehealth is remotely delivering care to patients with chronic conditions. In some instances, people are more scared of getting infected at the hospital than they are of getting their chest pain checked out. In fact, after outbreaks there is often a wave of hospital surges for chronic conditions that had gone unmonitored. Some recent news articles about low rates of admissions for heart attacks and strokes indicate there may be some public reluctance to seek emergency care for acute issues.
 
However, some health systems, startups, and physician practices are using telemedicine during COVID-19 to better manage care for patients with chronic diseases or complex care plans. For example, some diabetes clinics are checking glucose monitors remotely and following up directly with patients when numbers are off. In another example, people with hearing aids are getting remote tests and adjustments from a hearing care professional.
 
Cancer treatment centers and oncologists are using telemedicine to go over a scan together or follow up on how a patient is responding to treatment. HIV care providers are using telemedicine to stay in touch with patients on preventive therapy and extend their script cycles so that they stay on prevention and care regimens. Some providers are even checking in on things like food and housing for patients.
 
In addition, statistics about the impact of the virus on communities of color are startling. Many free clinics and community health centers are starting to use a range of tools to reach underserved populations with texts, calls, or reminders about treatment regimens for high blood pressure, asthma or other chronic conditions that exacerbate the effects of the coronavirus.
 
For the most part, telemedicine has been forced on reluctant doctors and patients and guess what – many of them like it. Post COVID-19 they may not be in a hurry to head back to medical buildings and hospitals. And while it will be important to have face-to-face patient and physician interactions back when needed – there will certainly be a shift in how people seek care and how physicians provide it.

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