COVID-19 brought on a variety of new fears and concerns for humanity and caused exponential hardship for everyone. Mankind proved resilient by adapting to the new “norm” with tools that connected us to each other while practicing social distancing. We utilized digital platforms to provide one another with services but without contact. Contactless food delivery like UBER Eats or Postmates have thrived. ZOOM calls have become a norm, even in the office setting, for virtual meetings. Messaging apps like Microsoft Teams or SLACK allow for instant messaging from one colleague to another, while maintaining social distance. For the healthcare community, telehealth has proven to be impactful for supporting continuity of care across the healthcare continuum through virtual care.

Throughout the year, telehealth provided an alternative approach to physician patient contact source of and care. Telehealth (or telemedicine) is defined by HealthIT.gov as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.” Under this umbrella, the CDC elaborates further by separating the modes of telehealth into three groups: synchronous, asynchronous and remote patient monitoring. Synchronous telehealth includes real time audio or live audio-video interactions with the use of a smartphone, tablet or computer. Asynchronous telehealth is a means for message storing and cloud portals for providers to send messages, images and other data/info to patients. Finally, remote patient monitoring involves the direct transmission of a patient’s clinical measurements from a distance to their healthcare provider.

During the COVID-19 pandemic, telehealth was proven to be substantially beneficial for providing care without contact. To the untrained eye, contactless care may seem less (like something that isn’t as) effective than in-person care, but this is incorrect. Telehealth has many benefits; some of these benefits are not available during in-person care. These benefits include:

·            Screen patients who may have symptoms of COVID-19 and refer as appropriate

·            Provide low-risk urgent care for non-COVID-19 conditions, identify those persons who may need additional medical consultation or assessment, and refer as appropriate

·            Access primary care providers and specialists, including mental and behavioral health, for chronic health conditions and medication management

·            Provide coaching and support for patients managing chronic health conditions, including weight management and nutrition counseling

·            Participate in physical therapy, occupational therapy, and other modalities as a hybrid approach to in-person care for optimal health

·            Monitor clinical signs of certain chronic medical conditions (e.g., blood pressure, blood glucose, other remote assessments)

·            Engage in case management for patients who have difficulty accessing care (e.g., those who live in very rural settings, older adults, those with limited mobility)

·            Follow up with patients after hospitalization

·            Deliver advance care planning and counseling to patients and caregivers to document preferences if a life-threatening event or medical crisis occurs

·            Provide non-emergent care to residents in long-term care facilities

·            Provide education and training for HCP through peer-to-peer professional medical consultations (inpatient or outpatient) that are not locally available, particularly in rural areas

  Despite all the positives that have come out telehealth, there are some drawbacks. Getting reimbursed for telehealth services can be problematic. For example, Medicare offers reimbursement coverage for telehealth services but it has limitations. If a provider’s Electronic Health Record (EHR) system isn’t integrated with the platform that is being used for telehealth services it can complicate workflow. Telehealth services can also simply be out of reach for smaller practices because of the cost of certain systems. As with most technology, there can be functional issues. Sometimes there is a weak connection so you don’t hear everything your doctor is saying or your doctor may not hear everything you are saying. Sometimes the system could be malfunctioning which would require extra support and delay appointments. Some patients aren’t comfortable with the technical skills that are needed for telehealth services. The older population may not have access to a computer or cellphone with a webcam or front facing camera. They also may not understand how to use the software or could just be resistant to using it. Patients in underserved communities also may not have access to the technology needed for a telehealth visit. There are also security concerns accessing patient data over the internet. HIPAA requires that information gathered through telehealth to be encrypted and patients must be contacted through a secure connection. Lastly, not all types of care can be performed over a telehealth visit as certain diagnoses require an in-person examination.

United Medical ACO, led by Kemal Erkan, was an early adopter of telemedicine.  Our goal was to ensure the health and safety of our patient population.  Telehealth effectively allowed us to continue to “see” our patients and address their health concerns while keeping our physicians and staff as safe as possible during the pandemic. Telehealth provided the platform for our physicians to see almost the same number of patients in comparison to the prior calendar year. 

According to predictions by Modern Healthcare, there’s a lot to look forward to for telehealth.  First and foremost, telehealth will become a standard practice. The opportunity to give for care in non-traditional locations will from home and respective locations create the highest level of convenience for all. This will lead to patients will choose practices that offer telemedicine; at times, even if it means leaving their current provider. Having the opportunity to go to any doctor without having to adjust your schedule is the ultimate convenience and in turn may lead to telemedicine becoming the most efficient option for preventative care. According to the CDC, chronic diseases that are avoidable through preventative care services account for 75% of the nation’s healthcare spending. Finally, wait times at hospitals will decrease. Waiting hours for an urgent need will no longer be a situation if the feeling you have can be addressed almost immediately!

Who would have thought 2020 could lead to such creativity and innovation? In a year where countries felt like they were crumbling and when everyone’s health was at the highest risk, our collective health gained a boost with the rise of telehealth. Doctors have easier access to patients and patients have easier access to care. Think you’re getting sick? Telehealth. Feeling down? Telehealth. Might have COVID-19? Telehealth. Any illness can be catered to and exercised by telehealth as long as your provider uses one of the many telehealth methods. And if they don’t? Call United Medical Clinic, get registered and seen as a new patient, and if a time arises when you need a telehealth appointment, we will be there for you, we’ll set up a telehealth appointment with you at (866) 862-2955!

Citations:

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

https://www.modernhealthcare.com/technology/predicting-future-role-telemedicine

https://www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine

 https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html

https://telemedicine.arizona.edu/blog/7-telemedicine-concerns-and-how-overcome-them