We are all aware of the impact COVID-19 has had on the world. Tens of thousands of fatalities, shattered economies, and millions of people isolated in their homes. However, one positive side of the crisis might be the newfound appreciation for Telemedicine.
According to Steven Shook, who is a neurologist at the Cleveland Clinic in Ohio, there’s one good thing that came out of this crisis, and that is we are finally learning how valuable Telehealth can be for our communities, as people want to be more included in their medical care. Dr. Shook specializes in neuromuscular disorders like Parkinson’s, ALS, SMA and polyneuropathy.
Telehealth utilizes technology such as laptops, tablets, smartphones and other specialty devices like the United Telehealth Corp’s Transportable Exam Station, to connect patients with specialists and other healthcare providers – doctors, nurses, psychologists. This type of connection can be made from anywhere so it doesn’t matter whether you’re at home, at your office or in your car. It’s basically how doctors will make house calls in the 21st century.
Telemedicine or Telehealth was present long before COVID-19, but it took a pandemic in order for it to stand out.
The novel coronavirus is a highly contagious and new strain of coronavirus (hence the name ‘novel’) and the outbreak has put all trips to a hospital, except the urgent ones, on hold.
People that have a chronic illness or weakened immune system as a result of their treatment e.g. for Crohn’s disease, lupus, lymphoma and most types of cancers, are at higher risk for this new infection. Another high risk group are people that have some type of airway disorder, like cystic fibrosis, pulmonary fibrosis or Chronic Obstructive Pulmonary Disease or COPD.
Jennifer Powell, a 51-year-old woman from California, says that she will continue to use Telemedicine for occasions when it is too risky for her to see her physician even though she still believes that it’s important to her doctor in-person. Jennifer has been diagnosed with Secondary Progressive Multiple Sclerosis.
With access to regular hospital visits being closed off in recent weeks, many people in the health care system (policymakers and professionals) and its users, are starting to get a fresh look on Telemedicine and the huge potential it has. Through video conferencing, phone calls and e-visits (basically email exchange), everyone could have access to the healthcare system to meet their needs, whether it’s just for a follow-up, routine check-up or prescribing medication.
Dr. Shook used Telemedicine in 5% of his practice before the pandemic broke out. But, during the COVID-19 crisis (starting from late February and onward) the use of telemedicine in his practice is 100%. Aside from the procedures that he does, all of his new visits are virtual. And he’s not the only one.
Jeff Gelblum, who is a board-certified neurologist and psychiatrist near Miami, Florida did maybe one Televisit per day, usually with people that are either too busy, out of town or working. But now, he is doing about 20 Telelvisits a day with people that are quarantining at home.
Critical time for an important policy shift:
On March 17th, the Centers for Medicare & Medicaid Services opened access to Telemedicine. With this, the providers will have the right to be paid for their services to Medicare users, at the same rate as in-person visits.
Before this announcement, reimbursements were only possible for certain rural areas.
Health and Human Services also waived the HIPAA enforcement and penalties. These enforcements are related to the type of systems that are being used for collecting and storing personal medical data. With that ‘out of the way’, providers were able to use everyday communication devices and technologies, like FaceTime or Skype, to offer their services. Of course these revisions are only temporary and will be in effect for the duration of the crisis.
Rakhee Langer, who is a vice president at a Telemedicine platform, said that reimbursement was the most significant change. Daily use, before the crisis was around 100 thousand minutes, but during March and onward, that use jumped to an astonishing 1.5 million minutes.
According to Rakhee, further adoption will continue, now that doctors and patients have crossed the technology barrier.
Europe has displayed similar changes, especially in France, Germany and the U.K. and they too eased the reimbursements and privacy restrictions.
Telemedicine – ease and convenience.
One of the most valuable perks for Telemedicine is that it’s easy to use, both for the patient and healthcare provider.
Back in 2014, when the service was first used at the Cleveland Clinic, the patient would receive a special camera and microphone before they could access their Telemedicine call, but now they can use the simplicity of their cellphone.
Convenience is yet another perk for Telemedicine. This translates to the patient being able to connect with their doctor from wherever they are, without having to visit an office and sit in a chair.
Brittany Foster, a 28-year-old woman from Rhode Island, who suffers from pulmonary hypertension, says that Telemedicine keeps her from driving an hour plus to visit a specialist. This saves her travel time and expenses.
Younger generations won’t be the only ones that will appreciate this new approach. The older demographic will find this as a very important tool as well.
Millennials, who are frequently on their mobile devices, are the first ones that adopted this technology. However, Dr. Shook says that he is noticing older patients making the change as well, especially when they learn how easy it is to use.
Dr. Shook’s ALS patients are a great example how doctors can successfully connect with their patients and provide excellent care, especially if you have patients for whom travelling back and forth can be very hard.
At first, Medicare refused to make this service available, although it’s unknown why. Medicare beneficiaries are usually older and more informed and have greater challenges going to the doctor for in-person appointments.
Healthcare providers are able to see the patient’s charts, lab works, imaging (if any) and all other records. And of course the system’s even support wearable apps in case the doctor wants to follow the patient’s stats like blood pressure, heart rate, oxygen saturation etc.
Some doctors didn’t support the idea of opening Telemedicine being used on popular platforms like FaceTime or Skype during the current COVID-10 crisis. But it was urgently necessary to shift about 100 million people from face-to-face to virtual visits.
Another proof of recent Telemedicine popularity is when the Cleveland Clinic’s tech department was forced to add applications such as FaceTime and Google Duo due to the number of Telemedicine appointment requests.
Dr. Shook believes that the institute will eventually return to the secure and HIPAA-compliant platforms.