Pandemic a turning point for telemedicine
For a follow-up visit after her recent cancer surgery, Gail Rae-Garwood chosen a video consultation with her specialist, avoiding a long journey -- and potential exposure to COVID-19 in medical offices.
"I am so thankful never to have to venture out that I've enrolled my grumpy husband into tele-visits, too," said the 73-year-old Arizona woman who was simply able to upload data from a blood pressure cuff and glucose monitor to her physician.
The coronavirus outbreak has severely strained medical system, but telemedicine is being seen as a essential method of coping including for all those influenced by the outbreak.
"COVID-19 is very conducive to telemedicine," said Omar Khan, a family group physician and head of Delaware Health Sciences Alliance in Wilmington, Delaware.
Khan said doctors can make an initial diagnosis by evaluating symptoms such as for example fever and cough, and the patient's travel and connection with others.
A lab order to verify an infection can be transmitted electronically to reduce contact.
"Eighty percent of men and women with coronavirus don't need to visit the hospital," Khan said. If an infection is detected, "they move from quarantine to isolation" and many still don't need to leave home.
Khan said he has been handling all his consultations remotely for days gone by fourteen days, and that patients are handling the shift well.
"They know the danger," he said. "They don't really want to put themselves or healthcare workers at risk, and do not want to come quickly to the hospital unnecessarily. At a time such as this a hospital is a scary place."
The crisis has highlighted the worthiness of telemedicine, long touted in an effort to deliver medical care to persons in underserved areas and deal more successfully with issues ranging from minor emergencies to mental health.
"A crisis sometimes eventually ends up giving you a motivation to modify things," said Preeti Malani, a University of Michigan professor of medicine who led a 2019 survey of telemedicine for older adults.
This past year, Malani said, the survey showed many older adults had little knowledge or interest in telemedicine, however the situation has changed dramatically.
"In a matter of days we've completely switched and particularly older adults who could be vulnerable to difficulties are being told not to come to clinic," said Malani.
With the virus raging, regulatory barriers to telehealth services have quickly drop.
U.S. authorities last month waived restrictions that had prevented telemedicine for government-sponsored Medicare and Medicaid and a rescue package passed by Congress included some $200 million to greatly help providers establish remote care.
Many U.S. states have lifted restrictions and insurance firms have waived co-payments for these consultations.
Privacy regulations which limited the kinds of technology for video consultations have also been eased, which makes it possible to use consumer-friendly services like Skype or FaceTime.
"I am pleasantly shocked to see (regulatory moves) which would have taken five to a decade," said Courtney Joslin, a researcher following regulatory problems with the R Street Institute, a public policy think tank. "We're going to emerge from this with a whole lot of evidence how well telehealth works."
Gary Berman, a New Jersey cardiologist, commenced remote consultations within an effort to safeguard his practice and his patients through the outbreak.
Berman would have offered telehealth consultations before, but until last month the visits weren't included in private or government insurance, or by his own malpractice coverage.
"I've been interested in telemedicine for years, but I didn't want to expose myself to legal risks rather than get reimbursed," he said.
The physician said he might continue offering remote consultations if insurance plan is extended.
"There are a few things you can't do -- you can't reliably take someone's blood circulation pressure, you can't hear a heart murmur," he said. "But I'd continue for some people. I've 90-year-old patients who can't reach the office."
Joe Kvedar, president-elect of the American Telemedicine Association, said the pandemic will probably help shed light on the varieties of services that require to maintain person versus those handled remotely.
Many urgent care needs, mental health, post-operative follow-ups and diabetes management are among the areas that are handled easily by telemedicine, he said.
Telemedicine is now easier with devices such as internet-connected thermometers, pulse oximeters and other technology to monitor essential signs.
"Until this crisis the only service delivery option was to come to the office," Kvedar said. "I don't believe we'll go back to that system. Following this is over, you will see tapestry of options that are top quality and convenient."
