Telehealth visits could play important role in COVID-19 crisis
LOS ANGELES - On Tuesday, President Donald Trump announced that his administration would be expanding telehealth benefits for Medicare recipients in response to the growing COVID-19 pandemic. The expansion could very well make telehealth more of an integral component of how Americans across the country receive health care, especially during periods of social distancing and self isolation.
But for many whose primary health care experience has been physically going to a doctor’s office, telehealth is new territory.
What is telehealth/telemedicine?
Sometimes the terms have been used interchangeably, but the American Academy of Family Physicians (AAFP) provides a stronger distinction between the two.
Telehealth is different from telemedicine in that it refers to a broader scope of remote health care services than telemedicine,” according to the AAFP. "Telemedicine refers specifically to remote clinical services, while telehealth can refer to remote non-clinical services.”
Who benefits from telehealth?
Historically speaking, telehealth has been an immensely valuable tool for individuals who are not able to receive medical treatment or speak with doctors at a physical location or in a convenient fashion. Someone who lives in a rural community and is dozens or hundreds of miles away from their nearest health clinic could use telehealth to receive a health consultation.
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Telehealth could also benefit a person who may live closer to a health care organization but requires specialized treatment. For example, if that rural individual were to visit a smaller health clinic and needed more specialized testing, doctors at the smaller clinic could use telemedicine to communicate with specialized practitioners who may live far away.
Can telehealth help me get tested for COVID-19?
Amid the current COVID-19 pandemic, telehealth can provide a helpful solution for those who may be in need of medical treatment but do not want to, or cannot, leave their homes. If a person is experiencing COVID-19-related symptoms, they could confer with a licensed medical practitioner through telehealth to discuss if testing is needed.
Dr. Mia Finkelston, a physician and Medical Director at Amwell, a telehealth solutions organization, noted that many of the patients they have been seeing are moderate to low-risk. By asking more in-depth questions regarding a person’s health history, physicians like Dr. Mia, who has been working in telehealth for several years, are able to determine the patient’s risk level.
In typical scenarios, patients who are deemed as high-risk can be escalated to the appropriate in-person care venues through a white glove referral process for further evaluation and testing.
This does not mean patients are able to receive a test for the novel coronavirus via telehealth services or at home, but a telehealth doctor could potentially advise a patient on whether testing for COVID-19 is necessary.
Even if you are exhibiting symptoms consistent with the novel coronavirus, such as fever or a runny nose, you can only know for certain by receiving a test in person. Several states have implemented drive-through testing facilities where people can be tested for COVID-19 while remaining in their vehicles.
If telehealth is so helpful, why haven’t all practitioners and health care organizations been using it?
Some already do, but patients and practitioners haven’t widely embraced it. For some, telehealth may not have been a viable option.
Not all conditions can be treated using telehealth services. For example, a physician could use telehealth to help determine if a person’s skin rash is indicative of a larger condition, but not necessarily if a person reporting pains in their knee has torn their ACL. Dr. Mia also notes that telehealth practitioners don’t order X-rays or testing.
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And not all health organizations or clinics necessarily operate by some larger uniform telehealth operation or mandate. One major hospital in Boston or a national insurance provider may offer more robust telehealth services to its patients than their peers.
While the new initiatives outlined Tuesday are aimed at increasing telehealth services, it is possible that a spike in demand could result in complications.
LEONARDTOWN, MARYLAND - MARCH 17: Signs directing patients to a COVID-19 virus testing drive-up location are shown outside Medstar St. Mary's Hospital on March 17, 2020 in Leonardtown, Maryland. The facility is one of the first in the Washington, DC
So, how can telehealth help in the coronavirus pandemic?
The new initiatives announced Tuesday can help Medicare beneficiaries (individuals 65 and older, which is also the population whose health is most at risk of the coronavirus) arrange for virtual doctor’s appointments that can be conducted from their own home. This can be especially useful for those who are in self-isolation or are self-quarantining due to the pandemic.
It can also help for those who want to determine if symptoms they are experiencing may be indicative of COVID-19 and if testing is necessary.
Telehealth services also don’t have to be strictly focused on coronavirus symptoms. Someone who is being treated for a preexisting condition could use telehealth to speak with a medical practitioner to discuss their current medical state.
What should I consider when using telehealth for the first time?
Dr. Mia provided the following suggestions for patients to have the best telehealth experience possible:
1. Ensure that your webcam works and that you have a strong internet connection
2. Make sure the room in which you are participating in the telehealth session has strong lighting
3. Ensure that you are in a quiet, private area
4. Be willing and able to move your device around if necessary
5. Don’t hold back and be open to sharing about your experiences
6. Be willing to ask questions if you don’t understand something
Dr. Mia noted the understandable skepticism that some patients may have when using telehealth, but reiterated that the communication methods are compliant and secure. “Tell us what we need, what medications do you take, tell us about your medical history, do you have allergies, all of that is so important for us to make a thoughtful diagnosis and treatment plan for you,” Dr. Mia said.
This story was reported from Los Angeles.