The coronavirus pandemic has forced a reshaping of the landscape of healthcare, requiring the medical community to look for new, safer approaches to patient care.
To keep patients and team members safe, virtual visits are now conducted via remote communication technology, such as Telehealth and Telemedicine. This is the new normal of patient doctor interaction, and represents a new era of healthcare delivery, and one that will continue into the foreseeable future.
As the pandemic continues, frontline workers at doctors’ offices and hospitals have been put to the ultimate test. In response, new and better programs of communications via Internet technology were enhanced, and audio check-ins restructured. Through telehealth and telemedicine, doctors and nurses can now engage patients via digital devices to meet basic healthcare needs.
During the height of the pandemic, most elective procedures at hospitals and doctors’ clinics were cancelled. With new variants of the virus threatening the country, a new challenge has been created. With elective procedures canceled, questions arose on how to safely care for emergency and non-emergency patients in a safe environment.
The solution was a broadening of virtual care to interact with patients, maintain safe environments, and adhere to mandated social distancing guidelines. The Centers for Medicare & Medicaid Services (CMS) increased access to Medicare telehealth services so beneficiaries could receive a wider range of care from their doctors without them having to travel to a healthcare facility.
“To protect both staff and patients, some medical practices closed their doors to in-person visits because of concerns over the risk of transmission,” said Randall M. Taubman, M.D., CPE, regional medical director at ClareMedica Health Partners LLC, Miami Lakes. “We remained open; our staff wore personal protective equipment (PPE) and each patient was thoroughly screened. Anyone screened as a possible COVID candidate was seen remotely.”
According to Dr. Taubman, video-based visits are preferred and more effective. “The doctor and the patient can see each other and it’s a more natural interaction,” he said. “Plus, if there are any physical changes, doctors can analyze the problem, and that’s a big benefit over an audio virtual visit.” Differences also exist between the way medical codes are applied and how video-based visits are billed.
Scheduling a remote health visit
Telehealth visits can be Web-based or done through a phone call to the office, but prior to the online interaction, most practices require verification of identity and insurance information. “Patients must consent to this form of care, and when they ‘meet’ with their doctor, the visit is conducted in much the same way as an in-person visit,” said Dr. Taubman. “The one exception is that doctors may ask additional questions about a patient’s general health and well-being.”
Before opting for a telehealth or telemedicine visit, patients should make a list of questions. They should also be prepared to explain any symptoms and list medications, dosages, and times they are taken daily.
“The best way to prepare for a virtual health visit is to find a quiet, private room where there are no distractions,” Dr. Taubman said. “Patients need to download any applications needed for the two-way communications and decide beforehand if the visit will be done on a computer, tablet, or phone. The doctor’s office needs to be aware of the patient’s choice. When prescribing medications, doctors still use electronic prescribing to send the script to a pharmacy — a routine practice even before the start of the COVID-19 pandemic.”
A new revenue stream
Reaching out to patients and serving them remotely is now a necessity to sustain physician practices. It is even a benefit to hospitals where there has been a revenue decline in long-standing money-making units such as operating rooms, interventional radiology, and outpatient services. Virtual care is now a proven means of caring for patients safely while tapping into a revenue source that helps offset the decline of in-person visits.
Over the months, regulatory and reimbursement barriers that hindered the widespread use of telehealth were relaxed, allowing providers more freedom to use virtual care for their patients. The Centers for Disease Control (CDC) says that during the first quarter of 2020, the number of telehealth visits increased by 50 percent. This allowed providers to scale their technology, learn more about various platforms, and reshape strategies that would be the most benefit to patients.
The difference between Telehealth and Telemedicine
The words “telehealth” and “telemedicine” are sometimes used interchangeably, but they don’t mean the same thing. The Health Resources Services Administration (HRSA) says telehealth is the “use of electronic information and telecommunications technologies to support long-distance clinical health services, patient and professional health-related education, public health, and health administration.” These technologies include videoconferencing, the Internet, store-and-forward imaging, streaming media, and wireless communications. Telemedicine, however, refers to “specific remote clinical services.”
Both play a critical role in the new era of patient care. Virtual care allows doctors to communicate with patients at a variety of locations that include their residence, a nursing home, an emergency room, or specific divisions within hospitals such as wards, special care units, and even psychiatric units. In addition, access to remote care greatly reduces the potential of exposure to the virus and lowers demands on frontline workers.
Types of remote visits
The three basic types of access routinely used are: Medicare Telehealth (MTH) visits, Virtual Check-ins (VCI); and E-Visits (EV). MTH utilizes telecommunication systems between the provider and patient and may include office visits, out-patient visits, or consultations. The VCI is a brief phone check-in with a practitioner to discuss whether an in-office visit is required, or a remote evaluation can be conducted where a patient can submit images (as in the case of dermatology) to his or herdoctor for evaluation. The EVs are a format to communicate between patient and provider via an online patient portal.
Telehealth popularity
According to the CDC, the number of telehealth visits in the U.S. increased by 50 percent during the first quarter of 2020 and providers reshaped their strategies to engage with patients. “The use of telehealth is a trend that I don’t foresee diminishing even if COVID improves,” commented Dr. Taubman. “It can help with physician shortage and travel issues in the medical industry, so I believe it’s here to stay.”
According to a Telehealth Impact Claims Analysis conducted by the COVID-19 Healthcare Coalition Telehealth Impact Study Work Group, the latest numbers on telehealth claims in Florida peaked at around 700,000 in April of 2020, and the primary diagnosis of circulatory issues exceeded 200,000. Claims nationwide for circulatory issues in the country exceeded five million in February of last year, and total claims exceeded 12 million.
New advances in digital health technology have transformed patient treatment models internationally. Greater access and more efficiency are the keys to serving patients in the era of COVID-19.
