For a follow-up visit after her cancer surgery, Gail Rae-Garwood opted for a video consultation with her specialist, avoiding a long journey — and potential exposure to COVID-19 in medical offices.
“I am so thankful not to have to go out that I’ve enrolled my grumpy husband into televisits, too,” said the 73-year-old Arizona woman, who was able to upload data from a blood pressure cuff and glucose monitor to her physician.
The COVID-19 pandemic has severely strained the US health system, but telemedicine is being seen as a vital way of coping, including for those affected by the outbreak.
“COVID-19 is very conducive to telemedicine,” said Omar Khan, a family physician and head of Delaware Health Sciences Alliance in Wilmington, Delaware.
Doctors can make a preliminary diagnosis by evaluating symptoms, such as a fever and cough, and the patient’s travel history and contact with others, Khan said.
A lab order to confirm an infection can be transmitted electronically to minimize contact.
“Eighty percent of people with coronavirus don’t need to go to the hospital,” Khan said.
If an infection is detected, “they move from quarantine to isolation” and many still do not need to leave home, he added.
Khan said that he has been handling all his consultations remotely for the past two weeks and that patients have been handling the shift well.
“They know the danger,” he said. “They don’t want to put themselves or healthcare workers at risk, and don’t want to come to the hospital unnecessarily. At a time like this, a hospital is a scary place.”
The crisis has highlighted the value of telemedicine, long touted as a way to deliver medical care to people in underserved areas and to deal more efficiently with issues ranging from minor emergencies to mental health.
“A crisis sometimes ends up giving you an incentive to change things,” said Preeti Malani, a University of Michigan professor of medicine who last year led a survey of telemedicine for older adults.
The survey showed that many older adults had little knowledge or interest in telemedicine a year ago, but the situation has changed dramatically, Malani said.
“In a matter of days we’ve completely switched and particularly older adults, who may be vulnerable to complications, are being told not to come to clinic,” Malani said.
With the virus raging, regulatory barriers to telehealth services have quickly come down.
US authorities last month waived restrictions that had prevented telemedicine for Medicare and Medicaid and a rescue package passed by the US Congress included about US$200 million to help providers establish remote care.
Many US states have lifted restrictions and insurance companies have waived co-payments for these consultations.
Privacy regulations that limited the kinds of technology for video consultations have also been eased, making it possible to use consumer-friendly services like Skype or FaceTime.
“I’ve been pleasantly shocked to see [regulatory moves], which would have taken five to 10 years,” said Courtney Joslin, a researcher following regulatory issues with the R Street Institute, a public policy think tank.
“We’re going to come out of this with a lot of evidence on how well telehealth works,” Joslin said.
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