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Telemedicine During Covid-19: Benefits And Limitations

Laura Messineo, Rn, Mha, Vp Telehealth, Amita Health

Laura Messineo, Rn, Mha, Vp Telehealth, Amita Health

The telehealth market is rapidly expanding. This is due to a variety of reasons, telehealth has nationally improved access to care, reduced the cost of care, improved the quality of care and has enhanced the patient/family experience. Telehealth serves as a vehicle for transforming the health care experience, outcomes and status of target populations. The public adoption and acceptance of real-time synchronous (live) audio/video social media platforms such as FaceTime has led to an increased acceptance of using audio/video technology within the health care environment.

Internally, we have been designing and implementing innovative telehealth programs for over 15 years, focusing on improving patient access to care, improving the quality of care, and scaling resources across the health system. Customized clinical workflows are developed for each telehealth program to align health care services and delivery with traditional in-person care.

Over the years there have been many challenges implementing telehealth such as reimbursement limitations by private, state, and federal payers, physician buy in and adoption, and consumer adoption. However, the COVID-19 crisis has dramatically increased the need for telehealth services throughout the continuum of healthcare, advanced reimbursement through waivers, and consumers have embraced telehealth as an option for receiving care. In response to COVID 19, the telehealth teamrapidly implemented 90 plus innovative telehealth programs. In the ambulatory setting, 750 primary care providers were trained over a5-day periodon how to conduct virtual patient visits.

This allowed patients to receive treatment during the pandemic in the safety of their homes. In the acute care setting, we implemented telehealth programs to bring the highest quality of care to patients and reduce bedside clinician exposure to COVID-19. We have centralized telehealth COVID-19 workstations to give psychiatrists, hospitalists, cardiologists, pulmonologists, and neurologists the ability to perform telehealth consults throughout the health system’s acute care locations. Increasing telehealth virtual visits also significantly reduced the need for personal protective equipment and allowed for the reallocation of resources to other areas of need. For health care providers affected by COVID, they have been equipped with telehealth access to ensure their ability to continue to treat patients in the acute care inpatient and ambulatory settings from home.

The healthcare community is strategically planning for a reemergence of COVID 19 coupled with influenza in fall of 2020. Telehealth is now a recognized delivery method available to providers, clinicians, and consumers for healthcare services. The unknown is reimbursement as telehealth waivers and executive orders are sunset. There is a great need to advocate at a federal, state and private payer level for the continued reimbursement for telehealth services. Providers are now embracing telehealth as part of the standard of care delivery. Consumers are seeking convenient health care options for example non-urgent visits, chronic care management, and follow up visits.

The pandemic highlighted innovative ways to utilize telehealth to meet healthcare demands. It has also shown improved access to care, improved quality of care, and scaling critical resources across large geographic regions. Developing a key performance indicator dashboard will validate the value telehealth has provided to various patient populations, specific disease states and transformed the patient and family experience. Imagine being in a hospital, unable to have visitors, anxious about your medical condition and wanting to have your support system with you. TeleHealth has enabled family members to be present while their physicians consult on their loved one, allowing the family to ask questions and understand the plan of care. Family members can virtually visit their loved one at any time, decreasing anxiety, stress and loneliness for both family member and loved one. This redefines the patient and family experience. In addition, telehealth has brought scarce resources to patients such as psychiatrists, intensivists, cardiologists, pediatric hospitalist’s and many more.

Advances in technology has equipped providers with peripheral stethoscopes, otoscopes, dermascopes and much more to in order to accurately assess patients remotely. We are ready to reimagine the future of health care are you?