Page 35 - BusinessWest August 3, 2020
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with COVID, nobody wanted to leave their house — as a country, we didn’t have a good understanding of how the disease spread; everyone was saying shelter in place, so people didn’t really want to go out.
As a result, practices saw signifi- cant dips in volume, he went on. “But as we put the telemedicine in place, I was eventually able to bring us up to just below pre-COVID numbers for office visits. We still had some patients, depending on the acuity, who needed to be seen in the office or the ER, but we were doing 75% to 80% of our visits via telemedicine.”
Viswanathan said having the dis- tance alternative reduced anxiety in patients during a generally anxious time. “They were happy to see us. Even with COVID testing, people had so many questions, and just the fact they could speak with us, communicate with us, really relieved a lot of the anxi- ety for them.”
“The barriers that have always been there for telemedicine are, one, you had to be able to see the patient, and two, the reimbursement around it. But with COVID, all that got waived.”
And now, with medical practices largely back open, albeit under strict safety protocols? “Televisits are here to stay,” he told BusinessWest. “As a provider, I find it convenient, and the patient finds it convenient. I think it will still be 20% to 30% of daily visits even after the pandemic is over.”
Pros and Cons
Viswanathan conceded that televis- its aren’t the same as in-person visits, in a number of key ways.
“The challenges come when we don’t know the patients from before — when it’s a new patient we’ve never seen before. There’s a little discom- fort level that I haven’t seen him. But for established patients and manag- ing chronic illnesses, it’s just great,” he said.
“It can’t replace all office visits because we really need to see some patients — there are subtle signs
we tend to miss if we’re seeing only through a camera. There are proce- dures we can’t do on a television. If they have a rash, that is not well-exam- ined on television. Those are some challenges.”
Medical organizations have brought up technology access gaps as well, par- ticularly among certain demographic groups. Health Affairs, an online pub-
lication of Project HOPE, recently reported that more than one in three U.S. households headed by a person age 65 or older do not have a desktop or a laptop, and more than half do
not have a smartphone. While family members or caregivers can help, one in five Americans older than age 50 suffer from social isolation.
Access to technology is also a bar- rier in other ages and minority groups. Children in low-income households are much less likely to have a computer at home than their wealthier class- mates. More than 30% of Hispanic or black children do not have a computer at home, as compared to 14% of white
Even on the provider side, organiza-
tions have work to do to fit telehealth seamlessly into traditional practices, Cameron said.
“We need to continue to beef up the infrastructure so that it allows for effec- tive management of both televisits and in-person visits, so that the physician can be flexible,” he explained. “They can take a laptop, go into a room, do
a normal visit with a person, do their documentation, and then, for televisits, go slide it into a docking station where they have two monitors up; they’ve got the documentation and can see the patient at the same time, right in front
of them.”
Like other trends that evolved
on the fly during the pandemic, like remote work (see story on page 22), telehealth may have served its purpose well during these chaotic months, but to make it a permanent fixture will require planning.
“We evolved from doing it very quickly and responding to the pan- demic — how do we keep our patients safe and get them the best care pos- sible? — to asking, what does this look like going forward? With the efficiency and effectiveness I saw with our prac- tices, this is absolutely a tool we can continue to develop.”
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