Does your doctor work online?

Telehealth has been around for years, but has never really risen – until the Covid-19 pandemic. As U.S. health centers had to close their doors, visiting a doctor online has become a real alternative to the visits of old.

As the country continues to struggle with the pandemic, millions of Americans meet doctors of all specialties – from urgent care to neurology – from their comfort.

And very happy. Patients are so likely to – or even a little more likely – rate their providers highly after telephonic or virtual doctor visits compared to personal care, suggests a national Press Ganey survey was released last month.

The healthcare company, which surveyed 1.3 million people among 154 medical practices between January and August 2020, found that patients feel positive about ‘all the concerns of providers, the ability to establish a bond and build trust’.

Madison Russell, a 20-year-old student with disabilities in Atlanta, Georgia, says there was always a doctor available throughout the pandemic when she was in urgent need of care.

Even if she had to hang around a bit in a virtual waiting room, Mrs Russell says’ it was still better ‘than cooling off her heels in a doctor’s office because she could’ be productive and meanwhile do something else, like to clean kitchen ‘. .

Telemedicine peaked in early May at about 37% of all medical appointments, declined to 22% in early July and has remained steady at 15% since mid-August. According to Press Ganey, it is still well above the rate of less than 1% before the pandemic.

An important reason for this increase was the removal of regulatory barriers. Prior to the pandemic, Medicare, the U.S. program for elderly Americans, limited how providers were paid for telemedicine appointments.

Most remote visits will not necessarily be reimbursed at the same rate as they would personally, says Dr. Jessica Dudley, clinical principal at Press Ganey and assistant professor at Harvard Medical School.

Another limitation was that providers also had to be licensed in the condition in which their patients lived.

But after the state’s health visits ended, the Covid-19 legislation eased these Medicare payment restrictions and allowed doctors to exercise over state lines, resulting in the tremendous increase in telehealth.

“Covid-19 has forced us to finally recognize the value of telemedicine to keep both patients and doctors safe,” said Dr. Eric Singman, a neuro-ophthalmologist and associate professor at the Johns Hopkins School of Medicine.

Patients appreciated the ability to contact providers without endangering themselves during the pandemic, and doctors also embraced the switch, and many tried telehealth for the first time.

Dr. Singman’s virtual visits were so successful that an organization in Texas recently began working with John Hopkins to allow him to remotely see their local patients.

The health history of a patient is 90% of the diagnosis, says Dr. Singman, “and history is something we do orally”.

If the remote visits have a video component, doctors can do 95% of what they would personally do, he adds.

For some fields, such as behavioral health, telemedicine can even ‘many times’ be better than visits to individuals, says Dr. Joe Kvedar, chairman of the board of the American Telehealth Association and professor of dermatology at Harvard Medical School.

This is because practitioners see patients in their everyday environment, which significantly helps them understand. Patients also tend to be more relaxed at home rather than in a doctor’s office, he says.

Virtual mental health care was especially important this year. The health insurance company Blue Cross Blue Shield receives 28,000 claims for telecom health per day, compared to 200 in February – and half of these claims are for virtual visits to mental health.

Elaine Vigneault, 44, of Las Vegas, recently had an appointment with health care for a painful outcome, saying she prefers the virtual method over personal visits.

“It gives you the freedom to stay home and not expose yourself to anything that might be in the waiting room,” she says.

Once she ‘put her face in front of the camera’ and described the discomfort, the doctor was able to diagnose her with shingles, a viral infection, she says.

Ms Vigneault felt she was enjoying her doctor’s full attention, even though she was not in the same room.

In addition to reducing the risk of viral transmission, telemedicine is undoubtedly convenient. Delays, such as getting stuck in traffic, are no longer an issue.

It is simply a matter of signing up for a call or online appointment, it helps patients to be on time and in turn doctors.

At Mass General Hospital in Boston, where dermatologist Dr. Kvedar works, the average waiting time for urgent care appointments is five minutes from the first start of the video call.

Despite the advantages, there are disadvantages to visiting virtual doctors.

Press Ganey found that patients tend to be dissatisfied with issues surrounding appointment planning and technical issues such as poor audio and video connections.

“If I have a complaint about telemedicine,” she says. Vigneault, “is it not consistent.”

Each provider has their own way of booking appointments and often uses different technologies, she says.

For one of her virtual appointments, Ms Vigneault was supposed to receive an SMS, followed by an email with instructions, but she did not receive one.

However, it was a ‘minor hiccup’ that could be easily resolved by calling her provider, she says.

Telemedicine was from a ‘small back road’ that no one took before ‘Covid-19’ to a ’16 track ‘in the field, says psychiatrist Dr Ken Duckworth, a senior medical director at Blue Cross Blue Shield of Massachusetts .

Before the pandemic, there were already signs that telemedicine “would be a big thing” for America and around the world, “said Dr Nicholas Lorenzo, chief medical officer at telecommunications company MeMD.

“I hate to say that there is anything positive about the pandemic, but over the last ten months, telemedicine has really moved seven to ten years forward.”

The pandemic has proven the effectiveness of telemedicine, which is surely here to stay.

But to make that happen, it’s crucial that ‘the payment model and the regulatory challenges’ are addressed in a post-Covid world, says Dr Dudley of Harvard.

“Telemedicine can be much more effective than driving in somewhere, but it will not happen unless organizations use it and in a way that they would normally use the clinic.”