Health: Telehealth here to stay

Written by Gail G. Collins

Until recently, a virtual visit with a physician via computer screen to discuss or assess a medical condition had the whiff of sci-fi, but the future arrived quickly.

“If there has been a silver lining of the COVID-19 pandemic, it has been the positive impact and growth of Virtual Care (Telehealth) … which allowed NAH (Northern Arizona Healthcare) and other health systems across the nation to fully embrace virtual care delivery,” director Travis Boren said.

Prior to the pandemic, telehealth had limited, but growing, application and acceptance. A host of barriers blocked broader usage of telehealth, such as insurance coverage, patient comfort, technology access, privacy and so on. As businesses shut down or migrated to home-based work, the overall need for health access increased. Policymakers, insurers and health systems searched for methods to deliver care to patients in their homes to limit transmission of the virus.

NAH had been working to expand telehealth for a decade, beginning with remote patient monitoring. After rapid expansion of virtual care programs, the focus is stabilizing the ecosystem.

“Key investments will continue to be made in the coming six-to-12 months to support our virtual visit, remote patient monitoring and acute telehealth capabilities,” Boren added.

When regulations were lifted after the first quarter in 2020, North Country Healthcare grew its site-to-site telehealth program to in-home visits using Zoom by leveraging the FCC’s COVID-19 Telehealth grants. This summer, the Patient Portal will transition to an integrated platform for smooth access without an app to enhance the workflow.  

North Country offered refills, medication changes, lab follow-ups and review, general questions as well as chronic patient care.

“Should there be any need for a physical exam or in-person tests, labs or imaging, we can then schedule curbside, in-office or referrals,” said chief medical officer April Alvarez-Corona, MD.

The pandemic created more than a physical health crisis. According to Pew Research Center, by May, one-third of Americans had already experienced high levels of psychological distress related to the outbreak.

Cultivate Counseling made a big pivot in March, moving its services solely to telehealth to provide a smooth transition of care. The rate of cancellations fell as access to therapy sessions rose. Patients can open a laptop, log in and receive therapy.

“People can pop in during lunch, from work or at home with the kids,” said clinical director and owner Melissa Dohse. “There are more benefits than drawbacks, and most (clients) prefer telehealth.”

Though developing a sense of connectedness may be harder for some, for others, the comfort of a familiar setting promotes connection. Therapist backgrounds are kept neutral and environments quiet. Dohse serves a lot of parents, who no longer have to plan for childcare, and sometimes, life introduces real-time learning and application during a session.

To assure privacy in telehealth, HIPAA-compliant video conferencing and text messaging are used to communicate.

Junto Skin and Laser did not use virtual appointments previously, but quickly adopted them for consultations and follow-ups.

“In our industry, people tend to feel like they need to be seen in person to be understood or properly evaluated—and in some cases, this is true,” said Amy Aranda, LE LMT CLT. She recognizes telehealth is a useful tool for determining whether the business can fit the client’s needs. “It also can help us set up a plan and is an effective communication tool prior to appointments, so clients know how to prep for actual treatment.”

Sufficient broadband to carry video conferences initially across the industry, and other challenges, such as Zoom fatigue, have added a new dimension to administering care. There are still hurdles to overcome related to technical access across lower income demographics and isolated geographic areas, but infrastructure grants and investments at the state and federal level aim to bridge this gap.

Today and looking forward, telehealth will continue to be a critical strategy for consultations, follow-ups, chronic circumstances, remote locales, mental therapy and more. The proper hybrid balance of in-person care and telehealth offers opportunities and efficiency for the best fit for provider and patient as far as preference and convenience. Delivering quality care anytime or anywhere enhances the patient experience overall.