These days, most people want to avoid in-person visits to a doctor’s office. Given the threat of COVID-19, many would prefer to skip the appointment and stay safe in their homes. Many doctors agree, and they’re rapidly working with health care systems on ways to see more patients virtually.
“When COVID hit, we were initially taken a little by surprise at the immediacy [with] which clinicians were saying ‘we want to do video’ or ‘we want to do telemedicine,” said Dr. Stephen Morgan, senior vice president and chief medical information officer at the Carilion Clinic, and faculty at the Virginia Tech Carilion School of Medicine. “The pandemic really surged it, literally overnight.”
He said face-to-face visits have dropped significantly since early March.
As the number of cases in the pandemic continue to rise, they started to focus on at-risk patients, working to see how many virtual visits they could set up for older patients and those with multiple health problems.
“Rather than treating the sick, per se, let’s try to keep the well out, particularly the high-risk well folks,” Morgan said.
Many of these patients’ appointments are follow-up visits for hypertension, diabetes and other conditions, and those are fairly easy to do without being hands-on.
“A lot of my patients already have a blood pressure cuff at home, or if they are diabetic, they have already shared their blood sugars,” he said. “So, unless they needed to come in for blood work, a lot of that care can be done just as efficiently through a virtual means.”
Even some visits that are much more in depth can be done remotely.
“There are technologies out there now that provide a video platform that has an otoscope to look in the ears, look in the mouth, a stethoscope. So, if you want to do an examination at home, you can actually do that. It’s very simple to use. It guides the patient where to put the stethoscope, for instance.”
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Already some health care systems are starting to distribute these types of devices to high-risk patients, or places such as nursing homes and assisted-living facilities.
“In addition to social distancing and quarantining isolation, if you can keep somebody from having to come to the hospital by having that, and … do a visit or a triage to say, ‘You’re well enough to stay there,’ it saves lives,” he said.
While only a few insurance companies had covered virtual visits in the past, almost all of them are now on board with paying for such appointments.
“I haven’t seen any payer not come on board,” Morgan said. “They’re not all aligned in the reimbursement and we’ll have to sort that out on the back end, but they’re encouraging us to use that technology.”
But Morgan said there are still hurdles to overcome.
“There are some technology challenges. We have some tech savvy docs and some that are just learning. We are also finding a wide variety of acceptance to video, where patients are reluctant,” he said.
Some patients don’t have smartphones or other devices to allow for a virtual appointment. Others don’t want to use video because it will use too much of their limited data, and those who live in rural areas may have connectivity problems.
Overall, however, Morgan believes patients are going to get used to this new way of care, and it will be the new face of many medical visits in the future.
