How to Use Telehealth Services During the COVID-19 Outbreak and Beyond

checkmark Fact checked Reviewed by: Sam Lippolis and Richard Albrecht
Published: February 17, 2021

 

No sitting, masked, in a waiting room—no exposure to the virus, no drive time, no need for child care to keep a doctor’s appointment. Telehealth connects patients and providers in a remote and safe way, and the speed at which we’re adopting telemedicine has accelerated tremendously since the start of the coronavirus pandemic.

Telehealth extends access to medical, counseling and the full spectrum of healthcare services. And, since COVID-19 began, providers are seeing a sharp increase in patients virtually—50 to 175 times the number of telehealth visits than before the pandemic, according to a 2020 McKinsey report.

For many providers, telehealth was the only way to immediately see patients during shutdowns. Dr. Kellen Scantlebury, DPT, CSCS and CEO of Fit Club NY, “jumped on Zoom” immediately to deliver physical therapy visits to patients. “We dub it ‘virtual rehab,’ and by March 18 last year, we were a fully virtual practice,” he says.

Telehealth allowed Fit Club NY to offer pain relief exercises, personal training recovery and exercise prescription by video. It allowed Dr. Scantlebury’s physical therapy practice to survive, thrive and grow to a national provider since patients from anywhere can book appointments online.

Because of the success Dr. Santlebury and others are experiencing with telehealth—albeit with some learning curve for providers and patients—the telemedicine way of delivering healthcare services has ramped up and is here to stay, and advance.

In fact, some doctors have seen more integrated care when specialists can assemble via video. “It has opened up the doors to integrated, team-based care where all the clinicians are able to give recommendations and look at a patient together to see from their own perspective what is important, and being able to work through that as a team as opposed to notes flying back and forth. It’s a one stop shop,” says Rafael E. Salazar II, MHS, OTR/L and principal owner, Rehab U Practice Solutions, Augusta, Ga.

How can you maximize the benefits of telehealth services during and after Covid-19? Here are some recommendations from our experts.

Can You Use Telehealth Services?

You can receive telehealth services in a number of ways. As the Centers for Disease Control and Prevention explains, telehealth includes video, audio, remote patient monitoring, electronic medical record platforms, and it also extends to provider administration and continuing medical education. Some typical telehealth experiences you can have during Covid-19 and after are as follows:

  • Synchronous: A real-time video or audio visit conducted by smartphone, tablet or computer.
  • Asynchronous: With “store and forward” technology, information is recorded from the patient and evaluated later by the provider. For example, you might take a picture of a suspect skin lesion and upload it to a patient/provider portal. Then, a specialist would review the image and make recommendations. The same type of interaction can occur in writing via secure messaging or by video recordings.
  • Remote patient monitoring: Patients can collect data like blood pressure or glucose levels from a device that transmits information to the provider.

To participate in telehealth video visits, you’ll need internet access. Your provider will provide a video platform, which could be a Zoom link or access to a secured patient/provider portal that includes video capabilities.

In her counseling practice, therapist Laura Goldstein, founder of Montgomery County Counseling Center, Rockville, Md., uses Google Meets because of a “jamboard” that is like a virtual whiteboard. “In my office, I would use a white board to draw out patterns, and I would say that the jamboard is even more helpful because I can save it and share it,” she says.

Some practices connect patients to video visits through their electronic medical record systems. “When I’m seeing patients, I can use video or telephone, and depending on the connection that the patient has, we could use a third-party connector like Updox telehealth video chat or Doximity,” says Sophia Tolliver, MD, clinical assistant professor of family medicine at Ohio State University (OSU) and physician at OSU Family Medicine at Outpatient Care East, Columbus, Ohio.

Dr. Tolliver emphasizes the importance of adequate lighting for patient exams. Find a quiet space. If using a smartphone or tablet to participate in a video call, close out all other applications to secure the strongest, fastest connection possible.

Some patients experience more of a learning curve than others when attending virtual visits, a term often used for telemedicine appointments. So, give yourself some time before the appointment starts to go online and log into the video portal. Test the audio and video to make sure it works, Dr. Tolliver suggests.

Telehealth is not always the answer. Some visits must happen in person. However, a virtual appointment can help providers determine if you need a follow-up so you can avoid going into the office during Covid-19 unless it’s absolutely necessary.

Can You Get Prescriptions Refilled Using Telehealth?

Yes, you can get prescriptions refilled using telehealth. In April 2020, the United State Drug Enforcement Administration (DEA) updated its policies to permit providers to issue prescriptions for controlled substances during a telemedicine visit during the pandemic.

If you are a patient who wants a prescription refill from your provider, he or she can review your request online without an in-person visit. “Patients can use our electronic health record app to send secure messages and I can reply back,” Dr. Tolliver says. “They can request medications, and I can approve or decline those requests.”

When Is Using Telehealth a Good Idea?

There are many reasons to use telehealth during COVID-19 and after the pandemic subsides. “For patients who are medically complex and have risk factors, especially with the COVID-19 virus, they can access services while in-person visits are halted or shut down,” Salazar says.

For physicians telehealth is efficient, reduces wait times and it improves accessibility because you can see specialists and patients outside of your geography without dealing with travel time. As a provider, Salazar says he sometimes would drive four hours to perform a patient assessment in person. “Being able to do that over the Internet did two things,” he says. “One, it prevented the expenditure of resources for clinicians, and we were able to increase utilization and efficiency of care being delivered because clinicians were more productive and could schedule more patients without worrying about travel time.”

Not just high-risk patients during OVID-19 should use telehealth. Anyone who wants the convenience of meeting with a doctor from home and has the basic technology on hand can make a virtual appointment if the provider offers it.

Telehealth is ideal for follow-up visits by using remote monitoring technology such as internet-enabled blood pressure monitors or glucometers to gather vital stats a doctor might need for continuing care. Having this information from patients between their normal visits changes the care model from the traditional “episodic care” where the patient’s information is only available when they appear in the office for a physical visit, to a better model of “longitudinal care” where the provider team has continuous information available, and can intervene whenever the patient conditions require attention.

Telemedicine is highly successful for counseling and behavioral health services, allowing patients to address mental health and other issues without going into an office. For example, during March 2020, the U.S. Department of Veterans Affairs (VA) increased mental health appointments by 70% from the previous month.

Salazar adds, “Telehealth can improve patient engagement from what literature calls ‘passive treatment’ where the patient is a recipient of care to more ‘active treatment’ where you move toward the self-management stage of care, which has longer-lasting and higher levels of clinical outcomes and better long-term results.”

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