Joseph
At some point in 2019, I was multitasking and racing between examination rooms amid the controlled chaos that defines a normal day in my crowded clinic. I was late as usual, and I could sense frustration in the air at my patients who had been waiting for a while. I knocked on the door and entered a room to see a patient for a follow-up MRI study.
The encounter was brief, as the patient was very irritable at having to wait. At the end of the appointment, the patient’s last comment stuck with me for weeks to come: “How can you not call me this finding?”
At first, I was offended, to be honest. I said to myself, I could actually call all my patients for a follow-up, but then I wouldn’t really need to work in a clinic and what kind of practice?
Fast forward a year. The world has been turned upside down and, ironically, I am one of the providers that uses telehealth the most in my large organization. I estimate that about 90% of my visits were visits to telehealth during the first four months of the pandemic.
Many studies over the years have found that patients Ready to deal with doctors via technology, many patients They report very satisfied with their telehealth experience.
But for years, thanks to reimbursement, regulatory challenges, and sometimes limited access to technology, telehealth hasn’t quite captured what many had hoped.
But since the onset of the COVID-19 public health emergency, our organization has expanded telehealth capabilities. Additionally, the state’s Workers Compensation System has instituted several temporary telehealth policies to allow injured workers to receive virtual medical treatment during this pandemic.
Brief background about myself and my practice: I am an occupational medicine physician working in a not-for-profit healthcare system. My clinic is located in a suburb surrounded by many industries and in a densely populated community. My visit type is 95% related to work injuries with the rest of the exams related to employment. My sick population is working class, aged 14 or over.
My organization’s leaders initially assumed that face-to-face interaction was the preferred healthcare experience, and that telehealth visits dehumanize medical encounter.
To test this assumption, I surveyed my patients.
All of our telehealth visits are pre-scheduled using a web-based application. We use HIPAA compliant software that allows full-duplex, high-resolution audio and video. We can also share media online effortlessly. There were no exceptions in this survey. I have included patients who do not have a smart device or live in an area with poor network connectivity.
Over the course of three weeks, from the end of August through early September 2020, I collected a total of 115 surveys. About two-thirds of the patients surveyed were dependent patients. All new infection visits were made in person. Each result was from a unique individual.
The survey consists of one question: Given the current COVID-19 pandemic, would you prefer a virtual visit (video or phone) or an in-person/in-clinic visit?
The survey question was given to the patient either on paper or read word for word in the case of virtual visits. The patient can choose only one preference. Much to my surprise, 60% of patients in person preferred a virtual meeting and 86% of virtual patients wanted their future visits to remain virtual.
Here are some comments from my patients:
-
“I like the first visit to be in person but follow-up visits can be virtual.”
-
“The default is fine, but when I had the cramp last time, I was actually a better person in person, so you can feel it.”
-
“Virtual visits are nice given the pandemic, but I would like to get checked out and checked every now and then.”
-
“I’m an essential worker, so virtual visits are convenient for me.”
-
“I don’t see anything you can’t actually do that you have to do in person.”
-
“I’m kind of like this, this is the side beauty of an epidemic.”
According to a similar survey in 2013, which pooled healthcare consumers (1547) from all over the world, 74% were satisfied with virtual doctor visits. Here I highlight an example where, with modern technology, modern patients prefer a new way of medical experience – approx.
I learned several lessons through this experience.
First, have powerful, easy-to-use telehealth software and make sure it’s HIPAA compliant. Next, targeting the patient population is critical. Younger generations (Gen X, Y and Z) feel more comfortable embracing technology. Also, be flexible and have a threshold for converting a virtual visit into an in-person visit when situations arise.
Additionally, avoid telehealth visits during the acute infection and trauma phase. Advertise and provide telehealth visits to patients who live remotely and/or have limited transportation. Consider grouping telehealth visits separately from in-person visits to improve workflow.
Finally, make plans for intermittent in-person visits to virtual patients, and remember that follow-up and patients with chronic conditions are the best candidates for telehealth visits.
Today, 76% of hospitals use telehealth technology5. Telehealth saves time and money for all parties involved. Its advantages and benefits are endless. Providing timely care is critical to improving the quality of care.
With telehealth, the healthcare system can be accessed more easily and quickly than ever before at the touch of a button. The loss of productivity is greatly reduced as patients do not have to take half a day or a full day off just to attend a doctor’s appointment.
to me single scan, nine out of 10 Americans said they would cancel or reschedule a preventive care appointment due to workplace stress. 6 Less transportation to and from the doctor’s office reduces traffic congestion, traffic accidents and air pollution.
Over the years, a few of my patients have told me that they have been involved in car accidents either coming in or leaving my clinic. I also find myself rushing to my medical appointments during or after work. The anxiety and stress associated with being on time has caused a few of my accidents.
Telehealth helps reduce unnecessary urgent care or emergency room visits – before a worker goes to see a doctor, he or she can first consult a healthcare provider via telehealth to determine if such a visit is necessary or recommended.
A research study shows that telehealth visits for the most common health conditions save employers Average $472 per visit. Telehealth enables a team-based approach and collaboration where other support members can join in on the virtual visit, eg dietitian on weight loss visit, prosthetics and/or orthopedist on amputee visit and professional counselor on appointment Occupational medicine
Telehealth is here to stay, and it will be a great platform in the future of medical service delivery. We must learn to adopt and use it to our advantage rather than seeing it as a hindrance.
Future challenges and opportunities include recognition of insurance for appropriate reimbursement, creation of best practices, training and adoption of the use of the platform, tighter cybersecurity, and finally, Expansion of every aspect of medicine (For example, additional telemedicine services such as telepathology and telepharmacology).
To the patient I met last year, who wanted to be given almost all MRI results, I want to say, THANK YOU!
Dr. Archie Adams is a board-certified occupational medicine provider. He is currently examining patients at MultiCare Centers for Occupational Medicine in Puyallup, Washington.
