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Telehealth, defined as a virtual platform to perform medical care services, has become an integral part of how we conduct healthcare in the last decade. The rapid uptake of telemedicine can be largely attributed to the COVID-19 pandemic that has overtaken our lives for the past two years. However, the pandemic has not been the only contributor, others include advances in patient access to and healthcare’s investment in technology. Three types of telemedicine services exist: 1) synchronous – an exchange of information in concurrent fashion, like a virtual visit, 2) asynchronous – health information is collected by the patient or clinician, and then that information is evaluated by a clinician, 3) remote monitoring – assessing the patients health over a period of time, in this instance with a mobile app. Telemedicine has produced health savings for patients and healthcare systems, allowed for easier delivery of multidisciplinary care, and improved patient satisfaction. Many barriers to clinicians delivering telemedicine were eliminated during the COVID-19 pandemic including limited reimbursement for services and licensing laws. Some of these barriers have been reinstated in some fashion as the pandemic surge decreases. Since many healthcare systems invested in telemedicine, they are devoted to continuing to offer this service to their patients.
NLA members will continue to see the use of telehealth in their practice for years to come. As patients and clinicians gain comfortability with this new platform for medical care, we will see an improved, more convenient, and manageable healthcare environment. Here’s how telehealth has worked for NLA members from across the country:
Laney K. Jones, PharmD: Thank you all for your willingness to share your experiences. What have you liked the most about incorporating telehealth into your practice?
Bruce Warden, PharmD: The emergence of telehealth has forever changed the landscape of how we deliver healthcare, for the better. Increasing exposure and availability of medical personnel to a larger group of the public has the potential to narrow the treatment divide.
Dean Karalis, MD: Telemedicine makes it easier for patients to see me, especially for those with a busy life and work schedule. When the pandemic started, I opened a virtual lipid clinic and now I see patients from a wider geographic area.
Suzanne Shugg, DNP: Yes, I agree! Not only can I see patients from far distances, even from different states, but tele-visits are also a flexible option for me as a provider. We can now do a tele-visit and get paid for remotely seeing patients, rather than doing it at night, on our own time, and not being reimbursed.
Lauren Williams, RD: Nutrition appointments appear to be more open and honest when the individual is in the comfort of their home. Plus, it’s helpful if they can grab food items from their pantry or refrigerator to look at food labels!
Laney K. Jones, PharmD: I love to hear that everyone is finding a benefit from telemedicine. What have you liked least about incorporating telehealth as an option in your practice?
Bruce Warden, PharmD: In addition to technical problems, from a provider’s perspective, the physical disconnect from colleagues can disrupt the comradery and thought-sharing typical of that experienced with in-person clinic settings. There is something tangible about face-to-face communication, whether with colleagues or patients.
Dean Karalis, MD: In addition to lack of clinical information, for some older patients, the use of telemedicine can be challenging.
Suzanne Shugg, DNP: Technology troubles and user error are barriers in my practice. No matter how much you try to plan for it, you are always going to have Wi-Fi connectivity problems and at least one patient that mutes themselves or turns off the camera. At my clinic, we have created user-friendly and secure links for patients to have easier access to the provider portal and ask the patients for consent to have remote control over their devices if they need assistance to unmute or turn on their video.
Lauren Williams, RD: I’ve struggled with not always having up-to-date anthropometric data. This can be overcome if the patient has a scale at home, but not everyone does. There also appear to be more distractions with telehealth visits, rather than the patient being able to fully engage as they would in a clinic setting.
Laney K. Jones, PharmD: Those are some immense barriers. Despite them, do you see telemedicine advancing the future of medicine?
Bruce Warden, PharmD: I see telehealth as a tool within our armamentarium of treatment options, one that supports and expands our current model of healthcare delivery. Though barriers to implementation and use of telehealth exist, these can be overcome for most, and for those that cannot, the standard in-person visit may remain the best strategy.
Dean Karalis, MD: Telemedicine is here to stay. However, we need to improve the technology by improving connectivity, adding vital sign monitoring, and removing state restrictions in bordering states where clinicians practice.
Suzanne Shugg, DNP: Once systems eventually streamline and reduce provider workloads and workflows, telemedicine will become incredibly effective and efficient. Intersystem communication and workflows that are implemented by Electronic Medical Records (EMR) are essential to the success of telemedicine. I am currently working on a very large population health project that involves telehealth, EMR, and prior authorization integration. I believe in the future of telehealth.
Lauren Williams, RD: Telehealth makes medical care more accessible and approachable for patients. I hope to see a blend of telehealth and in-person visits, as they both harbor distinct advantages for patient care.