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As states begin reopening and physician practices reassess how to operate in healthcare’s “new normal,” many – if not all – providers who emerge to offer post-pandemic care will weigh the pros and cons of continuing to incorporate virtual visits.
HIStalk Practice sat down with several physicians from Lee Health Physicians Group in Fort Myers, Florida to gauge their experience with telemedicine over the last several months, and their thoughts on how this method of care delivery may finally gain a permanent foothold in day-to-day operations.
What has uptake of telemedicine been like among your patients? Have they been receptive, or have they put off care until they can be seen in person?
Elizabeth Midney-Martinez, MD: “The majority of my patients were very hesitant at first. I care for a mostly geriatric population, so as you can imagine, it was difficult at first for many of them because of the technology. There has been a minority of patients who are not able to do telemedicine, but I’ve only had this come up twice in the last several weeks because they do not have a computer, tablet, or their phone is antiquated.”
Andre Anderson, MD: “The majority of the patients that have used our telemedicine interface have shared that they enjoy it. It gives them the opportunity to continue receiving quality medical care without leaving the comfort of their home. Caregility’s interface is very simplified and easy to use for any age group. Some of my patients have shared that it might be difficult to convince them to come to the clinic in the future if telemedicine is still available. They really enjoy it.”
Jose Orellana, MD: “My patients have been very receptive with our telemedicine services because they see it as an advantageous and convenient way to access to quality medical care that supplements the practice of medical visits. They also welcome the cut down of medical expense for them, and it extends access to consults from specialists. It also has increased patient engagement by allowing the patient to engage with his/her provider more frequently in a convenient way. Also, our elderly patients feel personally empowered because they do not need a family member to take them to the provider’s office (and miss a day from work) or the need of transportation, therefore cutting on their expenses, especially if they live on a fixed income.”
Do you foresee your organization using telemedicine as much once the pandemic is over?
Midney-Martinez: “I think that this could be used perhaps in a different clinical setting. In my case in particular, since I am the only physician in my small community, I think I will continue to do mostly in-person visits. I would like to be able to see patients via telemed for simple things on my day off to be able to earn more RVUs though, but I do not know if this will be an option moving forward.”
Anderson: “I think it will be hard for insurance companies to discontinue providing payment for telemedicine visits. The convenience factor is a big upsell for the patients. We live in an era that relies heavily on electronics and I think virtual visits will continue if it does not sacrifice quality patient care. It is a great means to reach populations that have difficulties with transportation as well. Telemedicine can also be done ‘on the fly,’ which allows prompt evaluation for patients and should lead to decreased negative outcomes.”
Orellana: “Absolutely, I believe telemedicine is here to stay. It provides an edge to our institution in a competitive healthcare landscape and it complements medical practice; it is the new frontier in medicine and allows us to reach patients in remote locations and areas of shortage of medical professionals. It expedites the care for minor but urgent conditions in a complex but integrative manner.
Finally, what best practices or words of advice (or warning) can you offer to physicians looking to embrace telemedicine as a key part of their practice moving forward?
Midney-Martinez: “Telemedicine is a wonderful way to keep in contact with your patients when not able to be with them in person. I have been able to keep patients out of the hospital this way. It also keeps patients out of urgent care, since most of their problems are minor issues that can be easily addressed like headache, rash, UTI, etc. I have found that even though my patients were resistant at first, once they connected with me, they were very happy, excited, and many told me they wished we could do it like this ‘all the time.’”
Anderson: “Telemedicine can help expedite care, but it still has its limitations. Physical exam is an integral part of the interview process and of course is difficult to assess virtually. However, good history-taking usually leads to an appropriate diagnosis. HIPAA is always an area of concern and should still be respected even during virtual visits. My biggest advice to other physicians is to always remember to smile! (You’re on camera.)”
Orellana: “Initially, telemedicine may create a technological hurdle for both patients and providers as we grapple with new technology. There is a learning curve with this technology and patients need time and education to register and install the appropriate app. Telemedicine as a tool must have HIPAA compliance and good IT support to be efficient and effective. Also, telemedicine may lead to a breakdown in care continuity if patients access a random doctor who does not know the patient and the patient’s medical history. The medical institution must provide the tools to providers to easily connect with their own patients. Providers must realize that telemedicine is a supplement to medical visits; in specific conditions, a physical exam is necessary to make a full diagnosis.”
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