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Telehealth: The benefits, the challenges and the future

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The coronavirus pandemic has changed every aspect of our lives, from the way we interact with one another to how we view the role of the government. It’s all encompassing. It also has changed the way we receive medical care. Telehealth, or virtual doctor’s appointments, has been one of the largest shifts in how we receive care and it’s likely here to stay.

In the last week of March 2020, as the coronavirus began its spread in the U.S., telehealth usage had increased 154 percent from the previous year, according to a study by the Centers for Disease Control (CDC).

“Telehealth could have multiple benefits during the pandemic by expanding access to care, reducing disease exposure for staff and patients, preserving scarce supplies of personal protective equipment, and reducing patient demand on facilities. Telehealth policy changes might continue to support increased care access during and after the pandemic,” according to the study.

The use of telehealth within Essentia was accelerated by the coronavirus, Essentia Chief Medical Officer Dr. Richard Vetter said.

“We had part of our strategic plan, prior to COVID, to really enhance our ability to do virtual care and Telecare or telehealth. We had been doing a little bit of it before … then with COVID of course, in March, it got accelerated and we jumped ahead about a year and a half and implemented almost overnight,” he said.

At one point during the spring, half of all visits were being done virtually, he said.

Brittany Jaehning, director of clinic operations at Sanford Wahpeton, said the use of telehealth expanded rapidly at the clinic.

“Prior to COVID we had done some virtual visits, our goal was maybe four or five a month — within days we were almost seeing half of our patients on a daily basis, virtually.”

Telehealth has been key in allowing doctors and patients to interact in a safe manner during the pandemic, she said.

As the coronavirus was beginning to spread, and consistent information was difficult to pin down, telehealth was useful in getting patients information about COVID-19, along with their risk levels and other information, Vetter said.

“It gave them access to their provider where they could ask those specific questions that were specific to them,” he said.

Convenience is one of the largest selling points about telehealth. No commute, no taking time of work, just open an app on your phone or computer and you’re connected to your healthcare provider.

The convenience factor is amplified for residents in rural communities, where a doctor appointment could be an all-day affair between commuting and waiting.

“You use the whole half of a day. Where with a virtual visit you can sign on and sign off all within a half hour to 40 minutes,” Vetter said.

Going forward, several challenges with telehealth exist.

“I think the key is just to find what visit types it works for and then excel at those, knowing that it’s not going to be a one size fits all and won’t be able to replace your hands on, patient care things that just aren’t going to be appropriate for telemedicine,” Jaehning said.

Both Jaehning and Vetter agreed behavioral health is one area where telehealth will be useful in the future. Telehealth will also be useful in monitoring chronic illness, Vetter said, which is an approach that Essentia is already using.

It will take time to find which visits are appropriate for telehealth and which require a more hands on approach.

Access to quality internet and the ability to use technology also pose problems.

“It’s so great, but obviously when it fails, it can be so challenging. We have a couple of different platforms that we use for our virtual visits, but there can be problems on the patient side, if they don’t know how to use the technology, or our provider side, if they have issues that can be a barrier,” Jaehning said.

Technical and logistical barriers aside, telehealth is a promising and convenient way to connect patients with doctors.

“I think post pandemic, this kind of forced us into it, and has laid the groundwork and, as long as we have the players on board,

I think it’s something that’s here to stay,” Jaehning said.

Telehealth also raises some questions about what the doctor-patient relationship will look like.

“I wonder a lot about what (effect) that therapeutic touch and the lack of that therapeutic touch is going to have on patients and how does that change the patient-physician relationship? I think that’s a question out there that I think still needs to be answered,” Vetter said.

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