On the front line: healthcare providers use telemedicine to circumvent coronavirus

As I write this, 37 states* are under shelter-in-place orders in an attempt to stem the unyielding, forward momentum of the coronavirus or COVID-19 across the country. (By the time you read this article, the number will undoubtedly be woefully out-of-date, having grown to include additional cities, counties and states.)
Right now that means there are approximately 175 million Americans who are now spending most of their time at home, leaving only to get groceries, some fresh air or, perhaps, go to the doctor. Some of these people, however, will not be able to leave their homes for any reason. They are those 65 years and older. People with chronic lung diseases, older adults living in nursing homes and others with pre-existing heart conditions or compromised immune systems, including HIV.
While older adults appear to suffer the most from symptoms and often pass away because of the virus, many children simply get “sick” and may pass the virus to others. A recent study from China looked at coronavirus cases and the close contact between people. Children, the researchers found, had fewer symptoms than adults, but a similar rate of infection, 7.4% compared to 7.9%, respectively. “We further show that children are at similar risk of infection as the general population, though less likely to have severe symptoms; hence should be considered in analyses of transmission and control,” according to the research.
It seems as though no one is immune from the coronavirus. Those with the coronavirus in the U.S., as of this writing, number more than 63,000 cases; the death toll is 884. (You can find the most up-to-date numbers at the World Health Organization.)
The Time for Telemedicine
People, no matter their age, continue to require medical diagnosis and treatment for the coronavirus and other illnesses.
They still need help. They need telemedicine. The concept of telemedicine isn’t new, but its time is certainly now.
The COVID-19 pandemic has changed the landscape of physician office visits. Many ambulatory encounters are being moved to technology platforms--like webinar-type, video-powered exams--that allow for non-face-to-face visits. The migration to the internet for diagnosis and care represents a concerted and thoughtful response to the pandemic.
“The extraordinary measures are necessary not just to effectively serve the rapidly expanding patient population with COVID-19 but also to keep otherwise healthy patients away from the hospital and protect health care providers from the highly infectious and dangerous SARS-CoV-2 pathogen that causes the disease,” explains John Scott, MD, medical director for digital health at the University of Washington Medicine in an article published by the AAMC.
While bandwidth in the U.S. remains strong at this time, some in the medical community have used telemedicine for quite a while. The Permanente Medical Group has been using it for the last 20 years and Jefferson Health, already well-known for its consistent use of telemedicine, has seen significant growth as the pandemic worsens.
Nevertheless, internet traffic has increased anywhere from 10%-20% or more, depending on the report, since February; much of it is from people streaming content to their homes. In Europe, however, major content providers like Disney and Facebook have or will downgrade video quality to keep the internet from bogging down. For its part, Netflix reduced the highest bandwidth content streams from Italy and Spain, and is moving to do the same throughout Europe and the UK.
Private companies are doing their part to keep bandwidth as high as possible to keep customers happy with their streaming services and a downstream effect is the ability for healthcare organizations to continue to offer or to build out new telemedicine services for patients. The federal government, too, has recognized telemedicine as judicious use of scarce medical resources during a time when all healthcare providers are spread thin and must remain healthy.
“The rapid expansion of telemedicine, both to triage possible COVID-19 patients and to keep non-COVID-19 patients away from the hospital, picked up steam not long after Congress passed the first $8 billion spending plan to combat the virus on March 6. That bill included $500 million to expand telehealth services during the public health emergency,” according to the AAMC.
The rules recently expanded by the Centers for Medicare & Medicaid Services (CMS) includes a variety of professional healthcare providers. “Medicare can pay for office, hospital and other visits furnished via telehealth across the country and including in patient’s places of residence…” according to CMS. “A range of providers, such as doctors, nurse practitioners, clinical psychologists and licensed clinical social workers, will be able to offer telehealth to their patients.”
Prior to the coronavirus, CMS’ support of telemedicine was far more circumspect and limited. “Previously, Medicare telehealth coverage was limited,” according to the American Medical Association. “Now, however, it will cover office visits via telehealth where services are provided by physicians and a range of other providers including nurse practitioners, clinical psychologists and licensed clinical social workers.”
With the many pressures now being exerted on the healthcare system at-large and the failure of governments worldwide to fully comprehend the potential and growing devastation of the coronavirus, telemedicine is an especially bright light for healthcare providers and patients. Telemedicine allows both to carry on some semblance of normal before COVID-19.
The coronavirus puts the practice of medicine worldwide in a unique and troubling position. But the use of technologies like the internet, telemedicine and others, combined with commonsense societal measures, will help in containing the virus, mitigating its devastating effects and ensuring those who need medical care today and in the future will receive it.
Allen Latham is Vice President, Provider Solutions at TriZetto Provider Solutions.

*This information is subject to change*
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