Telemedicine
“Without a doubt, tele- medicine will continue to be used,” Block said.
Prior to the COVID-19 outbreak, about 13,000 Medi- care-eligible adults – those 65 or older, or younger adults with certain conditions – received telemedicine services during an average week. In the last week of April 2020, that number had jumped to 1.7 million nationally, according to research published in the Public Affairs Journal.
Block said telehealth has improved continuity of care, improved delays in care and helps patients and their families feel more empowered.
According to a University of Michigan survey, 26% of people from 50 to 80 years old reported using telehealth since the pandemic started. Four percent of that group had used telehealth in all of 2019, the study found.
Dr. Catherine Kiley, who works for Premier Health, said she thinks telemedicine can help all sorts of people, especially older adults. Tele- health can be especially help- ful for monitoring chronic illnesses or going over test results, she said.
“There’s a lot just looking at someone, I can tell. There is so much observa- tional medicine that can go on during a telemedicine visit,” Kiley said. “The big- gest part of medicine is taking a good history and observing what is going on.”
Most of the older patients Kiley sees are in-person and she said many of these appointments are monitoring chronic illnesses, which could be done via telehealth. Those patients would still need to go out to get vari- ous tests done, but if they’re homebound, someone comes to them to take their tests anyway, she said.
This is different from 15 years ago, Kiley said, where people waited until they got sick to go to the doctor.
“A patient population like mine would be better served by telehealth, especially in this winter weather,” Kiley said.
Kiley said she walked into her office Tuesday morn- ing after all of the snow the region got and her first patient was an 88-year-old man who had driven there himself.
“The side roads were terrible. He doesn’t have four wheel drive,” Kiley said. “I was worried about him going home.”
Improving telehealth
Kiley, who mainly sees adults over 65, said some of her patients over the age of 80 have a lot of difficulty with telehealth virtual appointments.
“This is an area where we need to figure out how to put these tools into the hands of our older population to help them do telemedicine,” Kiley said.
She suggested that patients who already have a home health aide could use that person to help them get set up with their telehealth visit or teach them how to do it. Block, with CareSource, said this could also mean family members help that patient get the telehealth portal set up or doctors do a “dry run” with patients when they’re physically in the office with them.
Kiley said telemedicine visits can also have a social component to them.
“I have had very good tele- medicine interactions,” she said. “And it’s great right now because I can actually see them (without a mask, face shield or goggles on) and we can interact better.”
Kiley said for these older patients, telehealth makes access to doctors easier because they don’t have to worry about getting their walker or finding transpor- tation to get to the office. These aspects also are reasons telehealth can be ben- eficial for working people, developmentally disabled children and other patient populations. Block said he thinks the “sweet spot” would be 25% to 30% of one’s care being virtual in the future.
“It’s getting the mindset changed. Think of how much time you’re saving. You don’t have to take time off to drive there, drive back,” Kiley said. “I think telemedicine is a way to have physician or provider visits for any population.”
Block said telehealth, in the near future, will lend itself to more remote patient monitoring with smart technology,
vital signs or blood pres- sure or diabetes. This could alert the patient to contact their medical provider earlier when there is a problem.
“It can help your physician give you better care,” Block said. “Technology will play a really important role going forward.”
Both Kiley and Block said although telemedicine is an extremely useful tool, it can’t replace all in-person medi- cine. Kiley said acute care is one area that telehealth can’t serve very well.
“Until the technology is really, really good, nothing substitutes from laying your hands on your patient while you’re doing the physical,” Block said.