Not just for the sniffles

Mere months ago, major health care providers in the region were still in the early stages of rolling out their telemedicine programs.

But when a pandemic struck, telemedicine went from a matter of convenience to just short of a necessity, practically overnight.

With patients steering clear of hospitals as much as possible, demand for virtual visits surged. Some of that is directly tied to prescreenings for COVID-19 — yet, there’s been a marked rise in physicians conducting video appointments in other disciplines, too, including behavioral health.

And while the coronavirus crisis has since diminished in some regions, at least for the time being, health care providers anticipate the desire for virtual visits will remain.

“We didn’t want to put patients in a situation where they had to travel unnecessarily,” said Dr. Charles Barbera, vice president of pre-hospital and unscheduled care for Tower Health. “Now, we’re keeping these services because we found people have gotten used to them.”

The pandemic turned out to be the ultimate test run for telemedicine, not only proving that it works, but demonstrating the full extent of its practical application.

“We’ve seen some degree of return to brick and mortar,” said Chris LaCoe, vice president of operations for Penn State Health. “However, as a health system, we are going to stay focused on what we believe is the way forward, which is to have telemedicine as a health offering.”

Exploding numbers

Penn State Health introduced its OnDemand app in October 2018. The app provides patients experiencing common ailments access to a physician in minutes using a smart device, 24 hours a day, seven days a week.

A year-and-a-half after launch, Penn State Health recorded around 1,000 virtual visits through OnDemand. Once coronavirus screening began though — patients are encouraged to consult a doctor via the app before seeking in-person care — the numbers nearly tripled in a matter of months.

And OnDemand is only one aspect of the health system’s telemedicine program.

“With the onset of COVID, we trained over 1,000 providers and conducted over 27,000 virtual visits of all different kinds,” said LaCoe, hyping a 7,500% increase in telemedicine utilization across the entire organization.

“Most physicians were cut off from their patients except for by telephone, so this was another way they can connect.”

Tower Health has its own app, MyTowerHealth, that allows patients to submit questions to physicians. Then in April, Virtual Care by Teladoc Health was added for COVID screenings and treating common ailments.

Growth has been steady both in terms of online visits as well as Tower’s use of telemedicine across the board.

“Our numbers go up every month as far as how many encounters we have virtually,” said Barbera.

Naturally, some of that growth is spurred by the coronavirus — patients either seeking a diagnosis or trying to avoid busy health centers for more minor symptoms.

Telemedicine encompasses so much more than getting a prescription for a runny nose over the phone though. It can be used by a neurologist to diagnose a stroke, by a nurse or doctor to check how a wound is healing, or to follow-up on recovery from inpatient procedures.

Even in cases where patients require hospitalization for COVID, telemedicine may continue to play a role after their discharge.

“People are going home and we’re able to monitor their vital signs remotely,” said Barbera. “Their vitals transmit to us, so we know if they are having any problems.”

“Certain things are really amenable to remote diagnosis.”

Another such specialty is mental health. LaCoe noted that although area medical centers have been welcoming some patients back, around 60% of behavioral cases in the Penn State Health system are being handled digitally right now.

“It’s one of the greatest growth areas,” said LaCoe, “but it’s not a one-size fits all approach.”

Ironing out the kinks

It’s remarkable how far telemedicine has come in such a short amount of time, though the transition has not been without some bumps in the road.

Hospitals weren’t really prepared for the amount of bandwidth used by such a sharp uptick in use, said LaCoe, or in some cases faced shortages of computer equipment.

There also might be something of a slight learning curve for patients who should give virtual visits their undivided attention.

“We ran into a whole bunch of things we didn’t expect,” said LaCoe. “Patients connecting through a handheld device, sometimes they’re not stationary. Anecdotally, you hear patients being in their cars or out and about.

“We need to prepare patients for how to have a successful telehealth visit.”

There was also a level of skepticism of telemedicine as a gimmick that needed to be overcome, suggests Barbera.

“Many people, from patients to doctors, were a little weary of remote practices,” said Barbera. “Much of the health care system around the country and certainly in Pennsylvania was based on visits.”

Barbera adds that it might make sense for potential telemedicine patients to sign up and get acquainted with the system in advance so that when the service is need, they’re ready.

Telemedicine hailed a success

Despite the occasional hitch, mounting evidence indicates telemedicine may be the superior option in many situations.

“We adapted very quickly to where the outcomes were at least equally as good and often are better with technology,” said Barbera.

Most patients are not reporting a reduced level of care. In fact, to the contrary, they’re often happier with the results.

“When we connect, we see very high success rates, around 90, 92%,” said LaCoe. “We’re having higher satisfaction rates because they feel like providers are not has hurried and are focused on them as a person and their challenges and issues.”

It’s allowed health providers to be more efficient.

“We’ve made ourselves more efficient by being able to move from virtual room to virtual room rather than travel,” said Barbera. We’ve been able to use resources not readily available at one facility and spread them across the entire network.”

With all of that comes a convenience factor, too, and that always has a way of making people feel better.

“I think if we said that we could get rid of the parking lots and waiting rooms, people would be OK with that,” said LaCoe.