Due to the coronavirus, most elective and non-urgent health care services are being canceled or postponed. Many doctors’ offices are closed altogether. But our health needs don’t disappear just because we’re in the middle of a pandemic.
This is telemedicine’s moment.
To accommodate recommended social distancing, the federal government eased telemedicine restrictions to allow health care providers to offer remote services on platforms like FaceTime, Zoom, Skype and Google Hangouts. Before the pandemic, only 10% of Americans had used telemedicine; three-quarters were not aware of it or had no access to it. Since COVID-19, telemedicine companies have reported dramatic volume increases.
Dale Cook, co-founder and CEO of virtual mental health company Learn to Live, said his company added more than one million members in the past four weeks through health plan partnerships. “It underscores the level of anxiety and worry that we're all facing,” Cook said.
What is Telemedicine?
Consumers and clinicians are adapting to using telemedicine effectively. But what is telemedicine? And how does telemedicine work?
Like a teleconference for remote work meetings, telemedicine or telehealth uses technology to connect patients and health care providers who are not in the same location. Often, telemedicine refers to interactive video visits. It can also include consultations to get a prescription, remote patient monitoring, online toolkits or asynchronous online health services that allow consumers to report symptoms or access tools on their own time and at their own pace. These remote services can complement in-person or virtual live visits.
According to Jay Bhatt, D.O., MPH, the former senior vice president and chief medical officer of the American Hospital Association, “Telehealth expands the reach of individual care providers, allowing them to share their expertise and practice sound medicine practically anywhere without being physically present at a patient’s bedside.” That distance may once have seemed like a drawback; now, it is an advantage.
Telehealth and the Coronavirus
During the coronavirus pandemic, telehealth has allowed patients to follow the recommendations to stay home in all but the most urgent of health care situations. If you have a chronic condition or a new health concern, telemedicine helps you keep in touch with medical professionals when it may not be safe to visit them in person.
Dr. Bhatt explained, “The current pandemic has swiftly remade telemedicine into a must-have tool that is barely keeping up with demand.” Telemedicine allows people “to avoid a crowded care setting,” which is especially important now to protect health care workers and patients alike. "We as clinicians are getting upskilled quickly and patients and families are getting more used to telemedicine," says Dr. Bhatt.
Telehealth Is Bridging the Gap in Coronavirus Treatment
Telehealth may also be available if you are worried that you have been infected or if you get sick. The government now requires private insurers, Medicare, and Medicaid to waive consumer costs for telehealth visits that result in COVID-19 testing.
Some hospitals and health systems are offering free virtual screening and e-visits for anyone with symptoms, or triaging people who may have COVID-19. GetWellNetwork, a global digital health company, introduced coronavirus-specific tools to support triage, remote patient monitoring and virtual care. “In the face of the COVID-19 pandemic, empowering patients with the latest clinical guidelines to self-manage, monitor and quarantine has never been more important,” says Michael O’Neil, GetWellNetwork’s founder and CEO.
Dr. Bhatt believes telemedicine “will play an important role in recovery efforts for COVID-19 helping isolate suspected cases, check in on them and follow those discharged from the hospital.” New York-based Mount Sinai is already remotely monitoring COVID-19 patients recovering at home.
Benefits of Telemedicine for Other Health Needs
Before the coronavirus crisis, telemedicine was on the rise in hospitals as a way of connecting patients to specialists who might not otherwise be available. It has also been used for doctors to consult with each other, such as during surgeries.
Telehealth can make it easier and more convenient to access primary care, urgent care, medications, health screening, testing and specialty care, including psychotherapy or cognitive-behavioral therapy (CBT), sometimes with same-day appointments and lower out-of-pocket costs.
Michael Ostacher, M.D., Professor of Psychiatry at Stanford University, noted telehealth could reduce consumer hassles. “They don’t have to fight traffic to get across town, pay a babysitter or figure out what to do with their kids.”
Remote services can also reduce the perceived stigma of potentially sensitive services like mental health or reproductive health care. Online consultations with clinicians allow consumers to discreetly access therapy, birth control, sexually transmitted disease screening and treatment or erectile dysfunction treatment, among others.
According to Dale Cook, 3 in 4 people with a mental health problem do not get help. “That’s 114 million people in the United States who will have a problem but will not seek out face-to-face therapy,” Cook said. Teletherapy can lower barriers for some of these people.
How to Access Telehealth
Health insurers across the country have adapted their policies to encourage telemedicine. One Massachusetts health plan paid for 250,000 telemedicine visits in March, a 3,600% increase over February.
If You Have Insurance
Insured patients can probably use it now for telehealth. You may need to pay your normal copayment, deductible or co-insurance, but some health plans are waiving these costs. Check with your health plan for their specific policy. You can also check with the doctor or other health care provider on what platform they’re using and how payment will work.
If You’re on Medicare
You can now access a much wider range of telehealth services, including routine office visits, mental health counseling and preventive health screenings as a Medicare member. Medicare used to require telehealth visits occur in a health care facility; now, people can use telehealth from home. This increased flexibility is especially important for older Americans who are more vulnerable to COVID-19.
If You Don’t Have Insurance
If you’re uninsured or if your health plan doesn’t offer special telehealth benefits, you can access care through specific telemedicine platforms. Most charge flat fees for specific services and/or monthly membership fees. These can be lower-cost than in-person care if you’re paying out-of-pocket, and the prices are clear so you can decide if it’s worth it to you.
When you find the telehealth approach that works for you, approach an online visit as you would if you were going to a doctor’s office. Share the same information about why you need the visit. Ask the same questions to be sure you understand what the doctor or other clinician is recommending for you.
Dr. Bhatt suggested specific tactics to get the most out of a telehealth visit, including testing your computer or phone to make sure it will connect properly. Use a quiet room. Share appropriate medical records ahead of time if possible. And have a flashlight available to help the clinician examine your nose, throat, eyes and skin, depending on your health concern.
Where to Find Telehealth Providers
In the time of COVID-19, almost any health care provider could be a telehealth provider — from your local therapist to CVS Minute Clinics. But several telemedicine companies were operating before the pandemic. Teladoc and Plushcare offer care for chronic conditions like diabetes, asthma and anxiety, or urgent issues like pink eye, colds, and cases of flu or sore throats.
If they accept your insurance, you pay the same as you would for an in-person visit. If they don’t or if you don’t have insurance, you can pay visit fees and/or membership fees out of pocket. Others, like Forward, charge only membership fees and blend physical office locations with telemedicine for primary care.
Specialty Telehealth Providers
Some telehealth providers focus on sexual and reproductive health as a one-stop-shop for these issues and function as both health care providers and pharmacies.
- Roman: This site offers help and treatment for erectile dysfunction, hair loss and other men’s health issues.
- ThePillClub: The Pill Club offers online access to birth control. Patients can see a doctor online and have their prescriptions delivered right to their doors.
- Nurx: Nurx is a women’s health site offering birth control pills and STI home-testing kits.
- LemonAidHealth: This site is touted as an online doctor’s office and medicine delivery service, treating a variety of issues including anxiety and depression.
From mindfulness and meditation apps to live telepsychiatry, there are a plethora of online mental health providers. Some work with insurers but also offer out-of-pocket memberships which may create better access at lower costs than traditional in-person therapy.
- Talkspace: Users can find a therapist to meet with online.
- BetterHelp: This site connects users to therapists and enables online therapy.
Other telehealth companies offer services as a benefit to students, employees or health plan members. Check with your health plan, school or employer — you may have free access to these or similar telehealth services.
- DotComTherapy: This site offers school-based therapies, including speech and occupational therapy.
- Learn to Live: Learn to Live partners with health plans, universities and large employers to provide telehealth to subscribers.
The Future of Telemedicine
Dr. Ostacher predicts that “People will come to realize their access to treatment will be much more convenient and on their own terms, and therapeutically good.” He believes that once consumers realize the benefits of telemedicine, they won’t want to return to the more restricted pre-coronavirus telemedicine.
Dr. Bhatt agrees. “Telemedicine is here to stay.”
Deb Gordon is the author of The Health Care Consumer’s Manifesto (Praeger 2020), a book about shopping for healthcare, based on consumer research she conducted as a senior fellow in the Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government between 2017 and 2019. Her research and writing have been published in JAMA Network Open, the Harvard Business Review blog, USA Today, RealClear Politics, TheHill and Managed Care Magazine. Deb previously held healthcare executive roles in health insurance and healthcare technology services. Deb is an Aspen Institute Health Innovators Fellow and an Eisenhower Fellow, for which she traveled to Australia, New Zealand and Singapore to explore the role of consumers in high-performing health systems. She was a 2011 Boston Business Journal 40-under-40 honoree and a volunteer in MIT’s Delta V start-up accelerator, the Fierce Healthcare Innovation Awards and in various mentorship programs. She earned a BA in bioethics from Brown University and an MBA with distinction from Harvard Business School.
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