Telehealth, the virtual care platforms that allow health care professionals and patients to meet by phone or video chat, seems tailor-made for this moment in time. Also known as telemedicine or digital health, it’s often touted as a convenience for patients who are busy or far away, or when travel isn’t feasible due to severe weather or an urgent condition like a stroke. The current crisis makes virtual care solutions like telehealth an indispensable tool as COVID-19 spreads across US communities. As director of the Center for TeleHealth at Massachusetts General Hospital and vice president of virtual care for Partners Healthcare, I believe it can help flatten the curve of infections and help us to deploy medical staff and lifesaving equipment wisely.
How can telehealth help during the COVID-19 outbreak?
While it’s likely many people will become infected with the coronavirus that causes COVID-19, most will not get seriously ill. Those at greatest risk are over 60, or have underlying health conditions or a compromised immune system. The number one job for all of us is to avoid becoming a carrier and distributor of the virus. By using virtual care for much regular, necessary medical care, and deferring elective procedures or annual checkups, we free up medical staff and equipment needed for those who become seriously ill from COVID-19. Additionally, by not congregating in small spaces like waiting rooms, we thwart the ability of the virus to hop from one person to another. Keeping people apart is called “social distancing.” Keeping healthcare providers apart from patients and other providers is “medical distancing.” Telehealth is one strategy to help us accomplish this.
How can medical staff use telehealth to decide who should come to the hospital?
We think that patients with minor symptoms of COVID-19, such as cough and body aches, can rest at home, drinking fluids and treating this like any flulike illness. Test kits are in short supply and currently being used mainly for certain groups: for example, patients who are high-risk or seriously ill, and medical staff who have symptoms or have been exposed to COVID-19, to help prevent further spread of illness. Telehealth uses video chat, or even a simple phone call, to allow medical staff to ask specific questions and gather information to find out whether care is urgently needed, or if a person can continue to self-monitor symptoms at home while recovering. It can also be used for regular check-ins during recovery, as needed.
How can you make the best use of a clinician’s time on the call?
In the US, health care providers are following guidance provided by the Centers for Disease Control and Prevention (CDC), state and local health departments, and hospital infectious disease experts. The screening questions a clinician asks during the call help establish if a person is in a low-, medium-, or high-risk group, and if they have mild, moderate, or severe symptoms of upper respiratory infection that could be due to COVID-19.
By quickly and consistently gathering key information, the clinician you speak with can help determine if you need to see a doctor or go to the hospital for care, or if you are better off staying at home while recovering.
Before you call write down your symptoms, whether you have a fever, and whether you’ve taken any medicine.
Be ready to answer a few questions that might seem tedious or irrelevant, such as where you have traveled recently. As the infection becomes more widespread, travel questions will be less necessary, since it becomes more likely that you caught it within your own community.
Try to resist the urge to ask reasonable but nonmedical questions that are time-consuming: “Should I cancel our family summer vacation?” or “Can I catch this from petting my neighbor’s dog?” Many calls to triage hotlines go unanswered because call volumes are high. Keeping calls short allows clinicians to help more people. If you have questions about the coronavirus or COVID-19, visit reliable websites, such as the CDC or World Health Organization, to get answers. The CDC website offers information on how to protect yourself and what to do if you’re sick.
What telehealth services are available to me?
If you have health insurance, find out if your plan has an option for telehealth services. If not, several well-known national companies provide services for a fixed fee. Your doctor may be able to suggest a specific service, or you can search for “online urgent care” or “telehealth companies in US” or “telemedicine companies in US.”
Medicare and many health plans are currently reimbursing many types of health care providers for telehealth visits.
How can we help one another?
These are challenging times. Let us look to each other for support, kindness, and compassion. We must protect and care for each other, and lend a hand where we can, all while keeping a safe distance. There is nothing we cannot endure if we keep our humanity front and center, and carefully steward our shared resources. We have enough key health care workers — including but not limited to doctors; nurses; physical, occupational, speech, and respiratory therapists; and social workers — to care for the sick if we can slow the pace at which infection is spreading. We need your help to manage this. It’s well past opening night and we all have a part to play.
By Lee H. Schwamm, M.D.
Originally posted on health.harvard.edu
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