Healthcare practitioners share their thoughts on the explosion of telehealth services during the COVID-19 pandemic
In light of the COVID-19 pandemic, many industries have transitioned from traditional physical workplaces to virtual ones. The healthcare industry is no exception. As hospitals were consistently overcrowded and overwhelmed as a result of the COVID-19 pandemic, non-COVID-19-related healthcare faced its own challenges and needed to adapt.
At the beginning of the COVID-19 pandemic in March 2020, hospital admissions for non-COVID-19-related cases and routine healthcare appointments were abruptly canceled. According to a report from the Veteran’s Affairs Health System, 7.3 million appointments were canceled between March 15 and May 1 of 2020. This dramatic decrease in healthcare availability led to fears of decreased patient outcomes, creating an immediate demand for a way to safely and effectively deliver healthcare to patients from a distance.
Because of this problem, telehealth quickly arose as the obvious solution. Just as many other industries had switched to working from home, healthcare practitioners began to work remotely using technologies such as Zoom and Microsoft Teams to interact with their patients.
The rapid switch to telehealth, however, did not come without issues. According to a Centers for Disease Control report, the use of telehealth early in the COVID-19 pandemic was largely unregulated and varied dramatically in effectiveness.
When asked via email if telehealth appointments were useful in his practice, Dr. Emmanuel Zamora, a clinical neuropsychologist at UC Davis Health, answered with just one word: “Absolutely.”
“For psychotherapy, I’ve found that most people have adapted well to video visits,” Zamora said. “Patients feel safer in their own home during the pandemic. For the most part, people find it more convenient and I have less ‘no shows’ or cancellations. Some patients do prefer in-person visits because privacy is difficult to come by at home or they feel safer discussing sensitive information in person.”
Dr. Austin Merrill, an associate physician in the Department of Obstetrics and Gynecology for Kaiser Permanente, explained that the reaches of telehealth medicine extend far beyond treatment for mental health.
“Pregnancy is in itself a condition that puts my patients at high risk if they do become infected with COVID-19,” Merrill said. “Virtual medicine has allowed us the opportunity to continue routine obstetric care while minimizing our patients’ potential exposures during visits.”
However, similar to Zamora’s experience, Merrill explained that virtual appointments are not suitable in all circumstances.
“A very obvious disadvantage is the simple inability to conduct an exam—as many a physician mentor will tell you, the key to examining the patient is examining the patient [in person],” Merrill said.
Despite the initial setbacks of healthcare access in the early days of the COVID-19 pandemic, telehealth advances have ultimately led to increased access to healthcare. According to Zamora, more patients, especially those who typically have to travel long distances to be seen, are benefiting from the changes. Merrill added that these alterations will likely continue even after the pandemic.
“I believe moving forward we will find a happy medium in this amalgamation of virtual and in-person appointments that will continue to meet our patients’ needs,” Merrill said.
Despite the advances in telehealth throughout the course of the last year, not all healthcare sectors are able to convert to an online setting so quickly. The UC Davis Cardiac Rehabilitation Program, for example, relies heavily on in-person interactions for their patients. Dr. Javier E. Lopez, the medical director for the UC Davis Cardiac Rehabilitation Program, explained that during the early months of the COVID-19 pandemic, there was a noticeable effect on patient outcomes as the cardiac center was initially forced to close entirely. Though the center was able to reopen in the summer of 2020, they have been forced to cut down from their normal capacity of around 90 patients to around 40 patients.
The center has been able to launch a hybrid virtual program and recently enrolled their first patient, according to Lopez. He expressed that the hybrid virtual program is intended to accomodate more patients.
“That’s our goal, but [the center] is not there yet,” Lopez said.
Telehealth and virtual medicine are still rapidly expanding, with an estimated over one billion virtual appointments in the last year.
Pre-COVID-19 telemedicine appointments “were cumbersome and often difficult to navigate,” Merrill said. “This pandemic has taught all healthcare professionals a lot when it comes to maximizing our abilities to assess our patients and create really solid treatment plans.”
Even with this rapid expansion, there are a plethora of unanswered questions—namely the efficacy of virtual medicine compared to in-person medicine. Healthcare systems around the world are researching this topic, including UC Davis Health, which is conducting an ongoing study to evaluate the effectiveness of telepsychiatry.
Merrill, however, is optimistic about clinicians’ abilities to implement telemedicine.
“I am in awe when it comes to the rapid response, adaptation and dedication of my fellow physicians when it came to incorporating virtual medicine into our already complex repertoire of patient care and assessment tools,” Merrill said.
Written by: Justin Weiner — science@theaggie.org
