Among the countless changes, adaptations and innovations that have emerged in response to the longrunning pandemic, online visits with doctors, or telemedicine, has grown by leaps and bounds amid increased use and acceptance by medical professionals, patients and insurance providers.
The height of the pandemic saw crowded hospitals and left many patients weary of venturing to a medical facility for fear of being exposed to COVID-19.
It also saw a dramatic expansion in the use of telemedicine to allow patients to consult with doctors via virtual house calls, and local doctors said they don’t anticipate telehealth waning along with the virus.
“As far as the impact of COVID on medicine, I think telehealth will be the thing that changes the most,” said Dr. Armin Dikranian, a urologist who serves as chief of surgery and as medical director of robotic surgery at Huntington Hospital,.
The doctor also pointed to the increased use of non-narcotic anesthesia and pain management techniques, which allow patients to shorten hospital stays after surgeries, as a lesson learned from the pandemic that will likely have lasting effects.
“That was already starting, but now we’re seeing more interest in it, both from patients and from surgeons,” Dikranian said.
“So we saw a huge shift in how patients manage their conditions and how we help them manage their conditions with telemedicine and avoiding hospitalization,” he said.
But some patients have forgone care that would have been beneficial, Dikranian said. And, “On the flip side, we are now seeing larger [kidney] stones and more advanced cancers.”
On the whole, the doctor said the increased use of telemedicine has been “a very welcome change.”
While not all issues can be addressed through a remote appointment, particularly urgent ones such as trouble breathing or chest pain, it’s proven to be a valuable tool, Dikiranian said.
“It’s been a win-win, I think,” the doctor said. “Patients can stay in the comfort of their own home. They have easier access and it’s not just audio. There are multiple internet platforms that allow us to add video conferencing. We can share our screen, we can share radiographic images. The patients can, depending on the part of the body, show a rash, for example, or something that they’re concerned about.”
Prior to the pandemic, most insurance providers rarely offered reimbursement for telehealth services, said Internist Dr. Stuart Miller of Huntington Health Physician Medical Group.
“But with the pandemic, Medicare — and then the commercial insurance is quickly followed — said that they would pay at the same rate, at least temporarily, virtual versus in-office,” he explained.
With more people getting vaccinated and feeling more comfortable about being outside, Miller said his in-person visits have returned to about 80% of their former level.
But he said he expected telehealth to continue having a stronger presence in the medical field.
“My gut feeling is that it is going to be added to the basket of services we offer. I guess if insurance cuts off payments, then we’ll probably revert back to less tele-health,” Miller said. “But hopefully the insurance companies are seeing the benefit to this and will continue it,” Miller said.
“I think it’s just going to give more options to the patient. The patients are, themselves, becoming more advanced with using technology and not being afraid of it,” he added.
“During war and all sorts of tragedies, there’s always medical advancements that come out of these things. We all know that this is a horrible situation, but there are some advancements that came from it. So I guess that’s the bright side.”
UCLA Internist Dr. John Mafi, who also serves as an assistant professor of medicine at the university and as an adjunct for the Rand Corp., said much has yet to be learned about the application of telemedicine.
“On the one hand it has benefits. You can triage. You can decide: ‘OK, the patient is not so sick they can probably stay home,’ or, ‘You’re having some serious symptoms… you should come in. That’s great,” he said
“But telemedicine is also challenging because it makes it a lot easier to access the doctor, too. Whenever you remove a barrier to accessing the doctor, you get a lot of benefits, but then you get a lot of unnecessary care, too. You get phone calls that may not be necessary,” according to Mafi.
“Some studies have suggested that telemedicine can also create demand that may not have happened,” he said. “So I think it could go in different directions, and the jury is still out and more research is going to be needed to determine the true impact of telemedicine.”