Electronic Health Reporter

By Dr. Jason Hallock, MD, chief medical officer, SOC Telemed.

On March 13, President Trump declared the novel coronavirus (COVID-19) pandemic a national emergency. The declaration opens more than $42 billion in federal funding to combat the virus by expanding resources in key areas, including telehealth across the nation. While COVID-19 is novel there’s nothing new about telehealth solutions that are now moving to the forefront care in light of this virus.

Funding will support an increase in COVID-19 testing and expand telehealth services to virtually care for patients. HHS can waive licensing regulations to allow out-of-state physicians to treat patients via telehealth wherever outbreaks occur. And, critically, the declaration of emergency allows for $500 million in Medicare waivers for telehealth restrictions.

The action comes at a critical moment, as the U.S. health care system is confronted for the first time in its modern history with the possibility of a hospital capacity crisis. If too many COVID-19 positive cases descend on our hospitals at once, we could be in the unenviable position of lacking the onsite equipment, the beds, tests, staff and other resources to provide life-saving care for all. Such dark medical realities are already true elsewhere in the world.

As the contents of the national emergency declaration show, telemedicine is poised to play a key role in the fight against COVID-19. It’s not by accident.

While the virus spread rapidly to pandemic status, the reality is that the healthcare industry long anticipated the possibility of a fast-spreading global contagion. As we in the industry planned for the possibility of such an event, telemedicine was always among the solutions.

The role of telemedicine in the time of a pandemic is not an experiment or for use in a limited trial—it’s actively being used to treat COVID-19 today. In fact, the Centers for Disease Control and Prevention (CDC) continues to urge doctors and hospitals first to assess potentially infected patients remotely whenever possible, and to care for patients with mild COVID-19 symptoms from home using virtual check-ins.

It’s a true shift in pandemic medicine, but it’s happening in real-time thanks to the broader accessibility our technology grants us. Patients, especially those who are not extremely sick, can utilize home access with a computer, tablet or smartphone to connect with doctors remotely or even via telephone in some scenarios.

Hospitals learned a critical lesson from both the SARS crisis in 2002 and the Ebola crisis in 2014 that it is vital to keep non-infected patients away from the hospital wherever possible and to avoid crowded waiting rooms where the non-sick can catch the virus.

In combating the COVID-19 surge in the ED and ICU, tele-triage is an incredibly important tool for hospitals trying to manage capacity. By dealing with patients on the very front end and separating the sick from the rest quickly, telemedicine is ensuring physicians can quickly determine which patients require the ED.

For the public isolated at home, telemedicine gives access to medical advice and treatment without filling hospitals. In the hospital, telemedicine helps provide timely, safe care while minimizing healthcare workers exposed to the disease.

Telemedicine is not just for use in directing patients with minor medical concerns away from hospitals. It’s also an excellent tool for monitoring those with survivable and home-treatable cases of COVID-19.

When a patient is confirmed positive for COVID-19, a host of maximum respiratory protocols kick-off. The clinicians assigned must wear protective equipment, donning a sealed respiratory system including hood and body gear. Just getting into and out of such an outfit takes the support of several others and the result is that patient visits each take three times longer than average.

Telemedicine eliminates the need for sealed respiratory systems and full body protection, and it frees doctors and staff to care for other patients. In doing so, telemedicine is critically improving our healthcare system capacity management during this crisis.

There’s much fear of the unknown with this pandemic. Some of it is rightfully placed; COVID-19 is serious, and there is uncertainty about the extent of its spread. But as we work collectively to “flatten the curve,” we aim to reduce at any one time the number of very symptomatic cases arriving at hospital doors and protect our hospital capacities to a manageable number of those most serious cases.

Ultimately the current pandemic will fundamentally shift the way we think about telemedicine and how it is used for ongoing workflows within our hospitals and health systems.