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Telemedicine Gets Healthy Prognosis

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Fear and finance have fueled a tremendous spike in telemedicine in Southwest Florida. Since the coronavirus reached the region earlier this year, local health care systems have seen telehealth visits skyrocket.

“We’re in the tens of thousands of visits per month at this point,” says Kris Fay, chief administrative officer of Lee Physician Group’s Home Health and Physician Services.

When it comes to minor illnesses and injuries, telemedicine services such as Lee TeleHealth offer the option of seeing a doctor on demand while avoiding seasonal traffic, waiting rooms and someone else’s germs. Patients can connect via a digital device safely from home, work or even a parked car. “I think it really kind of took off for two reasons,” says Fay. “Number one, the need for social distancing. Everyone needed to kind of hunker down and stay in their homes. And number two, the federal government for Medicare and Medicaid, as well as commercial insurance payers, started paying for telehealth.

I think those two things were kind of the perfect scenario to drive these thousand-percent increases in telehealth.”

Prior to the national health emergency from the COVID-19 pandemic, patients were not reimbursed for most telehealth visits, when doctors had consultations with patients through a computer screen or smartphone. Patients privately paid for the service out of their own pockets.

This spring, local hospital systems temporarily waived the cost of telehealth visits when elective procedures were put on hold.

“I would expect Medicare will continue to cover it, because it’s going to be hard to put the genie back in the bottle, and everyone really likes it,” Fay says.

Although Lee Health has offered telehealth appointments as an outpatient option for medical care since October 2015, local physician offices used it only 260 times in the first four years—a figure that nearly doubled last year with 500 virtual visits. That growth has been quickly overshadowed, though, by what has happened since the pandemic kept people homebound.

After telehealth stats showed 200 scheduled or ad hoc virtual visits during the first two months of 2020, the Fort Myers hospital system charted an impressive 3,600 visits in March, an incredible 21,000 visits in April and an average nearing 1,000 visits per day in May. “Obviously, that has kind of gone through the roof in our COVID period here,” Fay says. 

A similar response has occurred at Naples-based NCH Healthcare System. Although virtual visits have been around for many years, most people didn’t do telemedicine before the pandemic, said Bryan C. Murphey, an internal medicine specialist at NCH.

“We’ve really ramped it up since the COVID-19 pandemic,” he says. “Our group has done more than 8,000 visits in five weeks.

Although some of the Lee Physicians Group’s more than 700 advanced practitioners and physicians were tentative about adding virtual visits to their repertoire, they now have embraced using telehealth through MyChart, their patient portal. “So, they are routinely doing visits now via video, and the physicians like it. The patients love it for obvious reasons,” Fay says. “So I think it’s here to stay, is my prediction.”

No physical exam is involved, so there are limitations to what a physician can diagnose in a virtual visit. The real-time experience is mostly used for straightforward issues such as medication refills, minor rashes, common colds, flus and lab reviews, Murphey said. “For complicated medical problems, it’s not satisfactory,” he says.

Although a medical role exists for virtual visits, they have some limitations. Doctors have to lay hands on a patient to find serious health issues such as irregular heartbeats or arrhythmia, Murphey said.

“We would not be able to find that in a telemedicine visit,” he says. “To see a patient, we need to listen to their heart and lungs and check their vital signs.”

Murphey also has noticed a difference in comfort factors. Maybe it’s because the technology is still comparatively new, but some patients seem a bit more uncomfortable when communicating through a digital device.

“I noticed people don’t talk as much on the video visit. It’s not the same kind of conversation flow as face to face,” he says. Nevertheless, patients are offered the choice between coming into the office or having a virtual visit at home. The new option offers a great clinical benefit and a tremendous convenience, Fay said.

“I think it will improve access to care overall—and most importantly, patients have a choice,” she says. “Not everybody wants it served up in the same way. So, again, it’s another opportunity to take care of patients in a manner that they find most convenient and comfortable.”

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