The Rise of Telemedicine During the COVID-19 Pandemic

Amid a global pandemic and stay-at-home orders in almost every state, most businesses have had to pivot to a virtual existence. In the healthcare industry, this means a much higher dependence on telemedicine, which has both doctors and patients adapting.

Doctors, therapists, dentists, and even veterinarians have shifted appointments to virtual settings as a means to triage health issues and provide non-emergency care to patients. A recent non-scientific survey on Facebook revealed that allergists, behavioral therapists, dermatologists, ENTs (ear, nose, and throat), mental health professionals, occupational therapists, ophthalmologists, orthopedists, physical therapists, neurosurgeons, and, of course, primary care providers have all moved at least some of their operations online.

“The pandemic forced many us to start with telemedicine without the infrastructure or training in place,” said Dr. Sonia Kupfer, Associate Professor of Medicine at the University of Chicago’s Department of Medicine Section of Gastroenterology, Hepatology and Nutrition. “However, once we got things running, I find that certain visits (consultative visits and return patient visits) work very well virtually.”

In fact, one large multi-state specialty practice recently reported seeing telemedicine appointments jump from 10-20 per month to more than 500 per day.

In the dental industry, many virtual appointments are about making the patient comfortable while dental offices are closed except for emergencies.

“Dentists truly want to be helpful to patients, and in this environment, 'help' looks like a virtual visit in which the patient can ask questions about their own oral health or perhaps a specific issue, and the dentist can provide a 'virtual outcome,'” said Chuck Cohen, managing director of Benco Dental, the largest independent distributor of dental supplies and equipment in the U.S. He added that “every dentist should have a teledentistry option in their practice.”

Likewise in the veterinary industry, “COVID-19 has put veterinarians in a difficult position as they navigate their role as providers of an essential service,” said Dr. Shlomo Freiman, co-founder and chief veterinary officer of Petriage, a veterinary telemedicine platform. “On the one hand, they are fully committed to ensuring their patients (pets) get care when they need it, while on the other, they must protect their clients (pet owners) and staff from unnecessary exposure. So, many have turned to telehealth as a way to provide non-urgent care to pets in need.”

A key variable to determining whether an issue can be resolved virtually is how well the doctor already knows the patient, including chronic issues, recent hospital visits, and overall health.

Dr. Jeff Bloomberg, President of Bloomberg Veterinary Services and a 20-year practicing veterinarian, said he has used telemedicine to allow clients to send photos or videos of their pets for a quick diagnosis of urgency.

Some issues can be easily identified in a client-submitted video and can save a trip to the vet knowing that the condition is not dangerous, Bloomberg said. On the flipside, there are numerous scenarios in which he thinks an in-person visit is necessary, such as “a mass that you want to feel, a heart that you want to listen to, lungs that you want to listen to, [or if] you want to take some X-rays, you want to draw some blood.”

There are advantages and disadvantages to telemedicine, so both doctors and patients need to learn how to navigate them in order to achieve the best medical result.

Among the advantages:

• Lower healthcare costs (usually) for the patient
• Higher efficiency and potential revenue for the doctor
• Convenience
• “Consultations for patients in other states who wouldn't otherwise have access to specialty services.” – Kupfer
• Reduces unnecessary, non-urgent emergency room visits
• “Frees up valuable appointment time for more important cases that you don't have to turn away.” – Bloomberg
• “Younger consumers are… coming to expect more digital services in all areas of their lives.” – Freiman
• “Connect[ing] with patients who are at risk of missing visits (due to transportation issues, etc).” – Kupfer

Among the potential disadvantages:

• Doctors are often unsure how much to charge for virtual appointments, and health insurers have a mixed history of reimbursing for telemedicine
• The cost of purchasing new equipment, integrating technology into existing systems, and training doctors and staff
• Healthcare laws and privacy protection rules struggle may not have been updated to cover all elements of telemedicine
• Raises patients’ expectations that doctors are always available, something Bloomberg refers to, perhaps tongue-in-cheek since he is a veterinarian, as being “on a leash.”
• Connectivity issues and limited access to Wi-Fi in some places
• The potential for reduced documentation and updating of patient records
• “I think there is a better client experience when you talk to somebody face to face.” – Bloomberg
• “For patients with acute medical concerns, it is challenging not being able to examine patients and get an expedited evaluation.” -- Kupfer

Professionals across healthcare industries are preparing for telemedicine to stick around long after COVID-19.

“I think telemedicine will stay with us in one form or another after the pandemic, so it makes sense to figure out how to integrate it to improve patient care and access,” Kupfer said.

Bloomberg added: “This is not going away, just like most advances in technology in our civilization. It's only going to become more and more incorporated into our life because of technology, because of convenience, because of cost. These are things that the general public wants.”