Telehealth is the new frontier of medical care. Here’s what you should know before you book your next digital appointment.
What a difference a year makes.
Patient attitudes about telehealth have drastically shifted since March 2020, when more than half of Americans were doubtful it could provide the same level of care as an in-person visit to their doctor’s office. Now, nearly 80 percent of patients say it is possible for telehealth to provide the care they need.
Timothy Quinn, MD, has been on the frontlines of this evolution at Quinn Healthcare in Ridgeland, Mississippi. He says telemedicine has allowed him to stay on top of the preventive care that his patients need, such as electronic medical records automatically notifying him during a telehealth appointment when a 50-year-old man is due for a colon cancer screening.
“As a provider, you’re now alerted that this man needs this preventative screening test that could possibly save his life,” Dr, Quinn says.
The use of telehealth jumped dramatically during the last 18 months — patients are using it at levels 38 times higher on average than before the pandemic. Telehealth users are more likely to be women, older patients using Medicare, people with chronic conditions, or those living in predominantly Black communities.
In this unprecedented time, health care providers have learned what telehealth can do and how it is changing health care.
Telehealth boosts access to health care in underserved areas
In rural parts of the country, a high percentage of people don’t have access to transportation, or face other barriers to getting to a doctor’s appointment, Dr. Quinn says.
In Mississippi, Dr. Quinn and other physicians partnered via telehealth with home health care agencies to stay appraised of patient health through bloodwork and monitoring vital signs.
“People no longer had to come into the office to see to the doctor,” Dr. Quinn says. “If they were eligible for home health care, they could get a lot of that testing done from home, and then the labs and information on vital signs would be sent to the doctor’s office.”
It gives doctors a chance to check in on prescriptions
When fear of Covid-19 exposure or other circumstances delay a patient from coming into the office to see a provider in person, Dr. Quinn says telehealth offers the opportunity to monitor how patients are reacting to medication and adjust their prescription type or dose as needed.
When it comes to assessing how a medication is working, “there are not a lot of scenarios where you need to do bloodwork and vitals,” Dr. Quinn says. “More often, we will just ask the patient, ‘How do you feel and how did the medicine make you feel?’”
Dr. Quinn says this option can work well for patients who have started taking medications for anxiety or depression. In fact, patient use of telehealth increased astronomically during the first eight months of the pandemic for mental health-related diagnoses, more than any other category of appointments.
It helps patients stay up to date on cancer screenings
Preventive cancer screenings such as mammograms and colonoscopies dropped by as much as 67 percent in the first few months of the pandemic, as patients skipped regular appointments to avoid exposure to Covid-19.
“A lot of the screenings were forgotten or postponed because patients didn’t go to the doctor,” Dr. Quinn says. “But with telemedicine, patients can be notified as to when and why they should come in for a screening, and they can then make an educated decision.”
Colorectal cancer screenings fell 64 percent, which could result in more than 4,000 excess deaths due to colorectal cancer over the next decade. That’s why Dr. Quinn is grateful for the chance to use telemedicine to make sure his patients don’t miss out on life-saving cancer screenings.
“Telemedicine offers an opportunity to assess the patient and study the history you have on file, which is especially crucial if there’s a history of cancer,” Dr. Quinn says.
Cologuard, an at-home colon cancer test, is an example of a type of screening made possible through telehealth. It’s an option Dr. Quinn offers to eligible patients who may be reluctant to go into a clinic for screening, or who can’t afford to take time off from work to prepare for and go through a colonoscopy procedure.
It supports patients taking charge of their health
Doctors are also discovering that telehealth can be a tool to empower patients on their journey to better health and disease prevention.
Dr. Quinn’s office facilitates a diabetes prevention program funded by the Mississippi Department of Health for patients at risk of developing diabetes, which includes a curriculum to support patients in their efforts to reach a healthier weight.
During the pandemic, the program was forced to shift from in-person to Zoom sessions. Despite the change to a virtual format, 80 percent of participants stuck with the program. Dr. Quinn hypothesizes that success was the result of people already being accustomed to using video meeting technology.
“People already know how to use Zoom to go to church, or from helping their children with virtual learning from home,” Dr. Quinn says.
Telehealth can’t replace all in-person appointments
Despite all of the ways health care providers can use telemedicine, Dr. Quinn says it is not appropriate for every appointment or patient. “There are some scenarios where the office visit is essential,” says Dr. Quinn, who served on the Mississippi State Medical Board advisory panel of physicians that established guidelines for use of telehealth.
Dr. Quinn says office visits are required for assessing patients on certain medications with side effects that require monitoring through laboratory testing, such as cholesterol medication that may affect the liver. It’s also essential that patients see a health care provider in person for an initial assessment of mental health conditions like depression or anxiety, Dr. Quinn says.
The experience of the last year and a half tells Dr. Quinn that telehealth is here to stay.
“The bottom line is going forward, we will use telemedicine when appropriate because it’s proven to be effective,” Dr. Quinn says. “At the end of the day, the most important thing is to make sure treatment is easily available to patients, and that we give them the best treatment possible.”
