2020: The Year of Connected Healthcare

The information contained in this article is not intended as legal advice and may no longer be accurate due to changes in the law. Consult NHMA's legal services or your municipal attorney.

Online or telephonic medical care? Virtual appointments? Physician access to real-time glucose readings?

Digital tools that allow us to meet healthcare needs without face-to-face contact have become essential in the year 2020. With the outbreak of COVID-19, patients are seeking
healthcare in nontraditional ways due to fear of potential exposure to the coronavirus at doctors’ offices and limited in-office appointment availability. Telehealth, also known as “connected care” can be an appropriate, helpful and cost-effective form of care for many situations. The key is understanding how connected care can be an important healthcare option to have, and knowing how and when to access this type of care.

What is Connected Care?

Connected care refers to any type of electronic communication, whether by computer, tablet, phone, or other device between a patient and a provider. While this type of care is not new, its adoption by patients and healthcare providers has been slow. The COVID-19 pandemic has put it in the spotlight and helped it gain more popularity among patients and providers alike. Barriers to accessing care virtually are fading, making it easier for patients and healthcare providers to engage in their healthcare even though they aren’t physically going to an office or clinic. Connected care can help improve access to care, reduce cost of healthcare services, and improve continuity of communication between patients and providers.

What Types of Virtual Visits are Available?

Many types of connected care services and programs are now available. Virtual appointments, patient monitoring programs, electronic medical records and patient portals are all examples of how providers and patients can engage with each other in a virtual setting. Here are some ways these online and telephonic appointments may be beneficial when face-to-face options are limited.

Visit with your doctor. Some doctors’ offices offer telephone or video visits for patients to visit with their own doctor or practitioner. Typically this type of visit works well when a patient/provider rapport has already been established, for services like follow-up visits, monitoring visits for an ongoing chronic condition such as diabetes or chronic obstructive pulmonary disease (COPD), or visits for minor illnesses or ailments.

Visit with a web-based program doctor. Web-based visits with doctors other than your primary care provider are also available through services like LiveHealth Online. Typically, services offered through web-based programs are appropriate for minor illnesses or perhaps for the same reasons you might use a walk-in clinic. Ailments such as conjunctivitis, minor skin rashes and sinus infections are examples of reasons you may use a program like LiveHealth Online. If prescriptions are necessary, some web-based doctors are able to order prescriptions that can be filled at a patient’s local pharmacy.

Virtual behavioral health visits. Accessing care from a counselor, therapist, psychologist or psychiatrist remotely (using a resource such as LiveHealth Online) can allow an individual to seek help from the comfort and privacy of home. There has been a shortage of in-person appointment availability with mental health professionals in recent years. Access to in-person counseling has become even more difficult due to the COVID-19 pandemic, and many people are experiencing increased anxiety and depression. For these reasons, online behavioral health visits have become an important option for care.

Nurse lines or call centers. Some programs offer a question and answer format with on-call nurses. This type of service may be a good idea if you are contemplating what level of care to access. Will your symptoms require a virtual doctor’s visit, an in-person urgent care visit or are they severe enough for a visit to the emergency room? Nurse lines are typically free and can be helpful with answering some health related concerns, especially when it is after hours at your doctor’s office.

What Makes Virtual Visits Attractive to Patients and Providers?

Accessing visits virtually provides an array of benefits for both patients and physicians, especially during a pandemic.

Convenience. Programs such as Live- Health Online offer medical and behavioral health visits 7 days a week, 24 hours a day, from wherever a patient
 as a webcam.

Time savings. About 37 percent of New Hampshire’s residents live in rural areas; for them, the closest doctor may be an hour or more away. Virtual visits save time by removing the commute
to and from a doctor’s office and by removing barriers like finding childcare before your appointment and shoveling the car out of the driveway in the winter!

Avoiding exposure to germs. Circumventing in-person doctor visits may reduce potential exposure to COVID- 19, influenza, colds and other viruses, making virtual visits more attractive,
especially for those with comorbidities and compromised immune systems.

Up-to-the minute information. Follow-up virtual appointments and monitoring for individuals with conditions like diabetes and COPD may become increasingly more popular as connected blood monitors (like those used for diabetes management programs such as CVS Transform Diabetes Care®), mobile applications, and more accessible patient portals make it easier for providers to effectively care for and communicate with patients without face-to-face contact.

What Barriers do Patients and Providers have with Virtual Visits?

Although online medical visits offer a wide array of benefits, there are challenges that may deter patients and providers from going virtual. According to the Mayo Clinic, some medical conditions and symptoms require an in-person examination for accurate diagnosis and effective treatment. Virtual visits do not offer the option of listening to a patient’s lungs or examining an internal injury. Reliance on patient self-reporting and the doctor’s ability to frame questions in a way to draw information is imperative with virtual visits. Additionally, individuals can vary in terms of their comfort level with technology and with New Hampshire’s large rural population, many residents have limited access to internet, computers, smart phones and tablets, making connecting virtually with doctors seem daunting to some.

Another barrier of virtual healthcare according to the Mayo Clinic is care continuity. Since, these providers are not directly connected to your primary care provider, doctors may end up with an incomplete medical history for patients. As a patient, ensuring diligence with relaying information about visits from web-based on-demand telemedicine programs with your doctor is an important piece of successful virtual care.

Connected care options like virtual medical visits, behavioral health visits and nurse call centers are popping up more frequently, especially with the outbreak of the coronavirus. People are seeking alternative avenues for accessing medical care while hoping to remain unexposed to COVID-19. Virtual medicine is a valuable option, however, it is still in its infancy and we have a lot to learn to make virtual medicine attractive for all. There is great potential in the future of telemedicine and only time will tell, but 2020 may give connected care the jumpstart it needs for this evolving avenue of healthcare access.

Ashley Dennis, RD, is a licensed, registered dietitian and a HealthTrust Wellness Advisor.

Disclaimer: The content of this article is intended to be informational and does not constitute professional health advice or an endorsement of the resources mentioned.

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147743/
https://healthinformatics.uic.edu/blog/5-ways-technology-is-improving-health/
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878
https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html
https://www.nhpr.org/post/depth-covid-19-and-telemedicine-nh#stream/0
https://www.ruralhealthinfo.org/states/new-hampshire
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1130