Before the pandemic, few Americans had given much thought to telemedicine. With the pandemic, it has become the preferred alternative for many patients.
That means not having to risk a trip to a crowded waiting room, possibly catching the coronavirus or spreading it.
Telemedicine, sometimes called telehealth, can be as simple as arranging a phone call or video chat with your doctor. But hospital networks, insurers and private clinics have gotten involved in systems that promise after-hours access and secure connections to medical records.
Dr Christopher George, an oncologist who practices at Northwestern Memorial Hospital, said he never used telemedicine until mid-March, but since then he’s been “immersed” in it, using it for most appointments. “For my patients, it’s about knowing what the biggest threat is. Is it their cancer or is it COVID-19? said George.
He said that after trying telemedicine, many patients will stick with it for routine checkups. “Some love it. It’s just super convenient and easy, and they don’t have to worry about parking, and if the doctor is late, that’s fine,” George said.
Northwestern encourages patients to use a system that provides secure video links to primary care physicians and certain specialists.
Rush University Medical Center was another early adopter of telemedicine with a system called Rush On Demand. It allows patients to schedule time with a specialist or their primary care physician, or have access to a physician from 7 a.m. to 11 p.m. seven days a week, said Amanda Tosto, registered nurse and clinical transformation manager. at Rush.
Rush turns to disaster preparedness while postponing routine and elective care. This has created greater demand for remote advice, but Tosto said wait time on the system has been limited to around 20 minutes. Rush On Demand handled around 150 visits per day compared to around 150 per month before the coronavirus, she said.
Medical staff said it was helpful that last week Gov. JB Pritzker signed an order requiring state-licensed insurance companies to cover telemedicine. Blue Cross and Blue Shield of Illinois announced new telemedicine benefits ahead of the governor’s order, saying they could cover virtual visits at the same reimbursement rates as office visits at this time. It also waived copayments and deductibles for COVID-19 testing.
Dr. Tariq Butt, president-elect of the Chicago Medical Society and a West Side family physician, said he’s curious how insurers will handle telemedicine once the pandemic passes. “I hope insurers will work with doctors. Most of us are like small businesses. The level of refunds remains to be seen,” he said.
Butt said doctors are learning about telemedicine and making sure their computer systems are following the protocols required to keep medical records confidential. “But that’s not the model that works for everything,” he said.
Regardless of the bells and whistles of a system, a virtual doctor cannot treat chest pain, broken bones, or cuts that require stitches. This doctor also cannot perform a coronavirus test.
But telemedicine can be a safety valve for a stressed medical system. It can treat conditions that typically clog waiting rooms, such as sinus infections, bronchitis, flu, asthma, pink eye, or fever. Dermatologists can examine warts or moles from a distance. Therapists can also treat anxiety, depression or stress while allowing patients to stay at home where they feel more comfortable.
A founder of a North Side clinic, Dr Rahul Khare, said he had relieved hospitals by using telemedicine to screen more than 500 patients for coronavirus. He said his business, Innovative Express Care at 2400 N. Ashland Ave., administered 250 coronavirus tests in an outdoor tent.
“We have used telemedicine to deliver effective care for years, so this portal has become the centerpiece of our COVID-19 response,” Khare said. “With telemedicine, we can see a high volume of patients while limiting exposure to the virus.”
Last week, the federal government announced it would immediately expand access to telemedicine to help people on Medicare, its coverage program for those 65 and older, and younger patients who are eligible due to a disability. And he urged states to expand the service to those enrolled in Medicaid, the government’s coverage program for low-income people.
Many insurer-managed Medicare Advantage supplemental plans also offer access to telemedicine.
What if you don’t have insurance? You can pay out of pocket through some telemedicine providers. MDLive deals primarily via video chat and charges $75 for an urgent care visit. A session with a dermatologist costs $69.
Another company, 98point6, charges an annual fee of $20, then $1 for each visit. The company diagnoses and treats via secure text messaging.
But Rush’s Tosto said remote clinics and services cannot replicate the value of high-quality hospitals. “When you talk to a doctor who’s out of state, you’re not going to get the best advice on where to go for a follow-up,” she said.