While telemedicine is not a new technology, it was one that was not widely used or incorporated across the medical spectrum, until recently.
But with the coronavirus, changes in medical protocols and a new age of social distancing, medical providers have a wide-reaching tool that can help patients keep in contact and keep up with their medical care.
“We use telemedicine as a way to make ourselves available to patients and address health care needs that don’t stop because of COVID-19,” said Dr. Diego De La Mora, chief health informatics officer at Texas Tech University Health Sciences Center.
De La Mora works to coordinate telehealth at the Texas Tech Physicians of El Paso clinics. He said the technology has helped during this era of closures and social distancing for those who are not comfortable coming into the clinic.
The clinics are still open for in-person visits, but the time between each patient is spaced out by about an hour.
De La Mora said Texas Tech is also using telemedicine in providing care for patients who think they might have COVID-19. He said a patient can be placed inside an exam room with a laptop, which health providers use to communicate, exam and check symptoms.
“We’re able to communicate with patients without having to use PPE, which initially was a concern that we wouldn’t have enough for the long term,” De La Mora said. “We reduced PPE use by almost half, and were still able to address patients possibly with COVID-19 without exposing our health care workforce, or limiting the amount of exposure.”
Zero to thousands
In the weeks before the March shutdowns, telehealth visits at Texas Tech Physicians of El Paso were close to zero.
Now, he said the clinics average about 1,000 telehealth visits per week, and expects the technology to account for 20% to 30% of all visits moving forward.
“That probably accounts to about 45% of our total number of visits,” De La Mora said. “Certainly with the restrictions being loosened up, more patients are willing and able to come into the clinics, and we’ve seen a decrease in the number of (telehealth) visits.”
In an emailed response to questions from El Paso Inc., officials with The Hospitals of Providence said they’ve seen a significant increase in the use of telemedicine for patient visits, and that 80% of providers with Providence Medical Partners are equipped with telehealth technology.
The Hospitals of Providence is also deploying telemedicine for visits with patients who are being screened for COVID-19.
The cost for telehealth varies, depending on what insurance companies cover. De La Mora said the technology is also a cost-efficient way for physicians to treat patients because there’s no brick-and-mortar costs.
“During the public health emergency, multiple insurance companies and payers were lenient, and were waiving copays and cost-sharing requirements,” De La Mora said.
But while costs to access telehealth might be accessible, there are other barriers for some El Pasoans in seeking that kind of health care.
Not always accessible
Many parts of El Paso have internet connectivity issues due to proximity to the U.S.-Mexico border or lacking connectivity infrastructure.
Other patients may not be comfortable using technology, or may not have smart phones or tablets to access telemedicine apps and platforms.
De La Mora said the federal government has been flexible in the ways in which doctors can provide care for patients, and that includes landline phone calls for when videoconferencing can’t be accessed.
The Hospitals of Providence officials said one strategy is to engage family members who can help elderly patients successfully connect via telemedicine, but that there are still connectivity issues doctors need to keep in mind in areas like behavioral health.
De La Mora said doctors are trained for in-person visits, and now have to do things a bit differently when communicating with a patient virtually.
“I think most of us have had to learn the etiquette of performing a history and physical exam through these telemedicine methods,” De La Mora said. “We can’t listen to the patient’s heart, connect with the patient physically or do some of the things that we’re able to do in person, and we’ve had to learn to be empathetic and show empathy in different ways.”
Connectiong outside of El Paso
Telehealth also helps connect patients to doctors across the state, and can save some patients trips for in-person consultations.
Miranda Aguirre, health center manager for El Paso’s Planned Parenthood, said the reproductive care clinic’s PP Direct app helps connect patients to care, even when there’s limited space at the brick-and-mortar Central El Paso site.
She said nearly half of El Paso’s Planned Parenthood visits have been through telehealth.
“We’re also seeing patients not just in El Paso, but from Austin to Lubbock and Odessa,” Aguirre said. “We see a lot of patients in rural communities that don’t have (in-person) access, or their primary care physicians aren’t taking appointments unless it’s dire. But what someone might not consider dire, our patients do.”