While health care providers have a heightened focus on screening, testing, and treating people infected with COVID-19, there are people who doctors and nurses are treating for reasons not related to the virus.
For some patients who don’t want to risk catching or spreading the highly infectious virus during a visit to a clinic or hospital, there’s another option. Over the last month, health care providers on the Central Coast, and around the country, have worked to increase their ability to treat patients through telehealth services.
Although the concept of telehealth—which allows doctors and nurse practitioners to treat patients over the internet—has been around for some years, the number of people using this service has increased dramatically over the last month. And there’s reason to think that at the end of this COVID-19 pandemic, telehealth could become a more central component of how health care is delivered in the U.S.
“If anything, this COVID pandemic has really opened people’s eyes to the value of telemedicine,” said Dr. C. Alan Brown, who is the chief medical information officer for Cottage Health. “As the technology improves, I think the use of telemedicine will only increase.”
The recent expansion in telehealth services has been aided by the loosening of state and federal regulations. On March 17, the California Department of Health Care Services sent a letter to the federal Centers for Medicare and Medicaid, with requests aimed at providing state health care providers with more flexibility during the ongoing pandemic—including expanding the places where telehealth can be provided.
“To get Californians the care they need during this crisis, we need to change how that care is delivered and communicated,” Gov. Gavin Newsom said in a news release announcing the request. “By expanding our telehealth options, we’re minimizing disruption to our health care system to prioritize care for those who need it most, while providing easier, more accessible options for other Californians seeking care.”
Lompoc Valley Medical Center CEO Stephen Popkin said changes to how health insurance companies, and the federal government through Medicare, reimburse health care providers for using telehealth has spurred this recent increase. Currently, health plan providers and Medicare are treating telehealth visits the same as in-person visits. This means that patients are paying the same amount as a copay and then health care providers are billing and being reimbursed by health insurance companies and Medicare. But normally, that’s not how it works.
Popkin said a lot of larger health care plans do have a telehealth component, but it’s through a specific provider. Most of the time, patients can’t use their health insurance plan to visit with their normal doctor virtually.
“Up until the easing of regulations, they wouldn’t be able to see their primary care physician or specialist through their health insurance plan,” Popkin said. “They’d have to pay for those visits out of pocket.”
Coincidentally, Popkin said Lompoc Valley Medical Center was in the process of rolling out a telehealth service for its health clinics prior to the current health crisis, but the situation quickened these efforts. The medical center officially opened up this service to existing patients on April 6.
Dignity Health, which operates five hospitals and numerous clinics on the Central Coast, recently rolled out telehealth services as well. Dr. Scott Robertson, who is the president and CEO of the Dignity Health’s clinic group Pacific Central Coast Health Centers, said prior to the COVID-19 situation, there wasn’t a patient demand for video visits. But this quickly changed over the last month.
“When public health orders started coming out, we needed to pivot very quickly to ensure we could still connect with these patients,” Robertson said.
Since Dignity Health began offering these video visits in late March, the number of people taking advantage of this option is increasing. Robertson said about one-third of all clinic visits are now taking place virtually. And these aren’t just primary care visits, many visits with a specialist can take place over a video as well.
Cottage Health has also experienced an increase in the number of patients using its telehealth service called Cottage CareNow, Brown said. Through this service, which started as a pilot program last July and expanded to all community members in December, patients can complete an online questionnaire and receive treatment recommendations from a nurse practitioner, or patients can schedule a virtual one-on-one visit with the health care provider.
In January and February, Brown said about five patients used this service through the hospital each day. That number is now closer to 25. He said the hospital hired two additional nurse practitioners in early April to help manage this increase in telehealth visits.
These virtual visits have become an important tool for the hospital to use when evaluating people with upper respiratory problems who may have COVID-19, Brown said. On April 13, the hospital announced patients who have COVID-19 symptoms can use this Cottage CareNow platform for free.
Additionally, Brown said the hospital has increased its use of telehealth tools that help nurses and physicians visit with patients who are already in the hospital.
“We placed iPads in patient rooms and at nurses’ stations, so that when it’s appropriate, they can do rounds virtually,” Brown said.
Although telehealth has become an important tool for health care providers during this pandemic, as it protects both patients and providers from spreading COVID-19, it’s important for people to still seek in-person services if they need it, Robertson said. Since Newsom issued the statewide stay-at-home order, patient volume at Dignity Health’s Pacific Central Coast Health Centers has decreased about 50 percent, which means people could be missing out on care they need, he said.
“We still want patients to take the orders seriously, but if you’re feeling bad, go seek care,” Robertson said. “We have ways to treat patients safely.”
Reach Staff Writer Zac Ezzone at zezzone@santamariasun.com.
This article appears in Apr 16-23, 2020.
