Deb Baker, an APRN with Renown Health, checks the vitals of a patient at Renown Regional Medical Center in July. In the COVID era, these types of in-person visits may not be as frequent, especially for those living in rural Nevada.
RENO, Nev. — Over the past few years, Carson Tahoe Health had been thinking about expanding its telehealth services.
When the coronavirus pandemic hit in mid-March, shutting down the state and shutting in Nevadans, the healthcare network was forced to put that thought into action — quickly.
“Within a matter of two weeks, we had telemedicine up and 60% of our outpatient visits were being handled through telemedicine,” said Alan Garrett, CEO of Carson Tahoe Health, a provider network with 21 locations, including its main 211-bed regional medical center in Carson City. “We had used telemedicine for some specialty areas and for tertiary consults. But, this was really the first time we went big into primary care medicine; this was the first time where we’re doing an office visit with a patient holding an iPad (at home).
“We literally went from zero to 60 (percent) in a matter of two weeks.”
Carson Tahoe Health is far from the only healthcare network seeing a surge in telemedicine during the pandemic.
Before the COVID crisis, roughly 13,000 people under traditional Medicare used telemedicine services per week, according to the Centers for Medicare and Medicaid Services (CMS). Compare that to the last week of April 2020, when nearly 1.7 million people received telehealth services.
All told, from mid-March through mid-June, CMS reported that 9 million people had used telemedicine.
Quite simply, in the COVID age of quarantining, social distancing and face coverings, telemedicine is no longer a nice-to-have, but rather a must-have for patients and healthcare professionals alike.
Along with worried patients whose symptoms mirror COVID-19, there are plenty of people with allergies, asthma and diabetes who still need prescriptions.
As a result, telemedicine, once a niche category of healthcare, has grown rapidly in demand throughout the pandemic — showing no signs of slowing.
What exactly is telemedicine? On the surface, it’s a video or phone call with a physician. But it can be much more.
Innovative uses of telemedicine are increasing with platforms and remote patient monitoring technology. New mobile health apps and wearable monitoring devices help track a patient’s vitals, provide alerts about needed care, and help patients access their physician, giving providers the ability to make online encounters detailed and meaningful visits.
At Saint Mary’s Health Network — which has 10 locations in the area, anchored by a 380-bed regional medical center in downtown Reno — about half of all primary care visits are currently done via telemedicine, said CEO Tiffany Coury.
“It’s really important to have the option,” Coury told the NNBW. “If patients are nervous about seeking healthcare because they have to get in their car, they have to come to a building, and they’re worried about exposure, physicians are able to interact with them at their home and understand what they might be dealing with.
“And if it truly is an emergency, (doctors may) give them the advice, the care, the direction that they need. From that vantage point, it’s closing a gap.”
Closing the care gap amid COVID-19, Coury said, becomes even more important in the rural areas of Northern Nevada, where many people do not have access to specialized healthcare services.
“It’s going to be important for us to all collectively figure out how to keep doing this going forward,” Coury said. “I think it’s put a spotlight on the need, but also shown us what’s possible.”
Garrett agrees.
“Telemedicine really gives us an opportunity to provide a different kind of care to all of those folks in Nevada in those rural areas,” he said. “So, I think that’s a real long-term plus benefit. Not to mention, it also helped us realize when the chips are down, you can get some things done if you really have to.”
Renown Health, Northern Nevada’s largest healthcare network, is seeing about one-third of its overall patients via telehealth, says President/CEO Dr. Anthony Slonim.
“In the rural environment, which Northern Nevada is known for, we cover a geographic primary, secondary, tertiary service area of 100,000 square miles,” Slonim said. “And you can’t do that simply with driving or flying to those locations. It’s more efficient to deliver some of that care with telemedicine. We have increased our capabilities of what we’re able to provide remotely.”
In fact, in June, Renown was awarded a nearly $1 million grant from the Federal Communications Commission for its COVID-19 Telehealth Program. According to Renown, the funding will be used to offset expenses incurred to establish virtual COVID-19 visit screenings during the pandemic.
Moreover, the grant will support Renown’s efforts to introduce a dedicated platform to enable all specialists and urgent care providers to deliver virtual care to patients.
“I think the pandemic has put a focus on the fact that you don’t have to be miles and miles away to access telemedicine,” Slonim said. “People like it because of its convenience, so why not use it even if I’m down the block from the doctor’s office? Because it’s more convenient and I never have to leave my house when I may not be feeling well.”
As the pandemic drones on amid flu season, however, there are financial hurdles ahead for people hoping to stay home and receive virtual care.
Early on in the crisis, the federal Medicare program and private health insurance companies wanted to encourage people to seek virtual care. Rules were relaxed and co-payments were waived.
“COVID has created a great number of waivers,” Coury said. “I think the question mark is, how long will that continue?”
For some, it might have already stopped. Starting Oct. 1, several private health insurers, such as UnitedHealthcare Group and Anthem, will no longer pay for virtual visits, according to a report by STAT news. Meaning, people once reliant on telehealth to avoid doctor’s offices during the coronavirus outbreak will need to check with the insurers to see how much their virtual visit will cost.
According to an analysis by nonprofit group FAIR Health, the average cost of a lengthy telemedicine visit with a plan’s network is anywhere from $55 to $92.
“One of the obstacles is traditionally Medicare has not paid for telemedicine,” Garrett said. “They are now amid COVID. We’re advocating that that stays. We’d like to see that funding continue. We’re talking to those in Washington who will listen that this is how you change healthcare — you create opportunities for people to do things different and not put a financial barrier.”
While senators from both sides of the aisle support for coverage of telemedicine, Congress would have to pass specific legislation to make some of Medicare’s temporary changes permanent, according to a report by The Hill.
If that happens, the phrase “the doctor will see you now” could become as commonplace as “the doctor will Zoom you now.”
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