Virtual care ‘ramped’ up by COVID-19, here to stay
Click Here to Manage Email Alerts
The COVID-19 crisis has totally changed the way we think about telehealth. The perceived barriers to virtual care before the pandemic have largely disappeared. Everywhere around the country doctors and advanced practice providers are ramping up phone or video visits, and it seems that most patients are grateful to be able to connect with their provider in a safe manner.
However, while a lot can be done over the phone or a video meeting for patients with inflammatory bowel disease, it doesn’t quite replace the physical, face-to-face meeting. Telehealth can be helpful for patients who are currently doing well, are on their biologic for their IBD and are supposed to see a health care provider, but are afraid to come to the office because of COVID-19. These patients can go to a local laboratory for blood work (or fecal calprotectin) in advance, and have their results faxed over — in most cases, a discussion of how they’re doing is all that is needed.
On the other extreme, virtual care can often help when assessing a complicated patient who lives far away. As an example, I had this happen the other week. The patient was in another state, she had a complicated history, and after reviewing her detailed electronic medical records, I realized she needed to change her therapy. She was in a COVID-19 hot spot, so she couldn’t travel; fortunately, they lived in a city with many IBD specialists. I was able to refer her to a nearby IBD specialist. I had performed the video visit on a Tuesday, and by that Friday she had a visit with the other gastroenterologist, who was able to start her on a new biologic within the next week. It was an ideal example of how the convergence of the electronic medical record and telemedicine (ironically precipitated by the COVID-19 emergency) allowed us to manage the patient. For patients who live in rural areas, access to an IBD specialist is limited, and virtual care may be a way for them to tap into subspecialty expertise.
At some level, however, symptoms, blood work and calprotectin will only get us so far. IBD patients will need to periodically come in for an assessment with colonoscopy or cross-sectional imaging. As practices reopen as the surge of the COVID-19 cases becomes less severe, we are already seeing these changes. About a month ago, 80% to 90% of my visits were virtual, but now most of my visits are face-to-face.
Virtual care is not going away. We’re going to use it, but we have to think about how we are going to use it most effectively. It will be most helpful for triaging brand-new patients, used to determine what tests and which consultations they are going to need when they come in, and also to streamline the patient itinerary. Telehealth will be helpful for stable patients doing well. Let’s see where provider ingenuity takes us going forward!
Collapse
Read more about
Click Here to Manage Email Alerts