How to use telemedicine to survive COVID-19 isolation?

The unexpected lockdown enforced on billions on people around the globe to fight the COVID-19 pandemic has created a crisis in medical care access. Millions are struggling with disrupted routine medical care needs and have been postponing hospital visits fearing exposing themselves to the highly contagious virus.

Despite the lockdown, it is a matter of hope that we are not completely cut out from each other. Despite the physical distance people are in touch with each other via different interactive platforms and audio and video technology. 

Today we have access to an entire virtual universe at the tips of our fingers. We are able to work from our homes, order our food, find the news we need, access the entertainment we seek and much more. With the lockdown, we have expressly discovered ways we can stay remote and yet operate efficiently. We have been praying, playing and mourning through our video interfaces. We have been rewiring our interactions with this world to get ahead of the tough times presented to us.

When we can do so much staying remote and yet feel we aren’t so cut off hasn’t it struck you that maybe medical care can also be made available via telecommunication networks?

Well yes, it can be. Numerous medical facilities and clinics are offering telemedicine or virtual care options of various scales today and are connecting doctors to patients via sterile, no-contact virtual environments.

What is telemedicine?

Telemedicine refers to a broad spectrum of modern technologies and tactics used to deliver virtual medical, health, and education services remotely and functions with the assistance of various interfaces like synchronous and asynchronous video, audio and mobile communication technology.  

The Centers for Medicare & Medicaid Services (CMS) and the Office for Civil Rights (OCR), in its guidance issued regarding HIPAA compliance, has said that medical practitioners can make use of available non-public facing video interfaces used ‘in good faith’ to connect with their patients and that the overarching privacy protocols laid down by the HIPAA regulations will be eased temporarily.

How does it work?

Telemedicine takes the process of meeting a doctor to a virtual plane altogether. There will be no front office or physical infrastructure for patients to register their appointment. Instead, they will be booking their appointment online and getting an email or SMS link to a video or audio call. There are three ways patients can meet with their doctors-  

1. Synchronous or live video: In the synchronous mode there will be live, two-way interaction between the patient and doctor using common, popular audiovisual telecommunication technologies like Apple FaceTime, Facebook Messenger video chat, Google Hangouts video or Skype.
2. Asynchronous or store and forward: In asynchronous mode, patients and doctors do not meet each other live real-time, instead they exchange recorded health information, like radiographs, photographs, video, digital impressions and photomicrographs through secure electronic communication systems. 
3. Remote patient monitoring (RPM): In RPM, personal health and medical data is collected from an individual in one location via electronic communication technologies and is transmitted to a provider (sometimes via a data processing service), in a different location to gain access to a virtual caregiver.

Apart from this the public can also leverage mobile phone networks to access medical care. 

The doctors, who receive patient information via any of these means then use it to evaluate a patient’s condition and perform an online triage. Depending upon the condition of the patient they may then recommend an e-prescription for medicines or refer the patient to an open medical facility where they can approach for in-person care. 

Most telemedicine portals and software also have inbuilt payment modes to make the process truly seamless and digital. 

Medical privacy and telemedicine

Medical care in the US is ruled by the stringent HIPAA regulations that protects patient privacy. Telemedicine obviously poses several challenges to the maintenance of these protocols. Several technologies used for virtual consultations are not HIPAA compliant.  

To tackle this, the authorities have sanctioned temporary leniency in the regulations and have allowed the use of more personalized communication technologies. 

Apart from this, the state agencies have also mandated that the providers must notify patients that the third-party applications used in the audio and video interfaces carry potential privacy risks, and should try and enable all available encryption and privacy modes possible while using such applications. 

The state directive also expressly bans the usage of public-facing video communication applications like Facebook Live, Twitch and TikTok.

Is telemedicine recognized by insurance carriers?

Under the regulatory flexibilities announced in the wake of the corona outbreak, the insurance companies have extended coverage to telemedicine treatment codes in both medical and dental care services. All that needs to be done is to add the special codes denoting the telemedicine service or the teledentistry service to the existing treatment code protocol while submitting a claim.

Is telemedicine the future of medicine?

Telemedicine is not something very new. Several caregivers have used telemedicine in different formats to help elderly, immobile, remotely located or differently-abled patients. Even teledentistry is popular in several parts of the United States. At several places teledentistry follow-ups are also simplified and there are doctors and dentists who visit patients at their homes to save them the trouble of traveling to get to a medical facility. 

With the exigent situation brought in by the COVID-19 outbreak, several millions will start realizing the convenience offered by telemedicine. With telemedicine, even during normal times, people can save travel and avoid skipping office days to meet doctors. This will also be extensively helpful for the less mobile patients or patients recovering from invasive surgeries and are going through long periods of rest and recovery. Moreover, it is safer than visiting any hospital or dental practice anyday as secure home environs mitigate cany chances of accidental germ exposure.   

With its potential to extend exposure-free care to remote locations, reduce crowding at medical facilities, make quality care access almost 24*7 and reduce travel and establishment costs, one can truly see teledentistry assuming more importance in the post COVID era.