The Box welcomes faculty-generated content to spotlight our university’s rich array of expertise. This contribution to our new “Faculty Forum” series of perspectives on timely topics is from School of Health Professions Associate Professor of Physician Assistant Studies Shinu Kuriakose.
2019-nCoV, aka COVID-19, has focused a spotlight on the problems facing the patient population in the United States. These include the difficulty in accessing efficient and timely health care, which has led to unfortunate consequences in cases where prompt care could have decreased instances of morbidity and mortality.
The use of telemedicine could have helped to lessen this crisis.
Almost 40 percent of Americans over the age of 18 (157 million people) meet the criteria for a chronic medical disorder, with 33 percent classified as having multiple chronic medical conditions affecting their quality of life. Due to the pandemic, patients have also experienced unnecessary invasive procedures and treatments due to delays in receiving care at appropriate times. Among other issues, this has caused increased debt and personal difficulties in patients’ lives and has led to an overemphasis on late-stage care where healthcare outcomes may not be as positive.
Furthermore, the lack of treatment of chronic medical illnesses, such as hypertension, diabetes, and heart disease at an early stage has led to increased hospitalizations, dependence on multiple prescriptions, and overall, a burden on the healthcare system.
Crisis of Judicious Healthcare
These various medical problems have immersed this country into a crisis of judicious healthcare. Patients need to see providers in a cost-effective, opportune manner, who also are available within a reasonable geographical distance. This health crisis continues to be exacerbated by the shortage of nearly 122,000 physicians. Moreover, the COVID-19 pandemic has led to the closures of many facilities, including primary care, private physician practices, and urgent care centers.
Telemedicine to the Rescue?
Increased usage of telehealth virtual modalities has provided needed care, given its decreased risk of spreading the coronavirus and families’ reluctance to frequent emergency rooms full of coronavirus-infected patients.
New York was one of the first states to adopt telemedicine to serve its residents unable to physically access providers and the first to scale telehealth services to deal with the COVID-19 crisis in March 2020. The Office of Mental Health of the State of New York defines telemedicine as “the use of two-way real-time interactive audio and video equipment to provide and support clinical medical care at a distance. Telemedicine services can be utilized for assessment and treatment services provided by physicians or medical nurse practitioners from a site distant from a recipient’s location.” The public hospital system in New York City scaled up its telemedicine visits from 500 encounters the month before the pandemic to almost 57,000 encounters in the first three weeks of the pandemic.
Telemedicine encompasses various electronic avenues (video, audio, teleconference via phone, tablets, computers, Internet-based, and electronic app-based) by which mental health clinicians, for example, can provide care for patients in a manner, which is, for all intents and purposes, as effective clinically as conventional care in a one-to-one setting. This virtual, economical mechanism allows timely access to a clinician, enhancing medical care due to early intervention and follow-up, leading to positive outcomes. There has been an increased reception of this modality by medical practitioners, nurses, social workers, hospital administrators, insurance companies, healthcare institutions, and hospital executives.
This contribution has been edited and condensed.
Look for Part II of Kuriakose’s contribution, which will focus on challenges and opportunities of the new evolving medium telemedicine, as well as acceptance hurdles that will need to be overcome.
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