Access to Care

Funny how what can and can’t be done has changed now that the entire world is living a sheltered life thanks to the COVID-19 pandemic. When it was just people who were living with chronic disease requesting the opportunity to do things differently it was viewed as too hard to change. We were asking for too much. If we just conformed to the rules and schedules of everyone else we were told it would work out.

Can people be treated sufficiently with telehealth?

An example of this would be telehealth. For several years there has been the question how can people be treated sufficiently through remote communication?

I’ve used a telehealth doctor to diagnose a sinus infection – I went to a website provided by my insurance company and was connected with a doctor in some distant state. After a brief consult, she sent a prescription electronically to my local pharmacy. End of office call. I was satisfied and got the treatment I needed.

Access to care according to the patient's needs

We’ve recently seen studies such as Step for MS underway to verify physical therapy and rehabilitation treatment via telehealth methods – be it skype or some special app – as a feasible alternative for people who might have challenges making it to the physical location of a health provider. The evidence leaned toward there being no difference in the quality of care, but it improved the experience for the patient to get this service on their own terms in the manner that fit their own needs best.

Long distance exams

I’ve talked to neurologists about the feasibility of telemedicine for our exams and have been met with resistance. The big question they had was how could they possibly do an exam when the patient wasn’t in the same room. How could they do the necessary measurements of their tests? Who would handle the paperwork and collect my co-pay for the office call? These are all good questions, but should not have been viewed as insurmountable obstacles.

Telemedicine

But now, along comes COVID-19, and people still need to consult their doctors for non-virus things.  We might even need to do a consult with our neurologist. How can this possibly happen? Drum roll, please......  Oh yeah, we can do it by telemedicine!

Flexibility in treatment

COVID-19 has forced the remote treatment issue and doctors and health care systems are reaching out to offer their services by phone. My husband has COPD, and has regularly scheduled appointments with a pulmonologist. This lung doctor’s scheduler called him the other day and he paused during the call to ask me, does his computer have a camera? When he got off the call, he said his upcoming appointment would be done on the computer. I’m curious to see how this exam goes, particularly testing lung function and oxygen levels.

Could telemedicine have a long term future?

My own neurologist, Aaron Boster, MD, has also started seeing patients at The Boster Center for MS through telehealth methods. Other neurologists, like Barry Singer, MD, are there as well. I interviewed both of them about their experience and attitude toward telemedicine and they seem receptive to the addition of this treatment tool. Both say they see a future use of telemedicine in their practices.

A few good lessons we might gain from this

COVID-19 has brought many horrors to our lives but perhaps there are a few good lessons we might gain. Delivery of our care using non-traditional methods such as telehealth might just be one of those. I just can’t help but be a touch salty that it has taken something as horrendous as a pandemic to get the experts adopting an approach we have asked for over many years.