Telehealth visits boom as patients navigate Colorado’s coronavirus restrictions




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In the same way coronavirus is triggering the collective realization that a lot of our meetings could have been emails, it’s also showing us that a lot of our doctor appointments could have been virtual visits.

Although Colorado is slowly reopening and has allowed non-emergency surgeries to resume, restrictions remain and public health agencies still recommend people stay home as much as possible. That means appointments that don’t need to happen face-to-face are typically being shifted to the phone or computer. And that’s not expected to change anytime soon.

Medical providers credit the coronavirus pandemic for an unprecedented leap in telehealth integration. Virtual visits are up more than 1,000% at UCHealth locations across Colorado, according to a spokesperson. Banner Health rolled out its new Banner Telehealth video visit program earlier than planned because of the coronavirus outbreak, a spokesperson said, and video visits now make up about 45% of Banner’s outpatient volume. Some doctors and medical professionals are now conducting all or most of their visits over the phone or computer.

Fort Collins dermatologist Tiffany Link is one of them. Working out of her home’s basement — where her diplomas were already conveniently hanging on the wall by her computer — she diagnosed 12 skin cancer cases, two severe abscesses and a handful of drug reactions in the first three weeks of her office’s closure.

Her office spent about two days setting up, a Health Insurance Portability and Accountability Act (HIPAA)-compliant telehealth platform, after learning they’d have to close their office for nonemergency procedures.

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“Telehealth has been around for years, but in its infancy,” she said. “Luckily or unluckily, I think COVID-19 has pushed a lot of companies to convert to these programs. People really rose to the challenge.”

Link can examine patients, talk about their symptoms, recommend treatment and prescribe drugs through a virtual appointment, which feels a lot like FaceTiming with a friend — if you told your friends detailed accounts of your skin ailments. Her clinic is open a few days a week for pressing procedures, like cutting out a melanoma.

Link is proud to share that the platform they’re using is easy enough that she’s gotten both a 12-year-old and 92-year-old connected for a telehealth visit. Patients can book the appointments online, and the telehealth platform often means they can get (virtually) in front of a specialist faster than if they scheduled an in-person appointment.

That’s also the case for Dr. Cathy Ow, a primary care physician at UCHealth Internal Medicine in Fort Collins, who went from fielding one or two virtual visits a week before the pandemic to nearly 100% in the second and third weeks of March. She’s now conducting about 65% of her visits virtually and has treated patients for things like depression and respiratory issues with same-day appointments.

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COVID-19 pandemic changing future of telehealth

HIPAA compliance and limited insurance coverage have historically stunted the growth of telehealth, but the pandemic changed that. Medicare and many other insurance providers have temporarily waived copays or enhanced coverage of telehealth visits, reimbursing them at the same rate as in-person visits. The federal Department of Health and Human Services has temporarily halted penalties for use of audio and video technologies that are not HIPAA-compliant for telehealth visits, as long as they’re not public-facing.

For telehealth to continue to blossom, those temporary changes would have to become permanent, Ow and Link said.

An in-person visit is still the best way to see a patient, Ow said, but she’s been surprised with how many issues can be resolved through a virtual visit — and how adept patients have been at finding ways to imitate an in-person visit.

She’s had patients weigh themselves and take their own blood pressure, then show her the scale or blood pressure cuff. Patients often step out of work and sit in their cars so they have a private spot for the appointment. Patients have had their partners stick lights in their mouths so Ow can get a better look.

“I bet if we continue, there’s going to be gadgets galore that allow us to see results in real time in front of us,” Ow said. “There’s a lot of things we can do virtually that I never thought we could do. This is my 35th year of practice. I never thought I’d be able to do this.”

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Ow attributes telehealth’s previously rare use in part to unfamiliarity, both on behalf of patients and medical providers.

“We had the technology,” she said. “But I think we were not comfortable with not doing the traditional, see me face-to face, let me examine you. This pandemic has forced us to learn there are other ways to take care of patients. All the barriers I had in the past went away very quickly when we were forced to do medicine in a different way.”

What to watch for

A few themes to come out of health care’s response to COVID-19 restrictions:

  • Fewer walk-in patients as more providers look to direct initial care through telehealth.
  • A slow restoration of non-essential operations as patients navigate their comfort level with visiting hospitals and surgery centers.
  • Improved doctor access for rural patients as telehealth and broadband connectivity is expanded.

Jacy Marmaduke covers government accountability for the Coloradoan. Follow her on Twitter @jacymarmaduke. Support stories like this one by purchasing a digital subscription to the Coloradoan.​​​​​​

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