Virtual doctor visits help COVID-19 patients

Ann Barton and Terry Schildt had a doctor's help as they battled COVID-19, but neither went to the physician's office.

Barton described her battle with COVID-19 as "the worst hangover in the world times 5,000."

She saw the doctor through telehealth from her home.

"Your doctor comes on ... and he asks you all the questions he would ask you in the office," said the 74-year-old Hagerstown resident. "Of course, I had info set to give him."

Schildt, 73, of Smithsburg, described a similar experience during what he called a scary bout with COVID-19.

"To me, it was very natural," he said of the telehealth visit from his house. "With the information I was able to give him, there was no reason to go there."

Schildt and Barton aren't alone.

According to a report by CNBC last week, telehealth, which basically describes medical services and education delivered digitally, has grown steadily as an industry. Global Market Insights reports that the market size in 2019 was around $45 billion and is projected to grow to more than $175 billion by 2026.

In March 2020, the Trump administration lifted Medicare requirements for telemedicine visits to make it easier for patients and doctors to use the technology in the wake of the coronavirus pandemic. That also allowed more providers to accept Medicare payments for virtual visits.

Now, social distancing measures at doctors' offices and hospitals could push telehealth interactions to 1 billion by the end of 2020, according to the CNBC report.

Telehealth volume has increased in Washington County, saidMeritus Health spokeswoman Joelle Butler.

Meritus surpassed 10,000 nontraditional visits with patients during the past 2 1/2 months, including virtual visits through the MyChart patient portal, telehealth visits, phone conversations and the drive-thru and walk-thru screening centers, she wrote in an email.

'Here to stay'

Dr. Mahesh Krishnamoorthy of Meritus Internal Medicine treats Barton and Schildt, and he had telehealth appointments with both of them during the pandemic.

He said area health professionals have been using digital technology to communicate with patients for years. The new Epic electronic health records system at Meritus has helped facilitate even more virtual visits. And the arrival of COVID-19 has accelerated the trend.

"It appears it's here to stay,"Krishnamoorthy said. "It appears it will be one more tool in our toolkit."

While the virtual visits can't replace in-person appointments, the doctor said, they are often more convenient for patients. And in a time of pandemic, staying at home limits patients' exposure to outside risks and it limits the staff members' exposure to potentially contagious patients.

A telehealth visit begins with some homework, he said, to make sure the patient has appropriate devices and software and knows how to use them.

Patients also can keep track of their own vital signs and report them to the physician during the visit. Over-the-counter items like blood-pressure cuffs and thermometers usually suffice.

"I find those devices fairly reliable," the doctor said.

He said a telehealth visit typically includes a video component, so the doctor can see the patient's appearance. Doctor and patient can talk through the patient's concerns, as they would during an in-person visit.

They also get to talk about other things, because the video often catches part of the patient's surroundings, from musical instruments to woodworking tools.

"I end up learning something about the patient," Krishnamoorthy said.

He acknowledged that the technology can be "daunting" for some people. He said health professionals need to take a leadership role in that arena.

"It is up to us to understand where we're going, what the needs are, where the technology is going and how to respond," he said.

'Caring for our patients from afar'

In Pennsylvania, WellSpan Health has been conducting video visits, telephone visits and e-visits. These digital visits range from urgent care appointments to specialty care, such as behavioral health and physical therapy appointments.

According to WellSpan, since March 19, there have been 13,075 video visits and 14,577 telephone visits in Franklin and Cumberland counties. Of some 40,000 patient visits since March 19, 69% have been through video or telephone.



Ed Schuurman, physician assistant at WellSpan Family Medicine in Waynesboro, Pa., said he completes between 12 and 18 virtual visits on a typical day.

"We were able to rapidly implement digital visits/telemedicine at the onset of this pandemic as a means to continue caring for our patients from afar," Schuurman said in an email from WellSpan. "We use telephone and video visits to discuss medications, new or worrisome symptoms, updated lab results and (at times) examine new lumps, bumps and rashes through the computer.

"Social distancing and the disruption in our day-to-day lives has also led to an increasing number of mental and behavioral health issues as a result of feeling isolated, restricted and alone. We have been using virtual visits to assist patients dealing with some of the emotional and mental health fallout from this pandemic."

In West Virginia, WVU Medicine also has taken several telehealh steps.

Most recently, for example, WVU Medicine East announced it is offering a virtual self-management program for those dealing with chronic pain. Called Living Well, it's a weekly workshop designed to help individuals coping with chronic pain learn to take day-to-day responsibility for their care, increase the skills necessary to manage their pain and work effectively with their health care professional.

A new workshop using the online video tool Zoom begins June 16 and will meet every Tuesday through July 28.

'Something else wonderful to do'

Back in Washington County,Barton and Schildt say they're happy to be on the other side of their COVID-19 battles.

"On the other side is a good side," Schildt said. "It's not fun."

They experienced different symptoms. Barton ran a fever; Schildt did not. Barton lost her senses of taste and smell; Schildt suffered from night sweats.

"I never once through the whole thing thought I was going to die," Barton said.

Schildt said, "The first two nights were really bad, to the point of scaring me."

Both said they came out of the experience with feelings of gratitude.

"I just assume that God didn't take me because I've got something else wonderful to do, and I can't wait to find out what it is," Barton said.