The current outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was officially declared a pandemic by the WHO on March 11th. The US CDC reported that, as of April 2nd, COVID-19 was confirmed to have infected 1,015,403 people globally. Data from Johns Hopkins University reports that as of April 2nd, COVID-19 was confirmed to have infected 1,015,403 people globally with 53,030 deaths. Moreover, the US has 245,213 confirmed cases, the highest in the world and 4,513 deaths. These severe statistics call for an immediate way to tackle the crisis and render people, physicians and health systems more accessible to each other without the risk of potential exposure to infection. One promising method to do so is the use of telemedicine.
What is telemedicine?
Telemedicine has its roots in healthcare providers who started using technology to reach patients in remote places who had poor access to proper care. In recent years, this technology has become an essential tool to provide quality healthcare, irrespective of a patient’s location. Of note, today’s patients prefer faster and better access to care. Their driving need for immediate medical attention and improved doctor-patient engagement is making telemedicine increasingly popular.
Four ways telemedicine can help manage the COVID-19 pandemic:
- Efficiently creates “social distancing” by preventing individuals potentially infected with COVID-19 from travelling to hospitals and putting medical care professionals at risk of exposure.
- Provides specialized care to patients in remote areas who do not have access to such services. In China, deaths due to COVID-19 in areas with low access to medical resources have surpassed deaths in areas with higher access. Telemedicine could help to reduce this discrepancy.
- Based on recent data, most individuals with COVID-19 have mild infections and may not need hospitalization. Telemedicine can successfully provide solutions to such low-acuity patients and avoid overburdening medical facilities. Telemedicine can also be used to treat comorbid patients with chronic diseases who are at higher risks of COVID-19 infection, thus minimizing their risk of exposure.
- Potentially significant cost cuts for medical care related to COVID-19. For example, the average cost for a hospital to treat a patient during an emergency department visit is priced at $2,032 by UnitedHealth Group, whereas a telemedicine visit is estimated to cost less than $50 for the healthcare provider.
Innovative telemedicine platforms combating the pandemic:
Ro, a New York-based direct-to-consumer telemedicine business, has developed a free telemedicine assessment service to disseminate medical information related to COVID-19 on demand. Ro has partnered with infectious disease specialists and uses CDC and WHO guidelines to assess a person’s risk for COVID-19 infection. People who fear that they are experiencing novel coronavirus-related symptoms can complete Ro’s online assessment to determine if they are at higher risks for COVID-19 infection. Afterwards, Ro connects them with proper licensed providers within the US for custom consultations.
Tyto, a $300 telemedicine device, is now being used by physicians in Israel to remotely monitor people with COVID-19. Aided by Tyto, doctors are treating quarantined individuals who were passengers of the coronavirus-infected Diamond Princess cruise ship in Japan. Dr. Eyal Zimlichman, chief medical officer at Sheba Medical Center in Israel mentioned, “Once the COVID-19 outbreak started, we knew we had to immediately adopt the best possible technologies to remotely examine infected patients in quarantine.”
MedWand, a user-friendly gadget which is expecting FDA approval later this year, uses a combination of 10 diagnostic tools and a powerful camera to enable remote medical exams of patients. It can assess respiratory rates and blood oxygen levels, measure body temperature, and perform skin analysis. It further transfers the medical data from a patient’s virtual exam to physicians who can interact through a secure video portal. Dr. Samir Qamar, the CEO and founder of MedWand Solutions, has stated, “MedWand has specific diagnostic instruments to remotely examine coronavirus patients, so we filed for an emergency use authorization with the FDA that would allow us to get these devices into the right hands, right away.”
PlushCare, a San Francisco-based company, accesses a network of online doctors and connects them with patients for birth control and other drugs. Currently, patients who have presumptive COVID-19 symptoms but aren’t seriously ill, are being monitored at their homes using PlushCare’s service.
Current challenges:
Despite having immense potential to tackle the COVID-19 pandemic, telemedicine remains difficult to implement within the current healthcare system. While some large medical centers are compatible with providing care through telemedicine, such is not the case for smaller hospitals and private practices. Such practices need to provide telemedicine training to employees, check insurance reimbursements around telemedicine devices, and update billing procedures, which can be an overwhelming process. Some hospitals also lack the necessary hardware and devices to fully implement telemedicine and thus often cannot deliver such services for COVID-19 patients.
The second challenge with remote management of COVID-19 results from unclear regulatory guidelines in the US. Physicians are eager to reach out to patients outside their licensed states, but several states have not yet finalized their telemedicine policies. As a consequence, medical providers are being forced to research on their own about the permitted usage of telemedicine platforms. While the federal government is being lenient with Medicare reimbursement around telemedicine, healthcare providers still need to be careful about regulations for expanding their services to new states. Furthermore, unlike the federal government, commercial health plans may not pay for telemedicine.
Silver lining:
Despite multiple limitations, implementation of telemedicine for COVID-19 management has just witnessed some hopeful advances. On March 17th, the Trump administration announced an expansion of telemedicine services for American senior citizens who are presently reimbursed by Medicare. Furthermore, Washington state has allowed doctors to treat patients in states where they are not licensed, using telemedicine tools. For ensuring better online connection between doctors and patients, states including Massachusetts and Florida have also expanded telemedicine coverage.
Internationally, several European and Asian countries have increased reimbursement options around telemedicine platforms and expanded statutory regulations to further integrate such services into their healthcare systems. Dependence on telemedicine will certainly surge as the coronavirus pandemic continues to grow around the world. These tools can support measures such as strict social distancing and nationwide lockdown of non-essential businesses, which are essential to bring about a quicker recovery. Hopefully, these approaches will be able to flatten the curve.
