A hundred years ago, family physicians would often arrive at your doorstep and be invited inside to diagnose everything from chicken pox to measles.
Now all these years later, physicians are once again implementing forms of that same house call, only this time with modern day technology like smartphones and computers.
Instead of literally sitting at your bedside like they did back then, physicians can now provide reliable diagnoses from their medical practices across town and perhaps even on the other side of the country without patients ever leaving their living rooms.
Telehealth, also known in some medical circles as telemedicine and virtual care, has revolutionized the medical landscape, experts say.
And in this uncertain time with COVID-19 continuing to cause chaos throughout the world, those experts also noted that telehealth has given patients and physicians both a safe way to still connect.
Adapting to a changing world
Dr. Martha Hoshaw, regional medical director for American Health Network [AHN] facilities in Kokomo, Russiaville and Lebanon, knows fairly well how quickly a virus like COVID-19 can change medical practices.
Prior to mid-March, AHN was still in the development stages of implementing telehealth, she said, with physicians and other medical officials still trying to navigate how to roll out the concept.
Then came COVID-19.
“We’ve definitely had to pivot in this rapidly changing environment,” Hoshaw said. “We changed basically overnight to still be able to see patients and have access to them, but we didn’t want to bring the vulnerable here. … We had to solve a problem quickly, and with virtual visits, we have a secure video availability for each patient so they can connect to us that way.”
Hoshaw said she conducted her first telehealth visit on March 17, and she’s seen many patients since then in a similar format, with most of the consultations dealing with ailments like allergies, rashes, depression and anxiety.
AHN isn’t the only medical organization that has had to quickly adjust to the global pandemic either.
It’s an issue that Ian McDaniel, executive director of virtual care at IU Health, refers to as “forced adoption.”
“Prior to COVID, there was certainly some adoption in virtual care,” McDaniel said. “And in virtual care, you have clinics where you go to a location and then see someone digitally on a screen. Then you also have direct therapy like you’d use from your own house. But what happened with COVID-19 is that you saw acceleration, primarily in that direct therapy space and even in the hospital space.
“Since our clinics were shut down but our physicians and providers were still passionate about delivering care, they came up against a choice,” McDaniel continued. “The only way they could continue to provide the care they wanted to provide was through a virtual means.”
But it wasn’t just physicians who had to adapt to telehealth in a short amount of time, McDaniel noted. Patients had to adjust, too.
“Patients wanted to see their physicians because it was natural and felt like the right thing to do,” he said, “but then you had this notion that if you went out in the community, you were going to put yourself at risk. But if you could talk with your physician or provider through the phone or tablet safely from your own home, why wouldn’t someone choose that?”
Reaping the benefits
An increased access to care is probably one of the biggest benefits to telehealth, the medical experts interviewed said.
“It’s about finding what works for the patient,” Hoshaw said. “Maybe they can’t get a babysitter for their children or take time off work. Say you have a cancer patient who is immuno-compromised that doesn’t want to risk getting out and exposing him or herself. Or maybe someone can’t find a ride to the doctor’s office. All of these scenarios aren’t an issue with something like telehealth.”
Dr. Lisa Koers, a family physician at Fountain Square Holistic Family Medicine in Indianapolis, agreed with Hoshaw.
“You’re touching on the needs for innovation and constantly responding to what the needs are of our healthcare system, and I think direct primary care is a response to what our healthcare system needs,” she said. “… It’s about having that access. A lot of people might live in areas where there are not doctors readily available nearby or maybe don’t want to spend an entire day there. So this is just a great way to increase that access without increasing time and energy.”
And along with saving time, telehealth can even save a patient some money as well.
“Say you’re cooking and slice open your finger,” Christopher Habig, chief executive officer and co-founder of Freedom Healthworks, said. “You can now take a picture of it and send it to your physician and possibly save you a trip to the emergency room. There’s a massive cost savings that comes with that, and that trickles down the line. If you can use telehealth to access physicians, and that can keep you out of the emergency room or hospital, those savings start adding up through the years.”
Hitting the limit
But though there are multiple benefits to telehealth, there are still some limitations as well.
For example, while doctors could perhaps diagnose a rash over a video conference, they can’t take an X-ray, conduct an MRI or perform a biopsy.
“People need to understand that virtual care is not for every single thing,” McDaniel said. “It’s good for a lot of pieces of healthcare, but it’s not going to become the only part of healthcare. We actually have tools in our system that we can hear the heart and lungs now, and we can see a good throat exam or do a self-guided ear exam. And those are going to continue to proliferate across the country. But there are still situations that just won’t fit.”
Hoshaw also added that the lack of human touch is probably one of the biggest drawbacks to telehealth.
“Often, especially with our older patients, their doctor visit is actually an important part of their social life,” she said. “They have a special relationship with our staff, and they often use that human touch to combat loneliness. … So when that human touch isn’t there, it’s difficult.”
Wave of the future?
And because there are still limitations, all the experts interviewed said telehealth will continue to be an effective tool for physicians to have in their arsenal.
But it likely won’t replace the physical visit anytime soon, they said.
“The pandemic has been incredibly dark for a lot of people, but if there is a light in that darkness, it’s the forced adoption of virtual care,” McDaniel noted. “And that medical care now will never be the same because of it, and that’s mostly for the good. And this might even replace 100% of some doctor visits, but it will never replace them all. So we’ll just have to watch and see which ones it will.”
For Habig, the increased popularity in telehealth shows a tremendous promise for the future of the medical industry, he said.
“This is something that’s here to stay, and I actually think it’s probably five to 10 years too late. When you could text Domino’s for a pizza but you couldn’t text your doctor, there’s a problem. So I do think healthcare was way behind on modern times, and this is healthcare finally catching up with the rest of the world.”