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Coronavirus has forced doctors

Coronavirus has forced doctors, insurers to embrace telemedicine like never before

Topic: Coronavirus has forced doctors, insurers to embrace telemedicine like never before

When pain radiated from Fred Thomas’ neck down his arm and he couldn’t feel his fingers anymore, he knew it was time to talk to a doctor.

After getting an MRI ordered by his primary-care doctor, the 49-year-old land surveyor had several phone conversations with a Rothman Orthopaedic Institute specialist he’d never met to discuss the problem and treatment options. He was scheduled for a cervical fusion to replace three damaged disks in his spine a couple weeks later.

“By the time I met him, I felt like I’d been in his office 15 times,” said Thomas, who lives in Wilkes-Barre. “We spoke in person for the first time a few minutes before he operated.”

Months ago, few patients or doctors would have considered surgery without so much as an in-person consultation, but the coronavirus pandemic has forced the health care system to embrace telemedicine like never before.

With no other way to see a doctor as the virus shuttered all but the most essential health care services, regulatory hurdles that hamstrung the growth of telemedicine for decades were wiped away: Private insurers, Medicare and Medicaid agreed to pay the same rates for telemedicine visits they would have for in-person appointments. The federal government loosened privacy regulations that had in the past restricted how patients and doctors communicate virtually.

In response, telemedicine visits soared. The approach has been exceedingly popular among patients and doctors, and so universally adopted by health systems that experts say telemedicine is likely here to stay. Not only have health systems proven that telemedicine is an effective and useful tool for treating existing patients, virtual doctors’ visits also present an opportunity for health systems now forced to grapple with the racial inequities highlighted during the pandemic to improve access to care.

“We have this opportunity as the result of a very horrific, virulent disease to reimagine health care,” said Nicol Turner Lee, a senior fellow at the Center for Technology Innovation at the Brookings Institution.

But maintaining telemedicine will be possible only if providers and insurers are able to agree to fair payment, and if regulators are able to work out security and patient privacy issues.


When the pandemic shut down non-urgent medical services in Philadelphia in March, Penn Medicine quickly equipped nearly 9,000 providers to meet patients by video or phone and now averages 5,000 telemedicine visits a day — a nearly overnight change from a few hundred doctors doing a few hundred visits.

While in-person visits plummeted 90% at Jefferson Health, virtual visits rose from a couple hundred a week in February to 20,000 a week in June. Some of those calls were about coronavirus, but the vast majority were “regular doctors’ visits,” said Judd Hollander, senior vice president for health care delivery innovation at Jefferson Health.

“Telemedicine grew out as rapidly as it did because people were afraid of COVID and because reimbursement models changed,” said Hollander, an emergency medicine doctor.

Jefferson is now bringing back patients for in-person visits, but Hollander expects that about a third of visits will remain virtual — in part because of how popular the approach is with patients, who score telemedicine “light years ahead” of office visits on patient satisfaction surveys for its convenience.

“They’ve seen the benefit of staying home,” he said.

For Thomas, meeting with his specialist at Rothman Institute by phone or by video eliminated the need for multiple, day-long trips into Philadelphia. That journey would have been especially difficult after his surgery, when he was not able to move his neck for several weeks. He had follow-up scans done near his home and spent a few bucks to mail them to Rothman — far less than he would have shelled out on gas and parking.

Topic Discussed: Coronavirus has forced doctors, insurers to embrace telemedicine like never before

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