Doctors turn to telemedicine in the Coronavirus Outbreak

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The use of virtual visits climbs as a way of safely treating patients and containing the spread of the infection at hospitals, clinics, and medical offices. The man had recently traveled, including a brief stop in Tokyo. He had a fever and cough about a week ago, but was now feeling fine.

He called the virtual medical line set up by Rush University Medical Center in Chicago recently to help screen patients for coronavirus.“He said all the right buzzwords: cough, fever, fatigue,” said Dr. Meeta Shah, an emergency room physician at Rush. After talking with him, Dr. Shah did not think he needed to be admitted but referred him to the city’s health department.

Rush and other large hospitals across the country are quickly expanding the use of telemedicine to safely screen and treat patients for coronavirus, and to try to contain the spread of infection while offering remote services.“This is a kind of turning point for virtual health,” Dr. Shah said. “We’re actually seeing how it can be used in a public health crisis.”

Health systems are racing to adapt and even develop virtual services that can serve as their front line for patients. “Telehealth is being rediscovered,” said Dr. Peter Antall, the chief medical officer for AmWell, a company based in Boston that is working with health systems across the country. “Everybody recognizes this is an all hands on deck moment,” he said. “We need to scale up wherever we can.”

By using their phone or computer, patients will be able to get guidance about whether they need to be seen or tested instead of showing up unannounced at the emergency room or doctor’s office. Patients, particularly those who would be at high risk for a serious illness if they were infected, can also opt to substitute a trip to a doctor’s office with a virtual visit when it is a routine check-in with a specialist or a primary care doctor. That way they can avoid crowded waiting rooms and potential infection.

While the notion of seeing a doctor via your computer or cellphone is hardly new, telemedicine has yet to take off widely in the United States. Health insurance plans do typically offer people the option of talking to a nurse or doctor online as an alternative to heading to an emergency room or urgent care center, but most people don’t make use of it. Now doctors, hospital networks and clinics are rethinking how the technology can be used, to keep the worried well calm and away from clinical care while steering the most at risk to the proper treatment.

“The use of telemedicine is going to be critical for management of this pandemic,” said Dr. Stephen Parodi, an infectious disease specialist, and executive with The Permanente Medical Group, the doctors’ group associated with Kaiser Permanente, one of the leaders in the use of virtual visits for its patients.

Telemedicine companies say they are getting an increase in the number of calls, both from those who want to know more about what they can do to minimize their risk of catching coronavirus and those with worrisome symptoms. “We see the whole spectrum of patients,” said Dr. Kristin Dean, medical director for Doctor On Demand, a company whose service is offered to customers of some of the major health insurance companies.

In evaluating whether patients may be safely monitored at home, doctors take into account people’s medical history and the severity of their symptoms, she said.

“The patients have been appreciative of that switch,” said Dr. Parodi of Permanente. “Many of them don’t want to come in and be exposed in a clinic or office setting.”

The system is also thinking about how it can use the same technology to deliver home health care, particularly for patients who are at high risk because of chronic medical conditions or have Covid-19 but can be treated safely at home. People at home could be equipped to take their blood pressure or test their blood sugars, and a doctor or nurse could be available over video.

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