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Telehealth helping medical community, patients connect

From the Coronavirus collection: March 22 through April 15 series
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Telehealth consult

Dr. Matthew Pender conducts a telehealth consult recently.

The coronavirus pandemic has made all people change their lives in some form. For the medical community, it has meant fewer in-person appointments.

Many medical practitioners, however, are using telehealth — in which electronic information and telecommunications technologies can aid clinical health care — to stay in touch with patients.

The most used part of telehealth is videoconferencing, but medical practitioners also have access to imaging, streaming media and other things, such as records, on the internet.

Patti Hammond, the vice president for physician practice management at Glens Falls Hospital, said the hospital has been looking into telehealth for over a year.

“But there were some regulatory issues,” she said. “Until they were loosened with the current COVID-19 crisis, we couldn’t use it. We’re thrilled with the opportunity to have this.”

One of the issues was that some telehealth software is not compliant with the Health Insurance Portability and Accountability Act that protects patient privacy. That’s the case for Dr. Carol Fisher, an orthopedic surgeon at Adirondack Orthopedic.

“For patients who fit the criteria, they have to agree that it’s done over an unsecure line, so it’s not HIPPA-compliant. Most trust it and don’t have a problem with it,” Fisher said.

Glens Falls Hospital uses doxy.me, which is HIPPA-compliant and can be used on a phone, tablet or computer. Both Fisher and the staff at the hospital have the ability to call up a patient’s medical records and other necessary documents on the screen while also viewing the patient.

“The physician actually has two screens up — the patient on one and their documenting on the other,” Hammond said. “There is a monthly fee to use it. For us it’s $50/month for each provider, and that is an ongoing cost for us.”

Patients seeing a practitioner from Glens Falls Hospital need Google Chrome or Firefox web browsers for the video application. Hammond said the hospital must first get a verbal consent from the patient. Once that is given, the patient is put in a virtual waiting room and then seen by the practitioner.

Mary Beth McCue, a dietitian and functional medicine nutritionist at One Roof Holistic Center in Saratoga Springs, sends her patients an email link.

“They click on the link to complete their forms and it’s a patient portal that allows them to do telehealth,” McCue said.

Before the pandemic, there were questions about telehealth billing, but medical providers will be reimbursed at the same rate as a regular office visit, at least temporarily. Medicare and Medicaid and most major insurance companies have relaxed prior reimbursement restrictions.

The pandemic has forced some providers into telehealth more quickly, but it has also made people in the medical field realize how much can be done using it.

McCue said she has been talking more about telehealth in the last few days than she ever has. She, like most local practitioners, has been using it for the last 10 days to two weeks.

“If we want to get people healthy, we should do it now,” McCue said.

“Every medical practice is probably going to do it to the extent they can,” Fisher said.

Of course, patients can opt for just a telephone visit/checkup with a practitioner. Hammond said that between the telephone and telehealth, hospital staff members have had more than 1,300 visits in the last 13 days.

“We feel it’s going to be used widely throughout our practices. It’s another tool in our toolbox,” Hammond said.

The practitioners say that, outside of the COVID-19 situation, they’d prefer to see patients in person — especially at first — but that telehealth can work well with follow-ups.

“I see people for six to 12 months usually,” McCue said. “The real work is coming back, and you find out what’s working and what’s not; you tweak and change things. And with telehealth, we’re looking at each other and really listening to each other. It’s more captivating.”

In her line of work, Fisher said there are obviously some situations in which she needs to assess a patient’s condition with her hands. But telehealth is helpful for most situations.

“Seeing how far a patient can walk, observing coloring or swelling and range of motion we can do,” Fisher said.

“A lot of our diagnoses are based on the patient’s history,” Fisher added. “I can look at X-rays remotely. But if you were a new patient with a new problem, there would be things I’m not sure of and I can say, ‘Let’s try something,’ but if that doesn’t work … but most of our patients we already know.”

Follow Will Springstead on Twitter @WSpringsteadPSV.

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