COVID-19 and Telehealth: Technology Can Help Us Triage a Nation in Crisis

In three short months since the outbreak of coronavirus disease (COVID-19), life as we’ve known it has been turned upside down. Stocks are tanking. Stores are cleared out of essentials, such as milk, toilet paper and hand sanitizer. Travel is grounded. Schools and public events are closing. Employers are sending workers home. With a fatality rate 20 to 30 times higher than the flu, and a shortfall of test kits and components, fear of this growing pandemic is palpable, rising and threatening to overwhelm the health system.

Hospitals and healthcare providers are girding up for what promises to be a battle unlike anything we’ve seen. In the worst-case scenario (not accounting for interventions now underway), disease modelers predict between 160 million and 214 million people in the U.S. could be infected over the next year, resulting in as many as 200,000 to 1.7 million deaths. Even the most conservative estimates report running out of hospital beds by the third week in May.

In light of the crisis, and bolstered by the passage an $8 billion emergency response bill that lifts restrictions on Medicare telehealth coverage, telehealth is finally getting the attention it deserves. A growing number of hospitals and healthcare providers are turning to virtual consults to help identify, monitor and slow the spread of the virus. Equally important is its ability to help ease the stress and anxiety arising from communication breakdowns as traditional modes of outreach are overwhelmed or unavailable.   

Improving access and intervention

To mitigate the risk of spreading the disease, the CDC is asking patients to call ahead before seeking face-to-face medical care. The problem is that phone lines are tied up and in-person visits have the potential to put others, including much-needed healthcare workers, in harm’s way. Providers desperately need a tool to help quickly sort out instances of seasonal allergies, the cold or flu from the disease – without tying up resources.

Telehealth can help by allowing providers to safely evaluate and identify potentially infected patients – whether through video conferencing or text-based communications. If a patient is at high-risk for contracting COVID-19, or has been diagnosed with it based on symptoms, they’ll most likely be advised to stay home and self-quarantine, since there aren’t enough test kits to go around and no available vaccination. In these situations, virtual consults can help providers keep a watchful eye on disease progression, enabling them to treat and monitor patients with milder cases and know who is sick enough to refer to a hospital.   

Preparing rural communities for the inevitable

COVID-19 isn’t just an urban area issue. While rural towns are more isolated and spread out, they are not shielded from the virus. If anything, they’re more vulnerable to the disease because their populations tend to be older, sicker and have fewer resources. It’s only a matter of time before virus shows up. Rural communities need to implement telehealth now to help slow the spread of transmission, and improve access to needed care and services. However, it’s important to keep in mind that broadband is lacking. Many rural areas have limited internet or no internet at all, making video teleconsults or even logging into an EHR portal difficult if not impossible. Providers should instead leverage a text-based telehealth platform that lets rural Americans use their cellular service to stay connected, report issues and keep up with their existing care plans for any pre-existing conditions. 

Modernizing healthcare communications

Despite the digitization of healthcare over the past two decades, communications strategies haven’t kept up. Most providers still rely on in-person consults, telephone calls, voice messages and answering services. These one-to-one methods of communication are inefficient, resulting in bottlenecks, delays and frustration. As communities are hit by the outbreak, we’re hearing stories of patients waiting on hold for more than four hours to speak to clinical staff. . The phone system will soon be completely overwhelmed, adding to the confusion, anxiety and stress.

Virtual consults can help providers manage resources and triage patients concerns quickly and easily whether through live two-way video conferencing, store-and-forward communication, remote patient monitoring, or asynchronous messaging and texting. All modalities have their benefits, but texting turns out to be the most practical, expedient and capable of handling a large number of patients.

Meeting patient demand with texting

Despite the many benefits of telehealth, not all are created equal when it comes to consolidating and streamlining communications. The crisis is showing these limitations as some telemedicine services crash, are slow to load and causing long wait times, or have bugs to fix. In hospitals, clinical integration with telehealth services is also a struggle and many solutions don’t integrate with electronic health records. Platforms, too, are often complex, unwieldy and can take a long time to implement and learn. Providers need a simple, clear and direct approach that can be deployed in a matter of hours, not days.

Text messaging stands out as a promising alternative for all these reasons. Texting allows for multiple real-time conversations, so clinical staff can triage questions from 6-10 patients at a time and route them to the most appropriate resource. In this way, practices can have the right people having the right conversations at the right time for the right action – whether to refill prescriptions, quell fears, monitor symptoms or route cases to a testing facility.

Maintaining humanity in a time of uncertainty

Hospitals that are leading in patient-centered care understand they need an effective communications strategy to reach patients where they are. They’re beginning to leverage communications platforms that support secure messaging, social media and telehealth capabilities to better communicate with patients in their preferred manner. These platforms enable providers to reach more patients, triage them quickly to maximize resources, and improve care collaboration, coordination and communication. And they can do all this while treating the very real emotional and psychological toll of the disease in a way that strengthens the patient-provider relationship by delivering more personalized care.  

About the Author

Kathy Ford is president and chief product officer for Rhinogram, a HIPAA-compliant, telehealth communications platform.