Christopher Cowan has left his house only twice since COVID-19 hit the U.S. in March.
The North Stonington, Conn., resident has serious underlying conditions that could be problematic if he were to be infected. He’s a diabetic, a disease that caused him to go blind about six years ago. Cowan also has had a foot amputated and a kidney transplant because of diabetes.
Both times he left his house in recent months were for doctor’s appointments at Westerly Hospital, he said: one in May to examine the amputation and the other in July for a checkup on his new kidney.
That’s not to say Cowan has missed the rest of his frequent appointments.
He’s consulted with his cardiologist, neurologist, primary care physician, diabetic doctor, and has even had wound-care assistance without leaving his home, thanks to the new emphasis on telemedicine during the pandemic at health care institutions such as Westerly Hospital.
“It makes it so much easier for me. I can’t see, so I don’t have to worry about social distancing or sitting around in a waiting room,” said Cowan, who is assisted by his wife during telemedicine appointments.
Cowan is one of countless nongeriatric patients with underlying health conditions who have adopted telemedicine in droves because of its safety during the COVID-19 crisis, because of its convenience and because health insurance companies have provided coverage for virtual medical visits since the start of the pandemic.
In Rhode Island, it has been so effective in getting chronically ill patients critical care without risking infection that Gov. Gina M. Raimondo extended her executive order on mandatory telehealth coverage until Aug. 3 and indicated she’s willing to work with the General Assembly to make it permanent.
It’s not just doctor’s offices that have turned to telehealth. Hospitals have done the same.
“When the pandemic really hit us, we realized that patients were not coming to the hospital,” said Susan Korber, associate chief nursing officer for Rhode Island Hospital and vice president of the Cancer Institute at Lifespan Corp. “Patients with follow-ups did not want to come to the hospital and no one was encouraging them to. But they are cancer patients and need care.”
After expanding telehealth capabilities during the pandemic at Lifespan, Korber said she saw visits that didn’t require active treatment, such as psychology visits, outpatient and survivorship programs, go from an almost total no-show rate to “everyone logging on and participating.”
And telemedicine is being used for inpatient treatment, too.
At Westerly Hospital, owned by New Haven, Conn.-based Yale New Haven Health System, 33 telehealth carts have been deployed inside patient rooms, allowing assessments of COVID-19 patients remotely and time-efficiently, without putting medical staff at risk.
The portable carts, which include two-way audio and video technology, have resulted in more than 770 telehealth sessions alone, according to the hospital.
Dr. Kevin Torres, the associate chief medical officer at Westerly Hospital, acknowledged that telemedicine does not replace in-person interactions between a patient and doctor, but during the pandemic, virtual appointments have ensured that patients aren’t falling through the cracks, he said.
But Dr. Susan Duffy, an attending physician in the emergency department at Hasbro Children’s Hospital, said there are still challenges with the technology.
While younger people generally are comfortable with the technology and will embrace its use, others might not have access to the needed equipment, can’t afford it or lack the training to use it.
“[Telemedicine has] really been a game changer, a disruption … it’s really going to change how we provide health,” said Duffy. “But it gives access to certain populations, but we still have to work to make sure that all people have access.”
Dr. Jody Underwood, psychiatrist-in-chief at Rhode Island Hospital and The Miriam Hospital, is trying to do just that.
She said telehealth was embraced by more than 100 providers and 60 office managers in her system, where nearly 28,000 outpatient psychiatry visits were conducted for both new and established patients. She said her departments received a Rhode Island Foundation COVID-19 Behavioral Health Fund Grant to purchase 200 computer tablets, with hot spots, in an effort to work toward equity.
“In the long term, we are hoping to break barriers to care,” said Underwood. She said if the governor’s executive order expires and telemedicine is still not covered, then some of these patients will lose care altogether.
For Cowan, he fears losing his ability to get care if telehealth is not covered with insurance plans.
“I don’t know what I would do without telehealth,” said Cowan. “I’m not leaving the house until there’s a vaccine.”
Alexa Gagosz is a PBN staff writer. Contact her at Gagosz@PBN.com.
