Boston Hemophilia Center

Contact the Boston Hemophilia Center 617-355-6101
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Contact the Boston Hemophilia Center 617-355-6101
International +1-617-355-5209

Telehealth: Connecting in the time of COVID

Physician perspective

by Aric Parnes, MD, Associate Director, Boston Hemophilia Center

Telemedicine and telehealth encompass many forms, from virtual visits (seeing patients through the internet) or telephone visits (talking to patients on the phone) to e-consultations (when I offer advice through a portal such as e-mail or the electronic medical record).

I realized the potential for telemedicine and particularly virtual visits early on. During my first virtual visit, I saw the patient face to face.” We had a meaningful discussion about her medical concerns. I ordered blood work, prescribed an effective treatment and answered all her questions, all in the comfort of our own separate lodgings. I believe we connected.

The patient loved it, because she did not have to leave her home, did not have to wrestle with Boston traffic, or pay for parking, find her way around the conglomerate of buildings that make up a very large Harvard system of hospitals and waste hours of her day for a seemingly short 20-minute session. Did I mention that this encounter took place in 2017 when we first started doing virtual visits?

Yes, I have been doing virtual visits for a number of years, starting when Brigham and Women’s Hospital (BWH) and Dana- Farber Cancer Institute realized the future of medicine might be electronic and if we were to keep up with a changing world, we would need to develop these skills soon. As of February, BWH providers in total were performing about 50 virtual visits a day. Nearly overnight, these numbers sky-rocketed to 500 a day, all a result of a virus known in the medical literature as SARS-CoV-2 and to the rest of the world as COVID-19.

As COVID-19 suddenly encroached on our lives, society went into hiding and we urgently needed to take care of patients in a new way. The spreading virus pushed hospitals around the world to engage in telemedicine. Most of us saw this service coming, but we never anticipated it to be the preferred technique for medical visits so soon— at least, not today.

Telemedicine is not for everyone. For instance, some individuals may be technologically challenged, some may not have a good Wi-Fi connection, and some may require a thorough physical examination for appropriate patient care. We cannot always diagnose someone by talking to them or looking at their labs. Sometimes, these healing hands need to examine the patient. And if we have a sense that in- person contact is vital, we will make that happen.

But for now, while we all try to stay safe and socially distant, I will embrace telemedicine. Most importantly, I remind our patients not to forgo their own health.

I understand that many of us are scared about catching COVID-19, and rightfully so, but it cannot be at the expense of ourselves. Don’t ignore chest pain. Don’t ignore shortness of breath or other concerning symptoms. Don’t ignore a bleed. Don’t ignore your mental health. Get some fresh air. Get some exercise. Zoom with friends. Zoom with your health care providers. Let’s stay connected and help each other during this unprecedented time.

Patient perspective

by Peg Geary, MA, MBA, MPH, Project Manager, BHC

The COVID-19 pandemic has advanced a relatively new approach to health care — namely, telemedicine and telehealth. Although telemedicine has been a developing technique in recent years, it was not commonplace and was primarily used as a way to offer medical services to rural areas of the country. Telemedicine usually refers to the use of highly-technical services and electronic communications to provide clinical services to patients who are physically separated from their providers. The term “telehealth” is broader in scope and usually refers to the provision of both clinical services and nonclinical services to geographically distant recipients of health care services.

Suddenly, virtual medical visits are accessible to almost anyone. It is a different medical experience, one in which you can actually see and be seen by your clinician in your own home. Let’s take a look at telehealth from a patient’s point of view by listing some of the positives and negatives of these visits.

Positives

Convenience. Could any medical appointment be more convenient than one that takes place in the comfort of your home? Where else could you roll out of bed, turn on your computer and be “seen” by your doctor? There is no commute, no wait, no need to dress up, and no need to do anything other than let your provider into your home virtually.

Financial benefits. In most cases, it is much more affordable to have a telehealth visit rather than go to a medical facility. You save money if you don’t have to commute. It can be quite expensive if you add up your gas, tolls and parking costs. Even if you don’t drive to your medical appointments, it can be costly to take public transportation or use services like Uber.

More services for patients with limited ability to travel. For years, if you couldn’t get there, you couldn’t get medical services. This greatly reduced the opportunity for patients with limited physical mobility — or no transportation method — to access some health care services. Now, these patients can take advantage of virtual telehealth appointments.

Increased availability of long-distance clinical services. Even for patients who can travel, second opinions or consults out of your area, state or even country were difficult to consider and arrange. Telehealth makes global consults a reality.

Negatives

Need for expensive equipment. Depending on the communication method used by your provider, a patient needs to have access to certain equipment and services, like a computer, a smartphone, WIFI, etc. These devices and services can be expensive and difficult to obtain in some areas. So, telehealth may not be a realistic venture for some patients.

Promotes isolation. While a telehealth visit may seem convenient for many patients, it may present others with a reason for not venturing out of their homes. This might limit social and physical activity for people who could benefit from getting out of their homes and into their community.

Need to be seen. There will always be situations in which the provider needs to see or examine a patient. Some individuals may require further medical/lab tests and services.

If you would have asked me a few years ago what I thought about long-distance health care, I would have laughed. Was that something from the movie, “Star Trek”? Now that I have experienced telehealth visits, I am sold, and I hope they are here to stay. I encourage you to try them if you haven’t already. You may be pleasantly surprised — the future is here.


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