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Telehealth likely here to stay after coronavirus pandemic

Jim Little
Pensacola News Journal

There's no doubt that the coronavirus pandemic has impacted the world of health care, and one lasting positive impact that Pensacola health care providers agree upon is the embrace of telehealth.

Health care providers from large hospital systems to small doctor's offices have dramatically increased the use of telehealth, essentially conducting doctor's visits virtually using video call software, since the start of the coronavirus pandemic and subsequent emergency public health orders urging people to stay home.

Dr. Thabet Alsheikh, an electrophysiologist at Baptist Health Care's Heart and Vascular Institute, said telehealth wasn't part of his practice before COVID-19.

"Of course, COVID came along and everything's different," Alsheikh said. "This is something we never experienced before."

Alsheikh said he was nervous that the technology would cause problems being able to meet with patients, but he said the experience has been great and he's excited about the future of the technology.

"It really has been very convenient for the patients I have seen," Alsheikh said. "I have seen a few patients not only from the comfort of their home, but their place of work, and one of them was at a construction site. A few patients in their car, and you say, come on, is this medical care? I think telehealth has provided the opportunity to provide the care without compromising the quality, while keeping the patient comfortable in the setting they are comfortable with, whether their car, their home, or their relative's home where they're staying in this time of crisis."

Dr. Randall Reese, a pediatrician at Pensacola Pediatrics, said his office quickly ramped up its telehealth capacity, which has not only allowed the doctors to continue to see patients, but has also sped up in-person visits.

Reese pointed to one recent example where he figured out that a child developed a limp because of walking on an unfinished deck barefoot, getting several splinters in his foot.

"Limping can be serious in a small child, so I started the visit with the telemedicine, but then I brought them in the office rapidly, determined it was splinters and removed them," Reese said. "So it was kind of a combination telemedicine/in-person visit, but the in-person visit was a lot faster because I'd already done the ground work before."

Reese said his office has planned for two years to start offering telehealth.

"We've been talking about it, but one distraction would come up after another one," he said. "But when we saw that coronavirus was coming, we rapidly implemented it. So within about a three-day period, we started doing telemedicine."

Telehealth is not new, but regulatory hurdles, mainly how much health care providers can be paid for telehealth visits versus in-person visits, disincentived widespread use.

Jacob Fischer, director of clinic operations at Ascension Sacred Heart in Pensacola, said Sacred Heart launched a telehealth platform for virtual urgent care about four years ago. He said the hospital system has gone from seeing almost no patients via that method to now seeing 2,500 patients a week.

"One of the things that made this possible was that from a national perspective and state perspective, a lot of regulatory and reimbursement administrative burden was lifted during this emergency period," Fischer said. "So stuff that 11 weeks ago, I could not get reimbursed for doing virtually in the state of Florida, we're getting reimbursed for now. And the real winners in that equation are patients because we're not seeing any more visits than we were before. We're seeing less (in-person) right now, but more virtually, but our patients are being able to get the care they need while staying at their house."

Baptist Health Care has seen more than 12,000 patients virtually since the coronavirus pandemic, according to Brett Aldridge, vice president of strategy and business development. He agreed that regulation had kept the use of the technology low pre-COVID-19.

"Now that that has been opened up and those restrictions have been loosened, it's made the number of use cases grow rapidly," Aldridge said. "And so, there's really a direct correlation between the regulation and restriction to the utilization."

Fischer said the coronavirus pandemic has shown the world that telehealth should have a permanent place in patient care and hopes that the Florida Legislature will take up the issue to allow regular reimbursement for the service.

Both Fischer and Aldridge said Ascension and Baptist patients have reported high satisfaction with the telehealth visits.

For Alsheikh, who sees patients from as far away as Panama City and Andalusia, Alabama, one of the major benefits, besides patients not having to travel for hours, is that the patients can talk with their doctor with other family members there who may not usually be able to go along to in-person doctor's visits.

"What has been beautiful is every patient I've seen, most of them had other family members joining in the conversation," Alsheikh said. "So the flexibility of having more members joining — not just the one who's giving you a ride or the one who has time to come and talk with you about the patient's condition — that has been very convenient. I felt in some cases, the care has been more comprehensive because you get in more family members involved."

Alsheikh said post-COVID-19, not every patient or visit is a right for telehealth, but there are a lot of visits that could be done that way and believes it is a positive for medicine that will emerge out pandemic as America rebuilds.

"I really believe we have had a lot of negative impact, and a lot of things we changed as a result of COVID," Alsheikh said. "But I think while COVID crisis took away a lot of normal and routine and regular life activities, I think it brought about amazing, positive opportunities that are here to stay and for a positive impact that will be long lasting."

Jim Little can be reached at jwlittle@pnj.com and 850-208-9827.