Telehealth is nothing new. In fact, the distribution of health-related services and information via telecommunication technologies can be traced back as far as 1948, when radiologic images were sent via telephone. The evolution and broad adoption of telehealth, however, has been slow. Advances were made in 2016 when The Health Resources and Service Administration (HRSA) received 16 million U.S. dollars in an effort to expand rural access to the telehealth services.
But there is nothing like a crisis to spark a breakthrough!
What was once intended to bridge the gap between providers and those in remote areas, those who had limited travel mobility, and those who were underserved suddenly grew exponentially and became mainstream at the onset of the pandemic. Once primarily reserved for long distance communication between healthcare providers and patients, telecommunication became much more than an avenue to communicate care advice, medication management, intervention, and education: it became the lifeline for patients seeking medical care in a time of an international crisis.
At the onset of the pandemic, healthcare providers were forced to turn to telehealth, a virtual experience that had been met with resistance in many populations, such as the elderly and foreign-language speakers, prior to the pandemic. As it turned out, though, many found the experience—undergone out of necessity—to be not only effective but also a comfort in uncertain times, when anxiety over leaving home was at its height.
Since the inception of telehealth, there has been questions about the intimacy of the experience: could the cherished and trusted relationship between provider and patient be truly honored? Or even maintained at all? There is also the question of whether the use of telehealth, which has been widely adopted, will persist once the pandemic subsides or passes.
In the fall of 2020, the COVID-19 Healthcare Coalition published the results of its Telehealth Impact Physician Survey, having surveyed more than a thousand healthcare organizations. The purpose of the survey was to look at how telehealth served the clinical needs of patients during the pandemic and, at the same time, get feedback from physicians on the kinds of telehealth platforms and technologies being utilized. The survey also accessed providers feelings about the benefits of telehealth and its use during the pandemic. Here were but a few of the findings:
“More than 75% of respondents said telehealth enabled them to provide quality care of COVID-19-related care, acute care, chronic disease management, and hospital/emergency follow-up.
Improved patient health noted by 60% of respondents
Increased motivation to integrate telehealth across 68% of practices.
Improved job satisfaction among 55 % of survey participants.”
The case for merit in the use of telehealth was strong for providers, but what about those on the receiving end?
I can only speak from my own personal experience. My husband and I are responsible for the care of my husband’s 83-year-old father.
During the course of the pandemic, my father-in-law had been experiencing declining health over a six-month period. Countless diagnostic tests with no significant findings, and examinations by many specialists and sub-specialists, turned up nothing. After a weight loss of 40 pounds and weekly platelet infusions to sustain him, we turned to the Mayo Clinic in Jacksonville, Florida, in desperation. He had a battery of diagnostic tests at Mayo and then returned home where, one week later, he had a telehealth visit to be given the findings of the tests. I was present for the telehealth visit. A cardiologist, who we had never met before, was speaking on behalf of an entire medical team, who had met in advance of our call. He addressed our family by introducing himself and then asking who was present in the room with my father-in-law. Immediately after the introductions, his very first words to my father-in-law were, “First, I want to say how sorry I am for the rough time you have had over the last 6 months with your health.” And then he paused. At this point I was off camera and I began to cry. It had been a very difficult time for our family and to hear someone we have never met acknowledge our pain was not only surprising but exactly what we needed to hear. This clinician understood from a chart review, medical history, and clinical findings that we were a family who was exhausted and desperate. A little empathy went a very long way in that moment.
The ability for a provider to be empathetic in a moment we need it most didn’t take any more than a few seconds. He had won our trust immediately. One of the many benefits of the tele visit was that the entire family could meet the physician who would eventually be entrusted with my beloved father in law’s life. I had the opportunity to ask the questions that I had from a clinician’s perspective. His wife could ask questions about recovery time (after surgery), and his son could ask about the duration and logistics of his father’s impending hospitalization.
The human connection that has forever allowed us to trust our lives to physicians is still possible with the telehealth experience and with a concentrated effort to connect- perhaps it can even be better. The lack of disruption, the eye-to-eye contact, the comfort of the patient meeting the physician in their own home, the timeliness of the appointments, saving the travel and expense all contributed to an experience that none of us will soon forget.
Telehealth most definitely is here to stay. And it can be done well to include the experience that every patient needs and wants when their health is compromised. And although there will always be a place for the in-person visit, telehealth is the perfect setting for medication management, follow up visits, education and evaluation.
If telehealth is to be embraced going forward by patients, providers will need to move beyond the mechanics of the visit, make a conscious decision getting inside the mind and heart of the patient and extend themselves in ways that are deliberate, showing empathy that every patient seeks.