Guest Column | September 29, 2020

Telehealth For Chronic Care Patients During COVID-19 And Beyond

By Michael Morgan, CEO of Updox

Virtual Covid 19 Clinical Trial

Ensuring that patients with chronic conditions receive the routine care they need is an ongoing challenge for healthcare providers on an average day. Add a global pandemic, which seriously impacts those with ongoing medical concerns, and it becomes exponentially harder. 

Since the rise of COVID-19, nearly half of all Americans have postponed or skipped medical care. Similarly, health centers saw a 43 percent decline in the number of patient visits compared to pre-pandemic rates, as individuals sought to avoid "non-essential" appointments to limit exposure to the virus. On the flipside, COVID-19 accelerated patient use of telehealth, growing from 11 percent of U.S. consumers in 2019 to 46 percent currently – as a result of in-person care visits being replaced by remote care. As a result, healthcare providers have ratcheted up their virtual care offerings, seeing between 50 and 175 times the number of patients via telehealth during the pandemic than they did before. Now, healthcare physicians strive to find the right balance of in-office and virtual care to best meet the needs of the practice and its patients.

Real Applications And Real Results For Chronic Care Patients

The impact of COVID-19 on routine care hit several groups particularly hard. A survey of patients reported that more than one-third of those with diabetes were impacted by the reduction in healthcare resources,  followed by patients with chronic obstructive pulmonary disease (COPD), hypertension, heart disease, asthma, cancer, and depression. The same survey noted that 67 percent of healthcare providers saw moderate or severe effects on their patients as a result of changes to healthcare services during the coronavirus outbreak.

Danny Butler, MD, an internal medicine physician in Kentucky, provides primary care services to about 5,000 patients. Pre-COVID, his clinic had never used telehealth before. But that all changed on March 11, 2020, as 90 percent of his patient appointments became virtual nearly overnight. During this time, telehealth enabled Dr. Butler to triage and follow up with patients, many of whom have chronic conditions.

Early in the pandemic, for example, a patient with COPD was scheduled for a follow-up, but she feared an in-person visit since she was at high-risk for severe complications related to COVID-19. Using telehealth in place of a virtual visit, Dr. Butler could see the patient was breathing heavily. Once probed, she admitted to feeling bad for several days and not having the energy to even walk to the bathroom. Due to the seriousness of the situation, Dr. Butler was able to quickly act and develop a care plan for the patient, first encouraging her to head to the emergency room to better maintain her breathing and to receive critically needed COPD treatment.

For another patient, Dr. Butler was able to address severe anxiety through a video visit. By observing facial expressions and body language that signaled potential issues, he facilitated an open dialogue with the patient and provided aspects of care that would not have been possible with just a phone call. 

While many of the initial telehealth visits were for acute issues, Dr. Butler's practice is now increasingly using the technology for managing chronic conditions. And a result, nearly 40 percent of his patients choose telehealth today because they like the convenience, ease-of-use, and flexible access to their doctor.

A Long-Term Solution For Providing Quality Patient Care

Going beyond the immediate response to COVID-19, telehealth solutions can help providers address the ongoing challenges of -- and growing need for -- chronic care management. Today, more than 157 million Americans currently suffer from chronic conditions, which account for nearly three-quarters of all deaths. Furthermore, these preventable conditions account for nearly 86 percent of healthcare costs.

The experience with telehealth solutions during the pandemic has given Dr. Butler and thousands of physicians like him a first-hand look at how promising and flexible this level of virtual care technology can be for chronic care management. For chronic care patients, telehealth offers many benefits, including:

  • Greater Access to Care: Patients in rural areas, or communities that lack primary care doctors or specialists, often find it difficult to travel to and from doctor’s appointments. Utilizing telehealth, however, patients can regularly see their doctors from the comfort of their own home, and more easily consult with specialists as needed.
  • Remote, Real-Time Monitoring: Patients living with diabetes, COPD, or heart disease need their vitals checked frequently, as any slight change may signal serious issues. Plus, chronic care patients also often need to follow specific medication or dietary guidelines to prevent any complications. Virtual visits via video telehealth appointments make it easier for these patients to quickly sync with their care team about their medication regimens or other necessary actions to take to improve their overall health and well-being.
  • Minimized Hospitalizations: Being admitted to a hospital is complex and costly – and oftentimes, can be avoided. Remote monitoring and regular telehealth visits enable providers and patients to ensure they are aligned on their care plan and to quickly triage problems that could lead to hospitalization if not addressed promptly – such as the situation Dr. Butler experienced with his COPD patient.

Regardless of the use case, offering the option of robust virtual care experience is the optimal way to serve the needs of patients with chronic conditions. Today and beyond the COVID-19 pandemic, telehealth solutions will remain key to expanding patient access, preventing diseases from progressing, and ensuring continuity of care -- even in the face of public health crises. Ultimately, leveraging virtual care, in coordination with in-office visits, creates a fully comprehensive patient experience that allows providers to be more productive, better engage with patients, and run a more profitable practice.                                    

About the Author

Michael Morgan is the CEO of Updox. With a successful track record in helping organizations use technology to transform the way healthcare is delivered, Mike has more than 25 years of healthcare leadership within software, behavioral health, and HIT organizations. Updox was named to the Inc. 5000 list of fastest-growing companies in America for the past six consecutive years.