MedCity Influencers, Telemedicine

 One way to limit spread of coronavirus: remote diagnosis

As fears over the coronavirus continue to circulate—despite the current low likelihood of infection in the United States—telehealth can make a big difference in providing support, information and advice for worried consumers.

As the number of coronavirus infections rises, concern about the disease is also spreading—especially among those who have traveled to or are afraid of coming into contact with those who have been to affected regions. It is still unclear to what extent this virus will spread; however, the threat of widespread person-to-person outbreaks outside of China has sparked fears of a worldwide pandemic or, alternatively, that this virus could persist each year in a seasonal pattern, like influenza.

The current coronavirus outbreak, dubbed 2019-nCoV, has infected more than 40,000 individuals in China alone and a few hundred worldwide on four continents. There have already been more than 1,000 deaths, which surpasses the number who died during the SARS outbreak. The virus continues to spread throughout China, particularly in the Hubei province, where it is believed to have originated, although there has been a slight drop in the number of new cases in recent days. In response, efforts are underway to quarantine patients and restrict unnecessary travel.

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The coronavirus, while similar in structure to the common cold, presents with symptoms more akin to influenza.: coughing, respiratory distress, fever and general malaise. Most patients have milder, upper respiratory symptoms, but for some—particularly high-risk patients—the disease can progress to lower respiratory disease or pneumonia.

Here’s the good news: While we don’t yet have a cure to the current coronavirus, we do have technology on our side that can help keep the disease from spreading.

As China explores virtual diagnosis of the coronavirus using a 5G network, it’s clear that remote diagnosis and monitoring through telehealth can help ensure U.S. residents who may have been exposed to the virus receive necessary medical attention and ongoing observation. It can also help low-risk individuals avoid costly and invasive emergency department (ED) visits while identifying and facilitating escalation of care for the patients with the coronavirus who require urgent or emergent in-person intervention.

Telehealth: The ideal first line of defense
Every year, more and more consumers are successfully utilizing telehealth urgent care programs to connect to physicians to be screened for a range of urgent and in some cases contagious conditions. Through telehealth interfaces, patients can easily and conveniently receive an evaluation and treatment. For a small percentage of patients who require it, escalation can be made for in-person care. This approach not only is effective and efficient for patients but also improves access to care, speed to diagnosis and affective triage, saving time and money in the process. Virtual visits also help prevent patients from being exposed to new infections in waiting rooms of healthcare facilities.

In a new disease outbreak, like the current coronavirus outbreak, telehealth can help patients experiencing coronavirus symptoms gain access to medical professionals quickly without having to undergo invasive testing or face exposure to other viruses. While physicians cannot confirm a diagnosis of coronavirus through a telehealth interface, they can screen patients, assign a risk category, answer questions and recommend the next steps a patient should take. Given that most patients presenting with coronavirus concerns, at this point, will be at low risk for the virus, but may face increased risk for other viral infections, telehealth offers a safe alternative for gaining expert medical advice quickly. This approach has been found to be very successful during the yearly seasonal influenza outbreaks.

Forging virtual connections
If you’re a consumer and haven’t tried telehealth, there are a few key things to keep in mind before firing up your digital device. A quick search in an app store or browser generates dozens of virtual-care applications. As a consumer or patient, how do you choose? Key considerations include cost, ease of use, modality and quality of care.

Ideally, the service should be covered by the patient’s health insurance, the user experience simple, and the service available 24/7 on existing home devices. Regarding modality, we believe that synchronous video visits represent the highest standard and most resemble a brick-and-mortar visit. And regarding quality: are the providers board certified and in the correct specialty? Are the providers properly trained and experienced? And finally, does the service have a quality oversight program?

If you’re a provider, the technology you use to facilitate virtual consultations also matters. A telehealth platform should be secure and easy to use, and it should ideally be interoperable with the EHR. Providers should be specifically trained in telemedicine, including the practice of “webside manner,” which involves best practices in videoconferencing with patients, and training in telehealth clinical practice. The provider should also be well supported and have access to relevant clinical information about the patient as well as relevant referral advice, and the care should be subject to quality oversight.

Supporting the right care in the right environment
As fears over the coronavirus continue to circulate—despite the current low likelihood of infection in the United States—telehealth can make a big difference in providing support, information and advice for worried consumers. The availability of this type of service can help keep low-risk patients safe at home and can facilitate proper, managed referrals for moderate and high-risk patients in a way that limits risk of person-to-person spread. This is another example of how telehealth is adding real value to our healthcare delivery system and making care more consumer-centric.

Peter Antall, MD, is chief medical officer for American Well , a telemedicine provider.

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