WA health professionals embrace telemedicine during pandemic
Health professionals in Washington state have seen exponential growth in the use of telemedicine, or virtual health visits from home.
Dr. John D. Scott is the Medical Director of UW Digital Health and said the genie is out of the bottle when it comes to the popularity of virtual healthcare check-ups.
“We had 20,000 telemedicine visits last year,” he said, “In February, we had about 300 outpatient telemedicine visits, in March went up to 14,000, April were at 30,000 and in May were at 33,000. So in a month we were doing what we did all of last year.”
Although he is in charge of digital health at UW Medicine, Dr. Scott didn’t use telemedicine regularly with patients before the COVID-19 pandemic hit in February. He stepped into the role of director in 2013 and just seven years ago telemedicine was extremely different.
“The technology was way more expensive, it was just really cumbersome, it was hard to use,” he said, “It was very hard to get paid for telemedicine, there wasn’t any kind of established training program or protocols on how to do it so it’s come a long way.”
Other health professionals in Washington are also getting used to the new way of seeing patients. Dr. Katina Rue is the Associate Program Director at Central Washington Family Medicine Residency and she said while she still works in a hospital and in a clinic, she is seeing many patients through telemedicine. Some of the patients she cares for she hasn’t met in person yet.
“I have met several brand new patients that that we new to me over telehealth,” she said, “One was a post hospitalization follow up and it was the first time I met this guy and I was just talking to them on the phone, trying to develop that rapport and making sure our communication was really clear.”
Phone and internet connection is one of the downsides of telemedicine because some people don’t have access. Dr. Rue said in Yakima Valley many people struggle with connection, even her.
“I live out in the country and I’m getting kicked off Zoom meetings all the time,” she said, “I go around the house and turn off all the devices I can find so they’re not hooked up to the WiFi. I don’t know if that helps, but you know, we still have a big access to care issue.”
Prior to the COVID-19 pandemic, telemedicine visits were rarely covered by insurance. Dr. Scott said only rural areas with limited access to care were allowed coverage for telemedicine visits. Only 20% of Washington state was considered for that coverage and Yakima County was not included. Those policies have been relaxed due to the health crisis, but professionals question the stability of coverage.
“There’s a couple of federal bills that are being proposed to make the changes permanent,” Dr. Scott said, “It literally does take an act of Congress to make changes in Medicare policy. The executive branch cannot make them permanent. They can only do it during a temporary public health emergency. There’s a couple of bills that we’re tracking and I think that that’d be great if they could make them permanent.”
Telemedicine can’t replace all appointments though. Tim Ausink is a physician assistant at Heritage University who didn’t use telemedicine with his patients at all. Now, it’s a regular occurrence to see them through a screen instead of in the office.
“It’s not that face to face interaction,” Ausink said, “It’s not as personal and you can’t do a full physical exam on somebody. So sometimes there’ll be something that you might think is important and you’ll tell me and we’ll address it. But I might also see something on my own and you didn’t know that that was important, but to me as a clinician, it’s like, Oh, that’s important. Those are the things that you can miss or not be able to capture with a telemedicine.”
Although there has been a spike in recent virtual visits, health professionals agree, in-person visits won’t be replaced.
“Talking to some month looking someone in the eye, listening to their heart, pushing on their leg, that is not there and I would hate to lose that because that’s what makes medicine so beautiful,” Ausink said.