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Telemedicine helps system absorb caseload while fighting coronavirus

Boosted by insurance coverage, remote visits gain popularity as patients opt for stay-at-home consultations.

Dr. Lisa Ravindra, associate chief medical information officer at Rush University Medical Center, counsels a patient using the hospital’s telemedicine network.
Rush University Medical Center

Before the pandemic, few Americans gave much thought to telemedicine. With the pandemic, it’s become the preferred alternative for many patients.

It means not having to risk a trip to a crowded waiting room, possibly catching the coronavirus or spreading it.

Telemedicine, sometimes called telehealth, can be as simple as arranging a phone call or video chat with your doctor. But hospital networks, insurers and private clinics have gotten involved with systems that promise after-hours access and secure connections to medical records.

Dr. Christopher George, an oncologist who practices at Northwestern Memorial Hospital, said he’d never used telemedicine until mid-March, but since then he’s “immersed in it,” using it for most appointments. “For my patients, it’s a question of what’s the greater threat. Is it their cancer or is it COVID-19?” George said.

He said having tried telemedicine, many patients will stick with it for routine checkups. “Some people love it. It’s just super convenient and easy, and they don’t have to worry about parking, and if the doctor has fallen behind, it’s OK,” George said.

Northwestern encourages patients to use a system that provides secure video links to primary care doctors and certain specialists.

Rush University Medical Center was another early adopter of telemedicine with a system called Rush On Demand. It lets patients schedule time with a specialist or their primary care physician, or get access to a physician from 7 a.m. to 11 p.m. seven days a week, said Amanda Tosto, a registered nurse and clinical transformation officer at Rush.

Amanda Tosto, clinical transformation officer at Rush University Medical Center
Provided photo

Rush is pivoting to disaster preparations while putting off routine and elective care. That’s created more demand for remote advice, but Tosto said the wait time on the system has been kept to around 20 minutes. Rush On Demand has been handling about 150 visits a day compared to around 150 a month before the coronavirus, she said.

Medical personnel said it helps that last week Gov. J.B. Pritzker signed an order requiring state-licensed insurance firms to cover telemedicine. Blue Cross and Blue Shield of Illinois announced new telemedicine benefits ahead of the governor’s order, saying it could cover virtual visits at the same reimbursement rates as office visits for the time being. It also waived copays and deductibles for COVID-19 tests.

Dr. Tariq Butt, president-elect of the Chicago Medical Society and a family practitioner on the West Side, said he’s curious about how insurers will handle telemedicine once the pandemic passes. “I hope the insurers will work with the physicians. Most of us are like small businesses. The level of reimbursements is yet to be seen,” he said.

Butt said physicians are educating themselves about telemedicine and making sure their computer systems follow protocols required to assure privacy of medical records. “But this is not the model that works for everything,” he said.

Whatever a system’s bells and whistles, a virtual physician cannot treat chest pains, broken bones or cuts that need stitches. That doctor also can’t perform a coronavirus test.

But telemedicine can be a safety valve for a stressed medical system. It can handle ailments the typically clog waiting rooms, such as sinus infections, bronchitis, the flu, asthma, pink eye or fevers. Dermatologists can examine warts or moles remotely. Therapists also can treat anxiety, depression or stress while allowing patients to remain in their home where they feel more comfortable.

A founder of a North Side clinic, Dr. Rahul Khare, said he’s taken a load off hospitals by using telemedicine to screen more than 500 patients for coronavirus. He said his business, Innovative Express Care at 2400 N. Ashland Ave., has administered 250 coronavirus tests at an outdoor tent.

“We have used telemedicine to deliver efficient care for years, so that portal became the centerpiece of our COVID-19 response,” Khare said. “With telemedicine, we can see a high volume of patients while limiting exposure to the virus.”

The federal government last week said it will immediately expand telemedicine access to help people with Medicare, its coverage program for those 65 and over as well as younger patients who qualify because of a disability. And it urged states to expand the service to those enrolled in Medicaid, the government coverage program for people with low incomes.

Many supplemental Medicare Advantage plans run by insurers also provide access to telemedicine.

What if you don’t have insurance? You can pay out-of-pocket through some telemedicine providers. MDLive treats mostly through video chats and charges $75 for an urgent care visit. A session with a dermatologist costs $69.

Another company, 98point6, charges a $20 annual fee and then $1 for each visit. The company diagnoses and treats through secure text messaging.

But Rush’s Tosto said clinics and remote services can’t replicate the value of high-quality hospitals. “When you are talking to a doctor who is out of state, you won’t get the best advice about where to go for a follow-up,” she said.

Contributing: AP