Specialists rely on telehealth to treat vulnerable patients

Posted at 3:36 PM, Apr 14, 2020

Virtual doctor’s visits have become increasingly popular amid the COVID-19 pandemic, with many urgent and primary care physicians asking patents to avoid coming to the doctor's office unless absolutely necessary.

"Coronavirus has pushed telehealth to the forefront, so everyone who is not doing telehealth is already on some app and really ramped it up,” said Dr. Kenny Banh, an emergency physician and professor at UCSF-Fresno Medical Center. “And many practices that were doing telehealth as really 10 percent of their business have really switched to now 95 percent of their visits are telehealth and 5 percent of their visits are not."

For specialists, using telehealth is proving safer for even some of their most vulnerable patients.

"It's a cloud-based service, and basically, we send the patient a link through their email or we can text it to them,” described Dr. Chetan Khamare, a cardiologist at Premier Heart and Vascular Center. “And when they click on the link, it brings up the window, and then, they start the chat with that.”

Dr. Khamare says it’s helped some of their most vulnerable patients.

“It’s really helped, because a lot of our elderly population are the Medicare patients and they’re the ones that are highest risk and most affected by this virus."

He adds that in the last three weeks, his office has seen a 20 percent increase in telehealth patients. While the virtual visits are not ideal for every patient, Dr. Khamare says they're great for three types of patients.

"Follow-up patients," says Dr. Khamare of the first group of patients that telehealth works for. "So, any patient who has known history, for example, and we want to assess who we're doing, or it's a patient we've seen in the office maybe a month or two ago and we're following up on to say, OK, we've made some changes, how are you doing with those changes?'"

Telehealth also works well for patients who are on certain medications and require frequent check-ins and patients with chronic conditions.

"Typically, the primary cares can handle the simple patient that is fairly healthy, but when the specialist gets involved, it is conditions that are either more difficult to manage or they are a higher risk patient,” said Dr. Khamare. “So, that's why for this particular population, it's important for specialists to have access so we can make sure we keep them healthy and stave off any potential adverse event.”

Dr. Khamare says he and other specialists share telehealth tips and learn from each other to make sure the patient experience is as good as it can be. The most important goal is to avoid hospitalization, especially at a time when many hospitals across the country are inundated with COVID-19 patients.

Here are some tips for patients seeing a specialist via telehealth.

"The biggest is preparation. Probably the same as if they were coming to the office,” expressed Dr. Khamare. “If you have questions, write them down. Have an up-to-date list of your medications, including any recent changes to those medications."

Dr. Khamare says many patients have tools like fitness trackers or blood pressure monitors at home and can even share vital signs with their specialist.

Still, the technology behind telehealth, while simple, isn't for everybody. Specialists are reassuring their patients that if they do not feel comfortable conducting a visit via video conference, they're welcome to come into the office and see their doctor in person, in as safe a way as possible.