Telehealth has become more and more prevalent, especially in the COVID-19 pandemic era, where visiting a medical care center in person may be more difficult or dangerous for many. Telehealth visits made up almost 40% of all primary care visits between April 2020 to June 2020, which is a dramatic increase from the previous year, when telehealth had been considered a more obscure way of delivering care. Meanwhile, office-based visits decreased by over 50% compared to the year before, which is not very surprising as the pandemic forced many into lockdown and/or quarantine. These telehealth visits usually involve doctor’s speaking with their patients over the phone or through video call to diagnose and possibly treat their concerns.

However, new studies and interviews conducted with various physicians have revealed some of the crucial clues that doctors may miss during online evaluations. This has caused the level and quality of healthcare to potentially be compromised.

 

What are doctors missing?

According to a study conducted by the Johns Hopkins Bloomberg School of Public Health in Baltimore, the frequency of blood pressure checks on patients dropped by around 50% during the pandemic, along with cholesterol checks which decreased by almost 40%. The main issue blocking doctors from completing these assessments is equipment – blood pressure and cholesterol readings require special equipment and services that a doctor can only provide on-site and in person.

While mental healthcare services have generally been more successful with the online transition, doctors still may have a hard time evaluating subtle nonverbal cues through phone or video, especially for concerns like depression and anxiety.

Additionally, physicians may also have problems determining the extent of pain, shortness of breath, and blurred vision when using telemedicine platforms, as those symptoms are much harder to assess without being face-to-face. The quality and level of care that can be provided through an online platform is limited compared to in-person visits, as it doesn’t quite replace the elements of a physical examination.

 

How is this affecting patients?

Lead researcher of the study, Dr. G. Caleb Alexander, a professor of epidemiology at Johns Hopkins, says that some people’s heart health have most likely suffered due to this shift to virtual platforms. 

Monitoring of crucial vitals, such as blood pressure and cholesterol, are “core, essential components of primary care delivery” and the loss of these important assessments could be negatively impacting patients, especially those at risk for heart attacks, strokes, and cardiovascular disease.

And while this is an obstacle that can be pretty easily overcome with new home monitoring technology, like blood pressure cuffs, smart monitors, and various related applications, it is not as easy to equip all patients with the necessary utilities. Many patients cannot afford such technology in their homes, and thus, these cracks in medical care will continue to exist.

In addition, it is important to note the disparities that extend to all telehealth in general. Many people do not have access to phones or computers, let alone devices with high-quality cameras that can be setup for a virtual doctor visit. 

 

What does this mean for the future of telehealth and healthcare?

All in all, telemedicine is here to stay, especially if insurance companies continue to reimburse its use. Despite the select setbacks, the benefits of this transition to remote care has generally outweighed those concerns. 

However, as healthcare disparity already exists in this country, this continuing transition could potentially widen the already existing inequities for certain patients, which has raised concerns for many doctors. 

As the amount of COVID-19 cases in the US gradually decreases with the help of the vaccine, this leaves the responsibility at the hands of doctors and health care experts to determine when online visits are appropriate and when patients should be encouraged to go to a hospital or clinic.

It is pertinent for healthcare professionals to reassure patients that in-person visits can be safe and sometimes more imperative for patients.

 

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