NOLA physicians and patients stay connected throughout the pandemic.

Telemedicine gets fast-tracked to meet the healthcare needs of Louisiana -- aiding with COVID-19 quarantine and social distance mandates.

Quarantine and social distance mandates resulting from the COVID-19 pandemic brought a unique challenge to the traditional physician-patient relationship in southeast Louisiana, enhancing the need for alternatives to the in-person, exam room consultation. As a result of this demand, medical professionals and science have fast-tracked the use of advanced audio, visual and other electronic technology to communicate effectively with patients. Physicians and healthcare experts weighed in on the value of telemedicine throughout this crisis and going forward.

“Telemedicine was a game changer in the COVID-19 healthcare crisis as opposed to previous crises such as Katrina in as much as we quickly transitioned to the telehealth format allowing our patients unfettered access to their providers, while providing our institution with an uninterrupted revenue stream which kept up from shuttering clinics and doctors’ offices” said Frank Wilklow, MD, Touro Infirmary cardiology, CMO Crescent City Physicians Inc., and Touro cath lab director.

“Telehealth also addressed the unique risks associated with COVID-19 and decreased risk of exposure to our providers and clinic staff. It decreased the burden on our system to provide personal protective equipment to our staff; allowing for valuable resources to be allocated to the hospital,” said Dr. Wilklow.

Mobile devices such as phones, tablets and laptops have allowed physicians to become more connected to their patients. For many in southeast Louisiana, telemedicine has provided the only safe and convenient access to acute and preventative health care since the beginning of the COVID-19 pandemic. Without it, patients would either have had no access to care or might possibly be too afraid to go out and find necessary healthcare. 

"As Aledade's Louisiana regional medical director, I work with physicians in private practice and community health centers across the state. Since the pandemic, many have commented that there's no possible way they could have maintained the health of their patients without telemedicine,” said Josh Lowentritt, MD, medical director, Louisiana Physicians Accountable Care Organization/nephrologist, internal medicine physician. “One physician who practices family medicine confided 'I know that with telehealth I have saved lives by being able to stay open for my patients during this crisis.' "

Telemedicine has helped expand access to care in this region at a time when the COVID-19 pandemic had severely restricted many patients’ ability to see their physicians. The demand for to mental health challenges has increased substantially throughout this crisis.

“Since we used telemedicine regularly at Integrated Behavioral Health prior to the pandemic, we were able to pivot quickly when the pandemic hit and ensure as limited interruption as possible for patient care,” said Orleans Parish Medical Society (OPMS) board member Mehdi Qalbani, MD, a psychiatrist and co-founder of Integrated Behavioral Health. “As long as the regulatory changes that were implemented as a result of COVID are allowed to continue and if insurers continue to allow equal access to care, we are confident that telemedicine will allow increased access to mental health services and ultimately, hopefully, result in better care of our patients.”

Louisiana physicians now have the technology to treat many ailments without ever having in-person contact with a patient. Patients can speak directly with medical professionals, take electronic photographs of troublesome conditions and are even able to monitor blood pressure from a remote location. This information can be communicated safely to their physician, who can determine an effective course of treatment without any need for human contact. Medicare recently approved the allowance of clinicians to provide telehealth services for patients throughout Louisiana, which provides much financial relief to seniors and those eligible for Medicare through disabilities. 

“Patients were able to maintain a direct contact with their providers and follow up on important acute and chronic medical conditions which required close monitoring,” said Dr. Wilklow. “It also allowed for the maintenance of the personal connection between the provider and the patient and often several moments were spent during the telehealth video conference with the patient and their family expressing their concern for the providers safety in the setting of Covid virus exposure to healthcare providers and their gratitude for being a healthcare provider during the COVID-19 healthcare crisis.”

According to a report published by McKinsey & Company published on May 29, 2020, in 2019 only 11 percent of patients nationwide were using telemedicine. By May of 2020, nearly half of in-person office visits had been converted to telemedicine. Clinicians saw 50 to 175 times the number of patients via telemedicine than they did prior to the COVID-19 pandemic. In addition, telemedicine has also brought some relief to physicians who were concerned about lost revenue throughout this most challenging time in our history.

“The nation has witnessed unimaginable pain and loss at the hands of the coronavirus. Still, we have adapted and survived," said Margaret "Peggy" O'Kane, president, National Committee for Quality Assurance, in an article published in Modern Healthcare on September 21, 2020.

"In some cases, we may find our way to a better tomorrow because of these challenges. We owe it to those who have sacrificed so much in 2020 to maximize these opportunities and build a stronger, more resilient healthcare system. Expanded telehealth is a promising tool for getting there,” said O'Kane.

“In a difficult healthcare economy, telehealth helped providers maintain revenue streams by allowing clinics to remain open and seeing patients through video conferencing where in the past they would've been closed for two to three months often leading to support staff layoffs and even physician and clinic insolvency,” said Dr. Wilklow.

The current COVID-19 crisis and resulting social distancing have made access to healthcare more challenging throughout southeast Louisiana, but due to advancements in mobile technology, many southeast Louisiana physicians and telemedicine were ready for the challenge.

“As a health system we went from less than 500 telemedicine visits a month in February 2020 to over 20,000 in April 2020,” said Scott Mackey, D.O., associate chief medical information officer, LCMC Health. “We are now doing telemedicine in almost all areas and specialties including inpatient, emergency and ambulatory. Without a doubt the ability to pivot to telemedicine kept many people with access to their doctors during this pandemic.”

Actions taken by state and national healthcare leaders today will determine if the full potential of telemedicine is realized after the coronavirus pandemic has passed. In addition, beyond patient care, telemedicine now provides a feasible option for Louisiana physicians to remain in medicine who might otherwise need to transition from in-person patient care due to physical limitations or age.