telemedicine

Telemedicine Still Not Widely Available Despite Need for ‘Distancing' Amid Coronavirus

On Tuesday, California took steps to make telehealth more accesible by expediting the application process for out-of-state doctors hoping to provide care to California patients via telemedicine

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Telehealth services that allow you to video conference or correspond digitally with your doctor certainly aren’t new technologies, but these remote consultations have found new support in the midst of the COVID-19 pandemic, as state and federal regulators work to remove barriers that have historically prevented doctors from caring for patients from afar.

I noticed I had a little bit of a sore throat.

Jim Corsaro, 63, who utilized telemedicine to consult with his physician

Telehealth and Coronavirus Screening

63-year-old Jim Corsaro fears he may have been exposed to the coronavirus during a recent trip to Denmark, where he was helping his daughter pack and move back to the United States.

"When I was flying, I noticed I had a little bit of a sore throat and I was concerned about it," Corsaro told the NBC Bay Area Investigative Unit. "I wanted to chat with a doctor, but everyone was recommending to stay away."

Since returning to California, Corsaro has been under a self-imposed quarantine, but he was still able to see his physician, face-to-face, through a telehealth video conference.

I was not sitting in a doctor's office around a bunch of sick people.

Jim Corsaro, currently under self-quarantine because of concerns around coronavirus

"Just having that visual with him was just comforting," he said. "It didn’t take a lot of my time and it didn’t take a lot of his time, plus, I was not sitting in a doctor’s office around a bunch of sick people."

Corsaro's consultation was with Dr. Dan Field, an emergency room physician of more than 30 years.

“You can be anywhere at any time," said Field. "You can have banks of doctors sitting there, taking these calls every 15 minutes, every 20 minutes."

NBC Bay Area
Dr. Dan Field consults with a patient using video conferencing. (March 20, 2020).

Field also serves as the chief medical officer for MDstaffers, a medical staffing agency based in Rancho Cordova that helps fill positions at hospitals and clinics across the country. He recently began video conferencing patients in response to the coronavirus pandemic. E-consultations, however, still are not widely available to patients throughout the country.

Only 18% of doctors have access to video conferencing, according to a survey by the American College of Physicians. Among those doctors, only 19% book video visits with patients each week.

One possible reason for the delayed adoption – many healthcare plans will only pay doctors for in-person appointments.

A lot of health plans right now are not reimbursing telemedicine.

Dr. Ranjani Chandramouli, medical director for Gardner Health Services

"I think that is one of the biggest challenges," said Dr. Ranjani Chandramouli. "A lot of the health plans right now are not reimbursing telemedicine."

As the medical director for Gardner Health Services, Chandramouli heads seven clinics in the Bay Area that provide care to 35,000 patients. None of the health network’s 35 physicians, however, use telehealth services.   

“It is an expensive thing to set up," Chandramouli said. "And if you set it up and if you're not getting reimbursed for it, it's not going to be beneficial."

Suspended Regulations Aim to Increase Telehealth Availability

Last week, state and federal regulators agreed to reimburse doctors who provide telemedicine services to patients on Medicare and Medi-Cal. California also ordered all private insurance companies to reimburse doctors for telemedicine during the current state of emergency.

On Tuesday, California's Emergency Medical Services Authority unveiled new details to make telehealth services more widely available across the state. Using authority granted by the emergency proclamation Governor Newsom issued earlier this month, EMSA released new details to expedite the approval process for out-of-state doctors hoping to practice telemedicine in California.

The agency now promises to "review and make a written determination" on all applications within four business days. Previously, physicians licensed in other states were required to get a separate California medical license, which can take months.

“It’s just one more roadblock in delivering care," Dr. Field said. "We need to have remote options because we can't be everywhere at once."

We need to have remote options because we can't be everywhere at once.

Dr. Dan Field

Aging Workforce

Dr. Field believes expanding telehealth would help triage patients and free up valuable space in emergency rooms across the country.

"That will help free the front-line workers to continue to do what they do," Dr. Field said.

As an increasing number of medical workers are placed under quarantine because of possible exposure to COVID-19, Dr. Field believes telehealth services would allow physicians to continue caring for patients from afar.

This gives me the opportunity to stay safe in my home without being exposed.

Jim Corsaro, discussing his experience as a patient utilizing telehealth services

"You can be in quarantine and still be doing something to help the effort," he said.

He also believes making telehealth services more widely available would also benefit the nation's aging medical force.

According to the Federation of State Medical Boards, more than 30% of doctors and surgeons in the country are 60 or older, making them especially vulnerable to the coronavirus.

I am 64 this May,” Dr. Field said. “We need people with my skill set available to help."

Dr. Field's patient, Jim Corsaro hopes to continue taking advantage of telehealth services when scheduling future doctor's visits.

Corsaro, a cancer survivor, had previously scheduled to have an in-person appointment next week with his Los Angels-based oncologist. Late Tuesday, however, he received word that his doctor agreed to conduct the visit via video chat.

"I don't have to worry about my plane getting cancelled and me having to make new plans really fast," he said. "Plus, with more people being sick in California, this gives me the opportunity to stay safe in my home without being exposed."

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