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Thursday, May 19, 2022

Cal Lutheran Looks at the Future of Telehealth

 California Lutheran University organized panelists to speak about the future of telehealth during its most recent Corporate Leaders Breakfast. The event was held virtually on April 8.Panelists, including Drs. Keith Norris, executive vice chair of the UCLA Health’s Department of Medicine’s Office of Equity, and Gabriella Sherman, chief medical officer at Los Robles Health System, touched on access to virtual care, what practice areas benefit most and what challenges loom for this type of care.California Lutheran sociology Professor Adina Nack moderated the panel.Sherman told guests that, much like electronic medical records in the early 2000s, telemedicine platforms will “evolve over time” from dozens of platforms to three or so options across the industry.

“I don’t think it’s that far away. Just navigating the technology has certainly been a challenge, not just for our providers but for our patients,” Sherman said. “Every health system, every physician seems to use a different map.”Sherman noted that the pandemic push toward telemedicine left many of her older, less tech-savvy patients behind. She would like to see telehealth education catch up with platform rollout in the next couple years.“We rolled this out so quickly because of the pandemic, we probably weren’t conscientious enough to make sure we’ve educated our patients and our society as a whole about all the different things they can actually use telemedicine for. It can be easy if they just learn that technology,” she said.Norris, who admitted he’s not the most tech-savvy but isn’t at the bottom of the class either, agreed that tech education following the public’s thrust into virtual care is necessary. In the meantime, there’s always phone calls, he said.“I did a virtual visit and the health system app is on my iPhone. … I get on my iPhone and I’m trying to download the app, and then it routes me to the Apple store, it says my password isn’t working, it’s a minute before my visit and I can’t get in to get it set up,” Norris said of his telemedicine experience. “If I’m having trouble, what’s going on for other people out there? That’s something we really need to think through and figure out, and probably have those conversations with our patients, to find out what is going to be most effective for them.”Insurance companies will continue to push telemedicine on providers since they see it as a long-term cost savings tactic, panelists said.Patients in the Los Angeles area that don’t have to take a half-day off work to visit the doctor, pay for parking and spend time away from family while filling out repetitive forms will see time and cost savings in telemedicine. That translates to more reliable visits, Sherman said, and provides a strong link to preventative care and less seriously ill people in the long term.“By having telemedicine and having that virtual appointment, being able to get in to see your doctor more frequently, hopefully we can catch more diseases early on and prevent those long-term health care costs to our system,” she noted. “Insurance plans actually allowed for telemedicine visits to be billed in the same manner as in-person visits so providers use those reimbursements, and in fact they did waive co-pays for some of their telemedicine visits as well, to encourage their patients to access health care.”Norris and Sherman agreed that routine checkups, besides a physical, are prime opportunities to use telemedicine.

“If it’s just a blood pressure check, and somebody has a blood pressure monitor at home, they can probably call in, give the health care provider their blood pressure readings and say whether or not they’ve been having side effects, and we can probably go for a while without having someone come into the hospital or to the clinic setting,” said Norris. “For something like blood pressure, traveling around somewhere like Los Angeles, by the time they get there, now the blood pressure is crazy.”Behavioral health was mentioned as an option for telehealth visits, as well as those with chronic conditions like congestive heart failure.“Patients have to be seen quite frequently for their weight checks and for understanding how they’re doing with their breathing. To some degree, we can extend that service with telemedicine too, because now they can be seen more frequently than if they were doing in-person visits,” explained Sherman.

 “I think it will always be somewhat of a hybrid situation. There will be conditions in which virtual care is very appropriate, and we’re certainly able to extend care that we’re able to provide patients traditionally in the office-based setting.”Norris referred to the “digital divide” when it comes to telemedicine access, again stressing the importance of education with platforms offered by providers and making devices available to those in underserved communities.Seventy-plus attendees joined the virtual event via Remo, an application that allows for networking at “tables” prior to the main event.

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