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How Covid-19 changed the rules of the game

- By Dwaipayan, 18 February 2021 | 6 MIN READ


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The traditional provider of a doctor’s chamber visit for evaluation and management of chronic diseases has been the promise of medical care for well over a century. Even house calls, with all their advantages, are now a revered relic of bygone days. 

The Covid-19 pandemic has pushed many providers to move quickly to telemedicine, involving visits by phone and video, thus avoiding interruption in inpatient care. with this unexpected necessity came the opportunity to address many of the limitations of the classic office or hospital visit – most notably the reality that many patients’ chronic diseases are not well controlled and that only 50% of patients with chronic medical conditions take their medications as prescribed.

A study tells that less than 50% of those with hypertension are at BP goal and medicine non-adherence costs our health care system over $100 billion annually. The reasons for non-adherence and poor outcomes are many; poor health care literacy, confusion on patients and providers part on what medications a patient might be taking, particularly after a hospital stay.

While opting Telehealth services can combat the major pitfalls of the office visit that lead to medication non-adherence and poor outcomes. The prescription can be done over the phone or on video with medication bottles or pill dispensers at hand. 

It also becomes easier for family members to be present and participate in these visits even from another location and hear what the doctor prescribed, thereby extending health literacy for the entire family. This will bring the ability to have frequent visits, patient educations to be focused and reinforced frequently both with the patient and family members, encouraging dialogue and promoting positive lifestyle changes. 

Telemedicine helps patients to feel more comfortable as the treatment plan is entirely devised at home, allowing for more casual conversation and the patient to feel more involved in the decision-making process and take more self-ownership of their health. 

Here is an easy example of this is home blood pressure monitoring, the gold standard of accurate blood pressure readings. Frequent telehealth visits will allow the provider to encourage the patient to perform home blood pressure checks. 

Another advantage of telehealth that cannot be overstated is improved access to care. The appropriate management of chronic conditions such as hypertension, heart ailments, diabetes is enhanced by frequent collaboration with the medical system. The ease of obtaining telemedicine visits substantially improves accessibility to providers by breaking down the barriers that time, transportation, weather, and mobility issues can present to a patient. 

Telemedicine also comes as a boon, particularly in vulnerable/low socioeconomic patient populations. Research tells that more frequent contact via telephone may improve outcomes For nursing home patients, a telemedicine visit allows the facility nurse to be present during the visit, often providing useful information related to health care issues as well as more accurate medication administration.

While the most vulnerable in our society stand to benefit the most from telehealth. India already oversaturated healthcare infrastructure can reap the benefits. Telemedicine visits decrease the need for costly real estate and additional staff. A patient, the visit can start and end right on time, even permitting more patients to be seen in a day. Telemedicine does have its shortfalls, and cannot replace in-person visit in all cases. The physical assessment is key in a substantial proportion of medical evaluations. There will have to be additional reliance on home blood drawing and remote testing such as imaging studies. One must rely to a large degree on whether a patient feels a telemedicine visit is sufficient for their needs, but they may be the best judge of that. Telemedicine is not intended to replace the office visit.

We are seeing some return to normalcy as the Covid-19 pandemic continues to decline. We have learned from this pandemic how a new way of seeing patients at their homes can be the key to improving our grim rates of success in treating so many – but not all – chronic diseases. 

It is the time we need to take this opportunity to bring the house call back, though electronically this time so that we can learn more about a patient in a way that we can support their needs and identify barriers to treatment. In the coming time telemedicine will set a frequency that will ensure their success in having their chronic diseases managed to proper standards and to then enjoy the benefits associated with ideal blood pressure, lipids, heart failure management, coronary disease, and angina management, smoking cessation, depression, and diabetes management to name a few. 

A lesson learnt the hard way this time, the Covid-19 pandemic taught us the importance of managing chronic diseases and that telemedicine is a new hope to address other chronic diseases.

 

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