One of the really interesting pieces of telehealth that has exploded during this time has been a type of telehealth called Telequarantine. For those not familiar with it, it’s a video connection (generally it’s video, but some audio or text might apply as well) between the patient and a clinician. Instead of going into the room, the doctor will hop on a video call with the patient to see how they’re doing.
It’s obvious to see why this type of technology has become so popular. No clinician wants to go in a room where they’re at risk for contracting COVID-19. Plus, to enter properly they have to use their PPE supply in order to safely enter the patients’ room. For many visits from the doctor, there’s really not a need for them to by physically in the room with the patient. So, using a telequarantine solution just makes sense. It saves PPE and reduces the risk to the clinician. Plus, you have to believe it’s much faster as well.
There are obvious challenges to this. The first is making sure that you have enough devices for patients to be able to hop on a telequarantine video chat with the clinician. Once the device goes into a room with a COVID-19 patient, it’s not coming out without the proper cleaning procedures. Plus, can the device even be cleaned and disinfected properly. The good news is that there are a lot of commercial grade devices out there that can be cleaned. Plus, clinicians need a device as well.
The bad news for IT staff is that’s a lot more devices to manage and support. Plus, all of these video visits are going to start putting stress on your network infrastructure. If everyone is doing a video into a room instead of going around physically, can your network support all that traffic? Plus, do you have the right software that can make this happen in a secure and HIPAA compliant way. Yes, I get that you can do Facetime right now if you want, but it’s probably time to start thinking about a longer term solution since I predict OCR will roll back that enforcement discretion since there are plenty of HIPAA compliant solutions to this problem.
What’s interesting is when you try to look at the future of telequarantine. Is virtual rounding using teleqaurantine software and not entering the patients room physically the future?
I don’t think we fully know the answer to this question and the related question of how long we’ll need to physically distance ourselves from COVID-19 patients unless we have the right PPE. However, even before COVID-19 you could have made the case for the value of using telequarantine to interact with a patient. It just wasn’t as accepted back then because as a patient you likely feel better if the doctor was willing to come to your room, hold your hand if needed, and be there physically. Has the current environment changed that feeling such that telequarantine will be widely adopted when a physical exam in the room is not needed? In fact, will it be encouraged by some as a way to reduce risk?
Hard to predict. Especially since there are times when physical presence is valuable. I’ll never forget how amazing my wife’s OB/Gyn was in person when she miscarried a child and had to do a D&C. The doctor went to my wife’s side, held her hand, and showed that she understood the pain that my wife was experiencing. I loved this doctor for it then and still do now. I’m not sure I’d feel that same way had she been on video.
However, the world has changed. Many will have some trauma if you go in the room now and would prefer the video. I don’t think this is an all or nothing type of situation. It could very well by half telequarantine and half in person visits. However, I do predict that telequarantine is going to last well past COVID-19 and so we better plan accordingly.
A very interesting article as one who has been working in mHealth and telehealth including internationally. From. Y perspective it’s preventive care Prevention saves lives ! Prevention works!
Focus on treatment without support and efforts in preventive care will result in another 25 years of missed opportunities. As well as focus on telemedicine where patient and dr relationship on monitor screen serves both parties. One of the strategies is remote patient monitoring where patient and dr can monitor on instant time period the direction of persons vital signs. Is it telehealth 2.0 or 3,0? If it wasn’t for covid would we be where we are today as to raising awareness of telemed?
Thank you John for your continued valuable information on Telehealth/ Telemedicine. Also an important part of a Telehealth session is Consenting between patients & Clinicians. This collaborative decision-making process is an ethical and legal obligation of healthcare providers.
Physicians face risks every day when treating their patients, particularly with a large unknown, highly contagious and potentially deadly disease. Our Remote Informed Consent is an insurance to providers for any malpractice and costly risk mitigation’s. It would be naïve to think that there could never be any dissatisfied or, worse yet, harmed patients as a result of COVID-19-related evaluation, diagnosis, and treatment via Telehealth sessions.