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Thursday, July 9, 2020

Telemedicine Is on the Rise for Older Adults

With the advent of COVID-19, telemedicine has come into its own. But how does it work? What will you pay? Is it as good as seeing your doctor in person?

As the coronavirus sweeps across the country, older adults are isolating at home and in care facilities for safety. Problem is, the vast majority of them need health care, either for chronic conditions or acute issues. With the health care system strained, the Trump administration recently cleared the way for a temporary increase in the use of telemedicine.

Telemedicine is “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status,” according to the American Telemedicine Association. Simply put, it involves having provider visits via computer or phone, and monitoring patient health remotely with sensors. A steady stream of vital signs can be automatically recorded and shared while the patient stays comfortably at home.

“Having a feed of information that tracks vitals over time is much more comprehensive than the snapshot assessment that’s obtained during an in-office doctor’s visit,” says Majd Alwan, senior vice president of technology and executive director of the LeadingAge Center for Aging Services Technologies (CAST). “Doctors can prescribe appropriate treatments and interventions, as well as detect the early onset of disease, without patients even leaving their homes.” More than half of hospitals use telemedicine in some way to monitor patient health.

Coverage Increases

On March 17, the White House announced an expansion of benefits under Medicare during the COVID-19 pandemic. “Providers will be allowed to use everyday technologies to talk to telehealth patients, more telehealth services will be covered ... and providers will be allowed to offer these telehealth benefits to Medicare beneficiaries at a lower cost than traditional services,” Health and Human Services Secretary Alex Azar said in a prepared statement.

Telemedicine may be as simple as a call from an older adult to a health provider to report symptoms from a new medication and ask for guidance. But older adults who are not as able can benefit as well by having a caretaker give updates or detail an issue. And automatic monitors — such as fall alerts or heart monitors — can send critical information without the need for human intervention.

Many providers are hopeful that the new guidelines will endure beyond the pandemic. As lawmakers realize the cost savings and patients experience the convenience and accessibility of the technology, virtual care could become the new norm.

How Does It Work?

Telemedicine can’t mend a broken bone, but it’s amazing how many services can be delivered virtually. Doctors, Physician’s Assistants and other professionals can Skype or FaceTime clients and hear how they are doing with a new medication, if they may benefit from an antidepressant, ask about a rash that the patient can “show” them with a phone or computer camera, or recommend virtual mental health therapy. They can also go over prescribed exercises, ask how a patient is eating or get a report on vital signs.

The health care worker benefits by being able to handle a larger number of patients without the expense of upkeep in the waiting room or exam rooms. (Some providers offer their services exclusively via electronic communication, eschewing a brick-and-mortar office completely). Providers are also protected from catching any bacteria or virus the patient may have, and vice-versa.

While anyone can benefit from the ease of picking up the phone for a visit with the doctor, some groups are particularly grateful for the option. Older adults with mobility issues, those in rural areas where health care is geographically far away, and those who lack transportation all find a major problem fixed. In addition, patients with diabetes, heart issues or lung problems may be treated without the worry of exposure to someone carrying the coronavirus.

What Is Covered?

Currently, Medicare will cover three types of virtual services:

  • Check-ins. Medicare beneficiaries can message their care provider to cut down on trips to the office. This service may be included for chronically ill people who need to check in on a set basis.
  • Telehealth visits. Patients can consult with a professional over the phone instead of in person. This works for mental health care as well.
  • E-visits. Non-urgent communication is initiated by the patient via email, and follow-up is provided by the health care professional. 

Show Me the Numbers

  • Those casting a jaundiced eye at the novel technology may be swayed by numbers emerging from an ever-growing body of research. Consider the following:
  • At a chain of skilled nursing homes in Illinois, telemedicine is in use to cut down on both emergency visits and readmissions to hospitals. Nearly 81% of patients using the technology could be treated on site.
  • In Pennsylvania, a nonprofit running senior living communities managed to reduce the percentage of older adults moving into nursing homes from 20% to 12% just by having frail patients wear a monitoring device that could alert nurses to a fall.
  • The cost of starting a telemedicine program in nursing homes can be balanced by a reduction in costs of transferring patients to emergency rooms and doctors’ offices. 

And it’s not just patients who benefit. Caregivers find that telemedicine can be a lifeline, reducing the need to take Mom to appointments. They are also able to stay involved in the care protocol for their loved one, since they can ask questions and make reports electronically.

Veterans with limited mobility or chronic illness may also take advantage of telemedicine. The hope is that these services can avoid a move into a skilled nursing facility.

The future for telemedicine looks promising as more and more innovations in monitoring equipment hit the market, and older adults adapt to electronic visits. The population will become more device-savvy over time, and telemedicine, like online banking, is likely to play an ever-larger role in delivering a vital service.

Click below for the other articles in the July 2020 Senior Spirit


Blog posting provided by Society of Certified Senior Advisors