A virtual silver lining: the pandemic’s boost to telemedicine

While some of the pandemic-induced restrictions on everyday life will eventually recede along with the virus, some changes are likely to linger. More of us will keep working from home. We’ll likely continue washing our hands more frequently, and many of us expect to keep using face masks. For workers’ compensation cases, it’s reasonable to expect that the increased use of telemedicine for triage and speedy treatment will remain. Telemedicine has been around for years, but it was slow to catch on for many reasons:

Some doctors and patients were hesitant to use this new, unfamiliar technology

There was a common thought that most medical services could not be accomplished without physical, face-to-face contact

Not many payers covered it initially, nor did codes or rules for payment exist

Many states did not allow telemedicine due to HIPAA laws and other restrictions HIPAA-secure platforms were often clunky to use or incompatible with mobile phones

The COVID-19 pandemic caused a huge paradigm shift in yet another aspect of daily life. Many doctors and facilities closed their doors to protect themselves and patients, and many elective procedures and non-emergency visits were postponed making room for incoming COVID-19 cases. The U.S. saw unprecedented numbers of employees working from home, accompanied by a decline in workers’ compensation claims. Still, ordinary life went on with its scrapes and sprains and burns and rashes. Telemedicine was pushed to the forefront as an alternative for many types of visits, where doctors and patients could confer safely. But for all the self-evident benefits of using telemedicine in a pandemic, states still had to waive or change some rules so clinicians could make virtual house calls.

In this public health emergency, nearly all states moved quickly to relax the restrictions they had formerly put in place to accommodate the new need for virtual care. In many instances, they scaled back the privacy rules so patients could have easier access to telemedicine on social platforms such as Apple’s FaceTime. Other changes included:

New York allowed injured workers to access care through telehealth Washington allowed telehealth to be offered without requiring the initial visit to occur face to face in a brick-and-mortar setting

Many states allowed providers not licensed within their state to conduct telemedicine visits

Many states opened telemedicine up to interstate licensure compacts

Many states expanded the types of providers eligible to offer telehealth services, which allowed clinicians such as physical therapists, occupational therapists, and behavioral health clinicians to offer virtual care

The public’s use of telemedicine surged. Pre-pandemic, Coventry was receiving about 150 telemedicine bills a day. Then, in the early stages of the 2020 shutdown, that number jumped to nearly 5,000 a day. This massive uptick was seen across the country: a study by JAMA Network Open last year showed a 1000% increase in telemedicine use in March 2020 and more than 4000% in April 2020. When medical practices began re-opening their doors later that year, usage declined, though it remains much higher than before the pandemic began and appears to be holding steady. On the traditional health care side, many insurance plans may cover telemedicine visits just like traditional trips to the doctor; some even offer virtual visits at reduced or no cost. Telemedicine is here to stay. In the world of workers’ compensation, it can be a good choice for non-emergency conditions such as:

- Neck or back pain

- Skin lacerations

- Burns

- Sprains and strains

- Bug bites and stings

- Hives and rashes

- Headaches

- Mental health issues and counseling

These maladies can be addressed through visual examinations and discussions with caregivers. A doctor or nurse can log onto a video session to look at symptoms such as swelling, limits to range of motion, and skin irritation. They can ask questions and relay treatment options. Patients do not have to be physically present for that initial examination or for follow-up discussions with their providers. Of course, telemedicine is not ideal for every injury or illness. Conditions such as shortness of breath, dizziness, significant bleeding or blistering, eye injuries, and many others should be seen in person by a doctor as soon as possible.

The ever-growing field of telehealth encompasses more than doctor visits. Other services include:

- Telenursing: This includes telephonic nurse triage as well as other types of nursing such as home health care. With a nursing shortage in the U.S., combined with the growing number of aging and chronically ill Americans, telenursing has become a welcome option in some cases.

- Telepharmacy: Pharmacists can talk to patients about questions or issues they have, or they can receive services such as drug-therapy monitoring or counseling.

- Telerehabilitation: Injured workers can stretch and exercise at home with video supervision and guidance.

Virtual visits with a mental health provider: Patients can talk to a counselor or therapist from the privacy of their homes.

Benefits of telemedicine

Telemedicine provides unprecedented accessibility to health care providers. As we’ve seen through the success of telenursing programs for workers’ compensation claims, patients now have access to health care outside of regular business hours, when brick-and-mortar offices are typically closed, and when they might have previously gone to an emergency room or urgent care clinic. Patients who live in rural or remote locations, or who don’t live close to a specialist they need, have better access to providers now as well. They also don’t need to take time off work to drive to the doctor or catch public transit. And many patients who don’t want to be exposed to other illnesses (including COVID-19) or struggle with conditions such as agoraphobia or social anxiety can now see a provider from the security of their homes.

We’re still in a state of public health emergency, especially as new COVID-19 variants are emerging. The changes put in place by various states might not be permanent in all instances. But telemedicine has arrived as an accessible and practical way to receive health and medical care. In treating injured workers, the greater use of telemedicine is an easy call.