In the past year, telehealth has become the new norm for wide-ranging medical practices.
Telehealth was around long before the COVID-19 pandemic, but when the first El Paso COVID-19 case was confirmed on March 13, 2020, in El Paso, hospitals immediately began expanding telehealth services as an alternative to in-person services.
Telehealth, also known as telemedicine, allows patients to receive care through telecommunication technologies such as phone calls and video conferences.
“(Telehealth) has really been life-saving for me during this time, because I have always struggled with anxiety and depression and I needed help,” said Jessica Silva, who has been receiving virtual care for mental health issues since June 2020.
“I have learned so much about my emotions, about myself, and just talking it out and having someone else’s perspective, and learning strategies to help myself manage when I get overwhelmed,” she said.
Because of the convenience of telehealth, Silva said she would continue to attend virtual care even if it was safe to physically attend.
What’s happening with telehealth in El Paso is part of a national trend. From the last week of March 2019 to the last week of March 2020, there was a 154 percent increase in telehealth visits nationwide, largely driven by the desire to prevent the spread of COVID-19.
In El Paso, use of telehealth at hospitals has changed and grown significantly.
Telehealth’s introduction to El Paso hospitals
Two days after the first COVID-19 case was confirmed in El Paso, medical professionals at the Texas Tech University Health Sciences Center El Paso decided that they needed to implement a telemedicine visit system to accommodate patients.
“We have a telemedicine platform that we used before (COVID-19) that we were using internally,” said Dr. Diego De La Mora, chief health informatics officer for Texas Tech’s El Paso health campus.
“We adapted that (platform) to use it with our patients,” he said.
Implementing telehealth has presented challenges. Some patients have had problems accessing the necessary technology to speak to doctors via video.
“When that occurs, we can only do a phone call,” De La Mora said. “It really limits our ability to provide a more comprehensive physical exam, or at least to see the patient or look at their wounds or look at if they’re having any physical changes.”
The Hospitals of Providence took a slower approach to offering telemedicine services in order to assess the best way to provide patients with high-quality care.
“Late March-April, we began assessing what the services of our facility had in terms of the capability to potentially turn on a stronger telehealth presence,” Nathan Worley, chief strategy officer at The Hospitals of Providence, said.
Prior to COVID-19, The Hospitals of Providence only offered telehealth for patients who had conditions that needed to be assessed by providers that they did not have in-house. But once COVID-19 hit El Paso, professionals at The Hospitals of Providence decided to look to their outpatient clinics as a source of telemedicine.
The pediatric endocrinology clinic was one of the first specialty clinics at The Hospitals of Providence to practice telemedicine, to avoid requiring families to come into the facility. Since then, The Hospitals of Providence has fully implemented telehealth services throughout the rest of their outpatient clinics.
Telehealth has also posed its challenges at The Hospitals of Providence, especially at the beginning of the pandemic.
“There was a learning curve with our patients and with the community to ensure that they have the proper resources available to access telehealth,” Worley said.
With time, some patients have been able to more easily navigate systems and programs that are used in the telehealth care sector at The Hospitals of Providence.
“I think what we’ve seen is as the community has grown more comfortable with accessing and utilizing web conferencing and zoom and those sorts of things,” Worley said. “It’s helped to close some of those gaps in ensuring that our patients are able to access their telehealth appointment appropriately.”
At CareNow Urgent Care, a Las Palmas Del Sol-affiliated clinic, telehealth services were also offered in only some sectors of their health care system at first.
“As the pandemic occurred, we were able to quickly expand the services across all of our care now,” said Dr. Sonya Wilson, medical director of the Clinical Informatics Center at CareNow Urgent Care.
How telemedicine affects patients
Telehealth is increasingly used for wide-ranging medical services at El Paso facilities.
“A lot of our psychiatry visits are in telemedicine and of course, any kinds of mental health issues,” De La Mora said. “Many of them can be addressed via telemedicine.”
Telehealth at Texas Tech has also been useful for patient consultations. It’s helped patients to learn more about their specific conditions and how they can take care of themselves at home, De La Mora said.
“There’s also a lot of patients that have chronic conditions like diabetes or high blood pressure, and many of them are checking their sugars at home or checking their blood pressure at home,” De La Mora said. “If they are relatively well-controlled, we are able to set a follow-up visit through telemedicine.”
But internet connectivity issues have sometimes created a barrier between patients and providers, De La Mora said.
“The broadband internet is not as readily available in a lot of rural areas of Texas and rural New Mexico, so if they don’t have a good internet, we’re not able to really connect via video, we still do it over the phone,” De La Mora said. “We try to do anything we can to make sure that their health care (needs are) addressed, but we wish we could communicate with them through a video conference in a more robust telemedicine system.”
Telemedicine can also be useful for determining whether in-person evaluations are truly necessary.
“During that (telehealth appointment), if something comes up that our provider really feels they should have an in-person evaluation, then we will discuss that with the patient and bring him into the clinic to see our in-clinic team,” Wilson said.
But the majority of patients at CareNow Urgent Care have been operating just fine with telehealth, she said.
“The patients who have used the service, we’ve been getting very positive feedback from them, and that they’re satisfied with us providing that service for them,” Wilson said.
What medical centers look like now
Due to fears of COVID-19 and the rise in telehealth, fewer patients have been coming into hospitals in El Paso.
“Whenever we had waves of more community transmission, we would see that the number of in-person visits decreases, but the number of virtual visits increases,” De La Mora said.
The facility still stays fully staffed with medical assistants, front-desk assistants, and doctors to conduct telehealth appointments in their offices. It is critical that they have the staff coming into the facility to take care of patient registration, lab work, and to send out documents to patients, De La Mora said.
The Hospitals of Providence also require physicians to continue coming into the facility of their respective clinics. But integration of telehealth technologies also has affected the physical setting for care within the hospital.
Whereas physicians would typically be speaking with a patient inside their office, they are now expected to meet with their patients via Zoom. Physicians have to look at their schedule to see if they can meet with patients via telehealth and they have to follow up with patients to schedule appointments.
The future of telehealth
Medical professionals from The Hospitals of Providence and CareNow Urgent Care say they don’t see telehealth going away any time soon, even once COVID-19 cases are at a minimum. With that, physicians and medical staff have been exploring long-term ways to raise the quality of their telehealth services.
“(From) investing in better cameras and in better microphones to also providing better education and instructions to our patients before telehealth appointments, we’re always looking to improve,” Worley said. “I think we’ve come a long way from where we were when we first began using telehealth back in late March, early April.”
Telehealth companies across the nation have seen a boom in funding for telehealth technologies. In the first quarter of 2020, funding rose to $788 million. It has tripled since the first quarter of 2019.
Providers are putting more money into telehealth because it saves them time and money. A recent study showed that 83 percent of health-care organizations are “likely to invest in telehealth.” This is motivated in large part by the desire to increase their reach, the study said.
Although telehealth has become a convenient option for medical care providers, it does pose job loss risks. Because insurers tend to reimburse virtual appointments at lower rates than in-person appointments, the rise in telehealth has impacted hospital revenues significantly.
Further, because fewer people need to go to hospital facilities in person, this could lessen the need for some service jobs at hospitals like cafeteria workers or parking attendants.
CareNow Urgent Care is working to make their virtual care more readily available.
“We make sure that we are providing convenient care for our patients when and where they need it most, and virtual care is one of those ways that we’re able to do it,” Wilson said.
“We’re always looking to give those different options for the patient so that they’re able to receive care how and where they’re needed.”
Cover photo: Dr. Blake Busey is one of the physicians at Texas Tech Physicians of El Paso who regularly meets with his patients via video call. (Photo courtesy of Texas Tech University Health Sciences Center El Paso)