Trends in the use of telehealth during the emergence of the COVID-19 pandemic

Telehealth is a wonderful concept and I feel that it can save millions (if not more) in preventing unnecessary visits to emergency rooms. According to UnitedHealth Group research, two-thirds of hospital ED visits annually by privately insured individuals in the United States – 18 million out of 27 million – are avoidable (UnitedHealth Group, 2019). The average cost of a nonemergency that is treated in the emergency room is $2,032, a physician office visit for the same illness is around $167. The strain this puts on insurance companies effects every one of us as we pay insurance premiums that are higher than they’ve ever been. What we called “respiratory season” was a nightmare in the ER. We’d have an entire waiting room full of people with the flu or some other virus. Meanwhile we’d be getting actual emergencies coming in by ambulance through the back doors. We were completely overwhelmed and didn’t have enough manpower to go around, this was completely avoidable.

I believe the 2020 pandemic gave telehealth the opportunity that it needed to succeed. Telehealth most often involves an electronic connection to a geographically remote patient (Chamberlain University, 2021). During the pandemic, I used telehealth twice for my family. My son had swimmer’s ear and there was no chance I was taking him into the doctor’s office during the height of the coronavirus. Telehealth allowed me to keep my son at home, speak to the provider on my phone, then drive through the pharmacy for his prescription. It comes as no surprise that there was a 154% increase in telehealth visits during the last week of March 2020, compared with the same period in 2019 before pandemic-related telehealth policy changes and public health guidance were in place (Koonin, et al., 2020).

I don’t have many concerns about telehealth hurting my nursing practice. In long-term care we began using telehealth for the specialists’ visits. For instance, typically we had a psychologist to come into our facility once a month, now the visit takes place on an iPad and no one enters or exits the building. Other specialty appointments are also conducted in this manner and we’re hoping to keep this method even after the pandemic has ended. The residents of the facility have responded to telehealth in a positive way, although it was an adjustment in the beginning. As far as privacy, we do the telehealth appointments on a secure network and a particular iPad with the resident being the only person in the room (aside from the nurse).

According to the AMA Journal of Ethics (2014), there are four potential pitfalls that must be addressed to ensure that telemedicine is ethically acceptable: erosion of the patient-doctor relationship, threats to patient privacy, forcing one-size-fits-all implementations, and the temptation to assume that new technology must be effective. Face to face visits with the doctor do allow for a more personal experience and this allows for a more thorough assessment. However, if a relationship has already been established between the physician and the patient then this may not be an issue when in person visits aren’t possible. Privacy is always a concern and should continue to be, cyber crimes happen everyday and we must stay ahead of them. As with anything, there are positives and negatives. In my experience professionally and personally, telehealth has been a huge convenience.

Chamberlain University. (2021, August). Week 5 lesson: Virtual healthcare & simulation. Retrieved from Chamberlain University: https://chamberlain.instructure.com/courses/85274/…

Koonin, L., Hoots, B., Tsang, C., Leroy, Z., Farris, K., Jolly, T., . . . Harris, A. (2020). Trends in the use of telehealth during the emergence of the COVID-19 pandemic-United States, January-March 2020. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention.

Mehta, S. (2014, December). Telemedicine’s Potential Ethical Pitfalls. AMA Journal of Ethics, 16(12), 1014-1017.

UnitedHealth Group. (2019). The high cost of avoidable hospital emergency department visits. UnitedHealth Group.

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