A telemedicine consultation

I remember the first time I listened to a lecture about the future of telehealth in pediatrics. My first thought was, “Absolutely not! This is not how I imagined practicing medicine.” For me, being a pediatrician is rooted in the relationship you build with patients and families, and telehealth didn’t seem like a platform that could support that.

Then the COVID-19 pandemic started and in-person visits weren’t a safe option – so practices turned to telehealth. Through telehealth, physicians have been able to safely screen patients for symptoms of COVID-19 and provide families with accurate information about the spread of the virus. Over the last six months, telemedicine became a critical resource for families, and we must protect access to this resource when the pandemic recedes.

Telehealth, while new to many, has actually been an evolving aspect of medical care for many years. Over time, technology has become progressively more refined and with that has come numerous advantages. Such advantages include increased access for the medically underserved who often live in inner-cities or rural communities, as well as decreased costs to the health care system and families. In addition, telehealth is commonly used as a method of triage between emergency departments and has significantly decreased unnecessary transports from one facility to another, which results in an overall cost benefit without sacrificing quality of care.

Before COVID-19, many providers were hesitant to take the leap and adapt telehealth into daily practice, in large part due to a long history of patient care being delivered exclusively in person. When we remove that element of in-person care, it creates uncertainty and challenges the way in which we have become accustomed to practicing medicine.

Now that providers are embracing such care, the next hurdle that must be overcome is reimbursement. How will insurance companies cover these visits? Will virtual visits be reimbursed at the same rate as an in-person visit? What specific information needs to be obtained from patients and what level of treatment needs to be provided to patients in order to receive compensation?

Not all states have passed parity laws ensuring insurance coverage of telehealth, though Medicaid has been more progressive in coverage of these types of visits across the country. Connecticut is one of the states whose parity laws allow for telehealth coverage by private insurance, Medicaid and state employees’ health plans but this statute has limits.

Although in-person visits remain the best way to provide medical care, we are now at a crossroads where all industries, including medicine, are being asked to redefine how they offer services. This is the perfect opportunity to propel telehealth forward and to see how truly impactful it can be in both extreme times, such as a pandemic, and in daily life. We can use virtual visits to triage patients in their own home and reduce exposure to others along the way. This is invaluable from a public health standpoint, but also proves how useful this service can be moving forward.

Adapting telehealth into our practice does not replace in-person visits with a doctor or health care provider. Telehealth is simply an addition to our skill set. In order for telehealth to truly become a part of medical practice, we need parity laws that enable providers to receive appropriate compensation. Gov. Ned Lamont took a step in this direction by signing an executive order during the COVID19 pandemic to reduce restrictions on telehealth appointments. In July 2020, the State Senate codified this executive order by passing H.B. 6001 “An Act Concerning Telehealth.” Yet this bill only extends telehealth coverage laws until March 15, 2021.

Although no one can predict what the future will bring for the COVID-19 pandemic, it is clear that telehealth services will be needed for the foreseeable future. We have an opportunity to expand the utilization of telehealth and to understand how it can become an asset in improving access to medical care. We need to act now and urge our lawmakers to keep telehealth access in place even after the pandemic recedes.

Gabriella Chibbaro lives in Vernon.

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