It is highly unlikely that anyone in our nation can honestly say that they do not know about COVID-19. The respiratory illness of global pandemics has been spreading in rapid succession across the United States and data models depict that the peak has not yet been reached, revealing a critical need for flattening the curve.
United States situation summary
As of April 1, the nation is in the acceleration phase of this pandemic. The severity and duration of each phase of the virus depend on the locale and the variation of the primary mode of transmission. At this point, all 50 states in the nation have reported cases.
The causes include:
● Cases that have been imported from Americans traveling both domestic and internationally
● Close contact contamination of a known cause
● Community spread cases of an unknown cause
More than half of the United States is reporting either defined area or widespread community spread of the virus in their individual states. Daily updates of state-by-state confirmed case counts along with fatalities can be found on the CDC site.
CDC testing protocol and laboratory locations
Laboratory tests solely proposed for the identification of the COVID-19 virus are done by testing respiratory specimens. Public health departments on the state and local levels are in possession of tests that the CDC has provided. Providers are administering tests that have been developed and marketed by commercial manufacturers.
The CDC has specific guidelines on who can be tested with their tests, but the ultimate decision as to who can be tested sits with state and local level health departments and/or clinics. Clinicians are urged to work in conjunction with the health departments to coordinate for testing to be done through public health labs or work with clinical or commercial labs. A public health lab testing map is available through the CDC.
The Center for Disease control is expecting that there will be a widespread transmission of the virus. Unfortunately, the numbers we are seeing now are only expected to surge. The best way to protect yourself is by staying at home. If you think you have been exposed, stay away from family members, especially anyone in your home who may be considered at-risk.
Monumental relaxation of telemedicine requirements and regulations by the federal government
The federal government made a monumental move that may permanently redefine the delivery of health care. The CARES Act has been rolling out in phases and has changed everything from the use of HSAs and health plans with high deductibles (HDHPs). Congress changed legislation to include a “safe Harbor” for policies with high deductibles that began on or before December 31, 2021.
Provision of pre-deductible coverage for remote health care services via telehealth is included. This means that certain patients (such as Medicaid patients) can be provided remote care without the violation of federal regulations. It is important to note that the terms telehealth and telemedicine are interchangeable.
CMS has expanded the benefits in the CARES act based on the emergent pandemic under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. The goal of the waiver is to raise awareness for all Americans that they have access to benefits that can keep them in their home while still having access to the benefit of remote health care delivery. Medicare will now pay for multiple types of visits that are delivered by way of telehealth starting March 6.
HIPAA regulations have been relaxed as well. Platforms such as Facetime and Skype can now be used to provide remote services to patients, whereas they were not allowed prior to the pandemic due to lack of security for the information exchanged during the remote visit.
Clinician trend in leveraging telemedicine for remote monitoring of vitals
Many Americans are not aware that their doctor can receive their vitals at prescribed frequencies with patient compliance and the use of remote technology. Vitals such as blood pressure and blood glucose reading can be taken in the home by the patient or caregiver and be sent to the provider in real time.
The efficiency of remote patient monitoring
The level of an RPMs efficiency is dependent on usability and design. Communication is normally multimodal therefore it is necessary for clear and concise detail of the who, how, and when with regards to the transmission of patient data.
The user-centered design of these devices involves end-users in all stages of health care delivery and clarification of users’ needs along with the usage context are key elements for building the system within a pre-existing clinical workflow. Digital literacy will increase the satisfaction of the patient and raise the levels of adequate usability.
When the Pandemic Recedes, Will Telemedicine Usage and Regulations Remain? The boon for health care providers across the nation has shown the nation’s realization that illness is not going to disappear because of a pandemic. For patients who do not have transportation to and from the doctor, are in the at-risk category, or are in a rural setting where driving two to four hours just to see a physician the availability of telehealth has been a sigh of relief.
There is a current urgency to keep patient flow in the hospitals down so that COVID-19 patients can all be seen and cared for. IT departments everywhere are scrambling to enable EMRs to communicate with platforms for telemedicine that will meet the HIPAA, GDPR, PHIPA-PIPEDA, and HITECH requirements.
Just short of being able to physically touch the patient, physicians are able to conduct a true assessment of how their patients are doing and convey lab and test results to them. If remote patient monitoring is present, this is the time that vitals are discussed. The ability to see patients in their homes has served to increase the feeling of trust that patients have for their doctors.
Innovations in telemedicine and the relaxation of requirements and regulations has created a shift in the paradigm of American health care delivery. If all health care providers rally together and urge the HHS and the presidential administration to continue the current guidelines after this chaos has receded, the example has now been formed for insurance companies on the commercial front on how the facilitation of patient care can be successful. This is likely the new normal for medicine.
This groundbreaking change has many seeing a future of more technology becoming mainstream and widely trusted by patients. Telemedicine is not only here to stay; the expansion will likely become widespread.
Heidi West is a writer for Vohra Wound Physicians, and she writes about healthcare and technology in the medical industry.
