Telehealth has been an until recently underutilized tool in local health care. But with the onset of the COVID-19 pandemic, and both CDC (Center for Disease Control) guidelines and government restrictions including the cessation of all medical procedures deemed non-life saving or sustaining, conventional means of treatment and overall health care and maintenance were no longer viable.

But the need for patient care did not stop with the onset of the pandemic, and doctors at King’s Daughter’s Hospital in Ashland (and elsewhere) needed to devise a means of continuing vital patient support. The solution was to turn to a medical tool which allowed doctors to care for their patients while maintaining social distancing, and that tool was telehealth.

“Telehealth is basically doing a clinician to patient encounter using modern technology,” said Dr. Charbel Salem, KDMC Chief Medical Officer. “The patient and the clinician, provider or physician, even a social worker or a psychologist, nurse or case manager are able to interact and see one another on the screen. But they will also be able to document the encounter on an electronic health record, and in a very developed system be able to share medical information.”

One example Dr. Salem gave is the ability through telehealth to share imaging and labs.

“So, you know it is really a good way to share face time with a patient, but it is a medical facetime,” Dr. Salem said. Using the telehealth technology, doctors will be able to show their patients things such as X-rays in a near person-to-person equivalent and will be able to advise them of issues which might need addressed. And it also allows the doctor or health professional to perform a reasonable facsimile of a visual examination.

Though the technology isn’t where it truly needs to be, it is being refined as quickly as possible. Dr. Salem said. But he said he sees the role of telehealth as a supportive role, a useful tool among others in providing the best care for patients. “We have learned as doctors who have practiced telehealth that there is a role for in-person visits that cannot go away. A patient who has chest pain, who is short of breath, or has a severe cough needs to go to urgent care, and there is no question about it. But we have learned through this pandemic that there is a role for a visual encounter with a doctor where the doctor can tell a lot about them. They can take their blood pressure and blood sugar from home, so there is a role for both.

“I look at telehealth as being a supplemental role to in-person visits to the doctor or the hospital,” Dr. Salem said. “Especially in the follow-up to the in-person visits. And there is also a huge role it can play in substance abuse treatment. It can prove very effective in that role.”

Dr. Salem said telehealth can prove effective in all types of medical treatment across the spectrum of potential patient needs.

Dr. Stacey Caudill, Chief Medical Officer at KDMC, offered further potential uses of telehealth.

“I think as we move forward, allow home health care nurses back into the homes as well you could have the home health nurses initiate the call and do the exam for you,” Dr. Caudill said. “And those patients who are having difficulty getting out of their homes, while they have home health nurses, it’s a good opportunity for them. It’s also a good opportunity for nursing homes. I have a 96-year-old grandmother with bad arthritis at Kingsbrook Nursing Home. So, to allow her to not have to get in a car and travel to an appointment, they will set up a telehealth meeting with Dr. Salem. And he can show her labs and adjust her medications without that high-risk population having to go into a different high-risk area. Or if I am seeing a patient in primary care and I would like to consult Dr. Salem, I can do that through a telehealth call.

“It allows for a lot of collaboration we haven’t seen in the past,” Dr. Caudill added. “But the biggest piece that I believe has shown the highest results is psychology.”

Dr. Caudill said that King’s Daughters was awarded part of the Core Grant, the Opioid Response Effort Grant, to work with Greenup County Drug Court. As a result, Dr. Caudill, a nurse practitioner, and a case manager are regularly calling those in the program through telehealth.

“They typically have difficulty with transportation and difficulty with compliance. And telehealth gives us much more frequency of visits than if they have to try to come see us,” Dr. Caudill said.

Dr. Caudill said they have seen a serious increase in opioid-related deaths and suicides during the pandemic.

“So, I think moving forward, to allow more accessibility and being able to visualize someone as opposed to just speaking to them on the phone, we can get a much better feel of how that patient is doing,” Caudill said. And having “eyes” on the patient is often as important as seeing their labs, Caudill said.

The value, and future increased value, of telehealth is undeniable and is supported by the doctors and patients who have benefited from its use. It is another increasingly effective tool used by health care providers to achieve their ultimate goals — the health and well-being of those under their care.

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