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Telemedicine emerging as a first line of defense during flu season


By using proven technology, physicians can help contain the spread of potentially dangerous viruses to vulnerable populations, while still seeing patients in a safe, timely, and convenient way.

©Balint Radu/ 

We’re still reeling from last year’s flu season. The worst in 40 years, it culminated in a death toll of 80,000 people, including 180 children, and 900,000 hospitalizations. 

Flu season is especially exhausting for physicians on the front lines, who take the brunt of increased visit volume and risk contracting the flu themselves. Many of us have our own families and loved ones to worry about-and we end up doing double duty, taking care of our loved ones once our work days have ended.

Despite many physicians diligently working to help prevent the spread of the flu through prevention measures, such as vaccines and hand washing, horrible flu seasons can still hit unpredictably. However, in the past few years, we have seen physicians using an additional effective first line of defense to combat the spread of disease: telemedicine.

Why offer telehealth 

Even for patients with readily available, and easily accessible, in-person primary care physicians, using telemedicine has advantages over making a beeline for a brick-and-mortar office: 

Most importantly, telemedicine applications make it possible for patients to check in with a licensed physician without leaving the house. Minimizing the number of contagious patients in waiting rooms helps limit the spread of disease to other patients and medical practice staff.  

Second, most patients own at least one digital device. An all-time high number of Americans have one or more broadband access points (e.g., smartphones, tablets, laptops, etc.), and only one is needed for an IP-based telemedicine consultation. 

Additionally, most patients are likely covered. Changing legislation has made it easier and more affordable to access virtual care. Right now, 34 states and Washington, D.C., require insurance companies to cover virtual visits in the same way they cover in-person doctor’s office visits. Case in point: Seniors will soon be gaining more access to telehealth thanks to the approval by Congress in 2018 of a federal budget that includes expanded access to virtual doctor visits for Americans covered by private Medicare Advantage plans.

Virtual case studies

Last year’s flu season was intense and widespread, but also provides many illustrations of best practices in using telemedicine to assess and treat the flu. 

Nemours Pediatric, for example, directed patients to the organization’s 24/7 on-demand pediatric telehealth program (called CareConnect), which provides families with access to Nemours pediatricians through a smartphone, tablet, or computer-whether they are at home, school, or even on the sports field. The organization interfaced with hundreds during last year’s flu season, keeping many from getting sick or infecting others. In addition, physicians were able to help to ease the anxiety of families who feared the worst at their children’s first sign of sickness.

Another example comes from Anthem, which operates Blue Cross and Blue Shield plans in 14 states. The organization made news for skillfully directing its members to access “LiveHealth Online,” a service with an easy-to-navigate interface, that helps patients connect with U.S.-based, board-certified healthcare providers for a wide variety of non-emergency medical care 24/7.

American Well alone saw seven times the volume of flu-related video visits from the previous year. But telehealth traffic paled in comparison to that of emergency departments (EDs), which filled up so quickly that hospitals started redirecting patients to telehealth as a first line of care.  While there are circumstances in which you should go to an ED-such as if you are pregnant, 65 or older, or fall into a high-risk category (the CDC has some guidelines here)-a qualified physician or healthcare provider can assess your symptoms and recommend next steps virtually.

Finding the right platform

Providers who have never leveraged telehealth before should familiarize themselves with what telemedicine can do, but also what it can’t.   

The facts: Telemedicine can bring a patient face-to-face with physician or qualified healthcare provider in a matter of minutes, so the provider can listen to and observe the patient for symptoms, such as runny nose, watery eyes, and coughing. If the physician deems a patient’s condition serious but not urgent, he or she can explore treatment options, such as prescribing antiviral medications to lessen symptoms. And if a patient needs to go to the ED, a virtual physician can triage quickly, while providing much-needed reassurance.  

While understanding telemedicine’s role during outbreaks is important, the more critical part of incorporating telemedicine is understanding its role in the practice’s overall strategy. Physicians and other providers must understand the advantages and disadvantages of using technology to connect with their patients. The practice must come to agreement on its long-term and short-term goals associated with incorporating technology to increase access to care. Finally, patients need to be engaged and educated on what can and cannot be done through a video visit. 

With these parameters in mind, practice groups should carefully consider the quality of physician experience, as well as user ratings, when vetting digital health platforms. Does the telehealth technology connect with the EHR? Is the user interface sufficient for both the provider and the patient?  And is support available 24/7?

Bracing for the flu season will always be challenging. But by using proven technology, we can keep appropriate flu patients at home and help contain the spread of potentially dangerous viruses to vulnerable populations, while still seeing patients in a safe, timely, and convenient way.  

Sylvia Romm, MD, MPH, is the vice president of clinical transformation at American Well. 

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