As the nation pushes toward staying at home and distancing to prevent the spread of the coronavirus, some doctors are turning to the internet to stay in touch with patients.


Many doctors, ranging from physicians and family medicine practitioners to mental health services have turned to telehealth as an alternative to in-person visits with their patients.


“There are all sorts of places where telemedicine has been very helpful,” said Dr. Duke Carlson, a family medicine physician with TexomaCare.


Through telemedicine, a doctor will use an online voice or video chat to meet with a patient and help treat and diagnose remotely. Through this, doctors are able to offer medical advise and write prescriptions for their patients.


During the ongoing crisis, Carlson said about 90 percent of his visits are being done remotely.


“If we can keep you out of our medical health buildings by doing a telehealth visit, that’s what we are going to do,” he said. “That’s the smart thing to do.”


For about the past 10 years, TexomaCare has utilized a portal app for doctors to communicate with their patients. However, these programs have recently been expanded to allow patients to connect directly to telehealth meetings with their doctors that comply with HIPAA laws.


One of the things that has held back telehealth was state restrictions on telehealth, but some of these restrictions have been loosened amid the coronavirus outbreak.


Carlson said not all patients will be able to use telehealth, but is a key tool for those who may be immuno-compromised or have health problems that would be exacerbated by the virus.


“Those patients are just really shy about coming into the office at this point in time, and rightfully so,” said Nick Arledge, market manager for IPM at TexomaCare.


In the case of patients who do need a physical appointment, Carlson said he is trying to schedule them in off-peak hours. In the case of some minor treatments, the patients can be met outside the office.


With the relaxing of some regulations, and telemedicine becoming more prominent during the coronavirus crisis, both Arledge and Carlson said they expect it to increase in usage moving forward.


“We just needed to get our feet wet,” Carlson said. “I think most doctors realize that there are instances where this is just great.


“I will have a patient who is kind of sick and I want to see them tomorrow, and probably every day this week, but it is hard for them to come in. For me to be able to do a telemedicine visit … is brilliant and a great tool.”


“This has sort of forced the envelope in our market and a lot of markets,” Arledge said. “We are having to do this, we really don’t have a choice.”


TCC turns to telemedicine for mental, behavioral health services


Another group that has been affected by the loosening of regulations on telemedicine is the Texoma Community Center, who employs nurse practitioners, counselors, and case managers, among others.


““We started moving people to telemedicine I would say just over two weeks (ago) just because we could anticipate that we were going to be on lockdown,” TCC CEO Diana Cantu said. Seeing what was going on across the country, we started moving people to teleservices.”


In the case of TCC, many of their services require a face-to-face visit, however some of this can now be done online.


““I hope that some of these rules that we have been pushing from a community center standpoint, that make services a lot easier for clients … My hope is that they will keep a lot of this,” Cantu said, referring to state regulations.


With many of TCC’s clients, transportation can be an issue, however remote meetings have allowed the center to connect more easily with its clients.


In other cases, telemedicine has freed up time for coordinators that can then be spent meeting and working with more clients.


“If you have a client in Gainesville, that is a 40 minute drive there and a 40 minute drive back,” she said. “Now you get those 80 minutes back that you could be working with another client.”


With the ongoing crisis, Cantu said the majority of the center’s staff is working remotely. However, a small skeleton crew still works on site for cases that cannot be handled remotely.


Among the limitations of telemedicine is that it isn’t always accessible to one of the center’s major client bases — the homeless.


“They know where we are physically, but they don’t have a phone,” she said.


Another limitation comes from the medium itself. In remote areas like part of Texoma, high-speed internet is not available.


An early adopter


One of the early adopters of telemedicine was Sherman’s Stanton Optical, who adopted the practice a few years ago to allow for eye exams when an optometrist is not in the office.


The optometrist’s office turned to telemedicine to fill in for days when a doctor would not be in the office or when there was a peak demand. Now, during the ongoing crisis, Stanton is using telemedicine for all of its exams.


“We’ve had a lot of people come in, and it is just something new that people are not used to,” Brand Manager Matt Gentry said. “Once you talk them through it, and walk them through the steps of how everything is done they are usually more comfortable with.”


Unlike many other forms of telemedicine, where the doctor is at the office and a patient is remote, Stanton does the exact opposite. A patient will be in the office while the doctor operates the refractive machinery remotely to find the best prescription.


The pre-screening and tests are still done by support staff in the office, Gentry said.


“I’ve had some people come in that were apprehensive, they were unsure what they were about to experience and you just explain everything to them … the doctor is still going to sign off on your prescription.”


Michael Hutchins is the local government reporter for the Herald Democrat. He can be reached at mhutchins@heralddemocrat.com.


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