COVID-19 Local Resource Guide

Telemedicine brings accessible and efficient
healthcare to you at home, likely to last past pandemic
By Virginia Dean
RUTLAND — Although telemedicine has been practiced
since the 1990s, it is needed and being used now more than
ever, given the recent and daily difficulties of the coronavirus
pandemic.
“Social distancing guidelines make it harder to do many
things, including going to doctor’s appointments,” said Peg
Bolgioni, marketing and public relations director at Rutland
Regional Medical Center. “Telehealth or telemedicine
is a great option in these types of situations.”
Sending those who show signs of the coronavirus or Covid-19
to a hospital or clinic not only overwhelms physicians
but puts patients and medical staff in danger from those
who are infected and need to be diagnosed, monitored and
quarantined, Bolgioni related.
With limited surgical masks and personal protective
equipment (PPE), reducing hospital admittance is essential
in order not to waste valuable resources and risk workers’
health, she added.
As such, telemedicine is rapidly emerging as a viable
alternative to keep those with moderate symptoms at
home while routing more severe cases to hospitals. But sick
patients screened virtually still need in-person testing to
determine if they have the coronavirus.
At the Rutland Regional Medical Center, for example,
telehealth is a workable option in many types of situations.
Clinics inform patients in video chats, for example, with
providers who are suitable. After consulting with their doctor,
patients can click on a personalized link provided on
their cell phones or computers to join them for a video call.
All data is secure, private and no information is stored. Most
telehealth visits are covered by Medicare, Medicaid, and
private pay insurance.
Simply defined, telemedicine is the remote treatment
of patients. It has been hailed by many as a solution to such
health care problems as long wait times, rural access, and
workforce shortages.
“There are so many bad things that have come out of this
time, but one of the good things is telemedicine,” said Dr.
Rick A. Hildebrant, chief medical information officer and
medical director for hospital medicine at RRMC. “While it’s
been around for a long time, hospitals have been reluctant
to adopt it, but now our hands have been forced and we’ve
broadly adopted telemedicine... Some doctors are seeing
up to 200 people per week!”
Telemedicine will not go away after this pandemic has,
Hildebrant forecasts. “Doctors now understand what a
great tool it is to connect
with our patients,” he said.
At Dartmouth Hitchcock
Medical Center, the
goal of telemedicine is to
determine if there is a need
to come into the office. Telehealth service lines include
outpatient virtual visits, TeleEmergency, TelelCN (neonatal),
TelelCU (critical care), TeleNeurology, TelePharmacy,
TelePsychiatry and TeleUrgent Care.
“Most types of appointments that do not require a
doctor to physically touch a patient can be accomplished
through telemedicine,” said Lisa Cramb, DHMC spokesperson.
“Doctors can evaluate, diagnose and treat patients
all remotely through the use of two-way technology such as
smart phones, computers/laptops, and tablet.”
In response to the current pandemic, the TeleICU and
TelePharmacy programs have expanded substantially, and
the outpatient virtual visits have grown exponentially to
“It’s 90% of our business right now,”
said Josh Roylance. “This just turned
the light switch on for everyone.”
2,000 telehealth visits per day in April 2020, Cramb related.
“This allows patients to continue to receive the care they
want and need and helps to reduce the risk of potential
exposure to the virus for both our patients and providers,”
said Cramb.
Medical Director Dr. Kevin Curtis, who oversees telemedicine
at DHMC, added that it is vital to the hospital’s
strategy to deliver health care to rural patients.
As schools and businesses have shut down during the
Covid-19 pandemic, area counselors have also expressed
concern about patients who struggle with mental illness
or others who have increased anxiety over the sudden and
now ongoing lack of normal structure in their lives.
At Gifford Health Care, in Randolph, psychiatric services
are available through video conferencing in an effort to improve
access to effective mental health treatment. Gifford
has partnered with Alpine Telehealth in Brattleboro to bring
these services to emergency department patients.
“In terms of telemedicine during Covid-19, Gifford’s Behavioral
Health and Primary
Care teams visit with their
patients via Zoom when
appropriate,” said Maryellen
Apelquist, communications
specialist. “We also provide
telemedicine visits for nursing home patients.”
Per the partnership agreement between Gifford and
Alpine, which has been in place since the spring of 2019,
telepsychiatry services are available at the Gifford ED and
hospital inpatient departments 24 hours a day, seven days a
week, and 365 days a year, Apelquist explained.
Services are provided using video chat on a web-based
platform that is fully secure, encrypted, and Health Insurance
Portability and Accountability Act (HIPPA)-compliant.
“We’re discussing additional telemedicine options with
a variety of potential partners and will share more information
as plans are finalized,” said Apelquist. “In rural areas,
telemedicine is one way we can access patient services that
Social services
Submitted
Doctors in a large variety of fields are practicing medicine remotely, either via phone or video calls. It’s called telemedicine
and it’s helped countless patience, while minimizing the demand on hospitals.
we otherwise may not be able to provide here.”
One of the drawbacks of virtual individual or group
meetings, however, is the potential inability to access the
required technology in addition to the reluctance to make
a physical appearance in the doctor’s office, resulting in a
shortage of patients, a decrease in cash flow and the potential
closing of small, independent practices.
At the Upper Valley Natural Health Center in White River
Junction, licensed naturopathic physician Dr. Rebecca
Chollet related that telemedicine is used to manage chronic
conditions and treat minor acute illnesses and injuries that
don’t require a physical exam.
“Conditions that can be treated via TM include anxiety,
depression, PMS, menopausal symptoms, seasonal allergies,
hypothyroidism, IBS, acid reflux, and arthritis,” said
Chollet. “In most cases, we’re able to accept new patients
although not for primary care services.”
The Center uses Doxy.me, a simple website platform
that doesn’t require downloading or installation of
software or applications, Chollet said. It does, however,
require that patients have a device with a camera and
microphone, either Firefox or Google Chrome browser,
and good internet/wifi service. Telephone “visits” are also
available.
In Woodstock, the Upper Valley Rehab offers tele-health
or tele-rehabilitation for physical or occupational therapy
through an internet enabled device with a camera. The
visits are live video sessions to diagnose the cause of pain
and lost function of joints and muscles.
“It’s 90% of our business right now,” said Josh Roylance,
co-owner. “It’s a platform we’ve been sitting on for about a
year. There are people in some desolate areas that couldn’t
get here. This gives the patient and their family the choice
to be treated where they want,” Roylance said. “Patients
do not have to visit a clinic to get treatment. Our therapists
coach patients and their families every step of the way.
Insurance companies have recently acknowledged it. This
just turned the light switch on for everyone.”
Covid-19 Local Guide • April 24, 2020 • 13