Stanford Medicine Children’s Health Sees a Surge in Telehealth Visits During Coronavirus Pandemic

Since the World Health Organization officially declared the coronavirus outbreak a global pandemic, Stanford Medicine Children’s Health has ramped up its telehealth services and digital health programs to help care for patients safely amid the COVID-19 epidemic.

As of late April, Stanford Medicine Children’s Health care teams are seeing up to 800 virtual medical visits daily, before COVID-19 hit California, it was 35. Virtual visits allow patients and/or their guardians to interact and consult with their health care provider, who can review the patient’s medical information for the purposes of diagnosis and treatment, go over test results, fulfill prescriptions, and provide patient education.

Stanford Medicine Children’s Health care teams have been using telehealth since 2013 to connect physicians with patients who do not live near the hospital or a specialty services center. A pediatric physician with Stanford Medicine Children’s Health recently conducted his 1,000th telehealth visit.

Virtual visits allow patients and guardians to interact and consult with their physician. 

“The ultimate goal is to keep people with symptoms at home and to practice social distancing,” said Natalie Pageler, MD, chief medical information officer at Stanford Medicine Children’s Health. “Unless their condition warrants intensive hospital care, these virtual visits allow us to see patients who require ongoing care for follow-up appointments, decrease emergency room crowding, and save travel time for patients who need care.”

As use of telehealth continues to increase, children’s hospitals are seeing additional health benefits to using virtual visits. In some cases, the technology enables physicians to see aspects of their patients that they don’t normally see during a clinic visit. Some providers are having more open and natural conversations with patients and their family members because they’re seeing the child in their home environment and doing their daily routine.

“We had one of our pulmonologists doing a telehealth visit for one of his obstructive sleep apnea patients who happened to be asleep at home, so he was able to see him sleeping,” Dr. Pageler told Children’s Hospitals Today. “In some ways, it’s like bringing back the home visits—we’re seeing a lot of surprise benefits from this massive rollout of digital health.”

Doctor Pageler further explains how telehealth is being used and how it is changing the future of health care:

How is telehealth being used differently now from before the pandemic?

Telehealth utilization has ramped up significantly over the past months. Virtual visits are being used both for virtual COVID-19 evaluations and to support non–COVID-19–related health care remotely to minimize patient and family exposure and support social distancing.

A new use case for telehealth has also developed in the inpatient setting, where virtual visits are being used to allow physicians to care for patients in isolation while conserving personal protective equipment like masks and gowns. 

In our telehealth program for outpatient clinics, our pain treatment service, urology, and reproductive endocrinology patients are big utilizers of the virtual visits because they do not need to conduct physical exams every time. Telehealth is also being used for preconception consults, fetal consults, and postnatal checks.

Can telehealth be used to test for COVID-19?

While providers cannot diagnose a coronavirus infection during a telehealth visit, they can consult on symptoms to help determine whether testing is appropriate. They can also offer guidance on self-care and quarantine tips.

Are there visits that do not work via telehealth?

A provider may determine that a particular condition is not suitable for treatment via telehealth and that it may be necessary for the patient to seek medical care and treatment in person and/or from another physician or provider. For instance, regular prenatal care is one of the areas right now where our providers feel that in-person visits are still necessary.

Who is eligible to do virtual telehealth visits?

To get started with telehealth, talk with your provider’s office to see if you are a good candidate for virtual care.

Are telehealth and digital health going to change the way doctors practice medicine—is this the new norm? 

This pandemic has fast-forwarded this process immensely, and it is a huge change in practice and workflow. Telehealth is becoming the new way to monitor acute patient symptoms and keep people out of hospitals and clinics if they do not really have to be there. Once people try it and learn how to use it, they will see the value and incentive to continue using virtual visits.

When life returns to “normal,” our next objective is to look further into the value equation of digital health, including the clinical and technical quality side of care as well as patient and provider experience, to determine where digital health is the most appropriate form of health care delivery.

We will continue to develop our technology and our processes to best support patients and families such as increasing ability to have multiple parties in telehealth visits and the ability to share screens and documents. We already enabled remote signup for our patient portal, so then we started getting into remote monitoring or remote equipment requests. Now that people are seeing what can be done from home, the ancillary tool requests will also go up with that.

By monitoring the patient’s data, learning to identify the issues, and reaching out to the patient proactively to make care changes from a distance, we can better promote continuous, proactive, connected health care and happier, healthier children and families.

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