Columbia lawyer Byron Gipson gave telehealth a try for the first time because of the coronavirus pandemic. He needed hernia surgery. The surgeon he chose works almost two hours away at MUSC Health in Charleston, South Carolina.
Gipson would need to be in Charleston for the actual procedure, of course. But because of the pandemic, his preop meetings with his surgeon became virtual visits instead of in-person consultations. Gipson used his iPad to meet with Heather Evans, M.D., via video.
“There’s a little trepidation that you feel, that you’d like to see her face to face here or there, but she was reassuring,” Gipson said. “After meeting with her the first time, it was clear that she is obviously at the top of the profession. She knows what she’s doing. She’s just got a really good bedside manner. Well, video-side manner,” he joked. “She’d be great on Netflix.”
Telehealth was new to Evans, too. “I learned, along with everybody else in the midst of the crisis, trying to find a way to care for patients. My experience this summer was I switched to entirely video-based clinics for probably two or three months. During that time, I figured it out as we went along.”
She liked what she saw. “We really have made things work for patients in this unprecedented time. We took advantage of a crisis to be able to follow through on something that needed our attention at the time. I really think this opens us up to a whole new way of taking care of patients.”
As the South Carolina Telehealth Alliance marks telehealth awareness week, it does so at a time when more people than ever have actually used telehealth. The SCTA is a statewide initiative created by the state legislature in 2013 to expand telehealth. MUSC, which has its own Center for Telehealth, serves as the SCTA’s headquarters.
While it’s not clear yet how many people have tried telehealth in 2020, a report from the Department of Health and Human Services noted that the number of Medicare primary visits jumped from less than 1% in February to 43.5% in April as the coronavirus forced people to stay home.
Doctors across the state and across a range of specialties are adjusting. Gregory Perron, M.D., a family care doctor at MUSC Health, had never used telehealth before the pandemic. “I see patients from the child-adolescent years on up but the majority of my patients are adults. During the pandemic, I’ve done video visits for patients as young as 6 and as old as 95.”
That works for a majority of the problems he treats. “We can really provide very good care via telehealth. I have some people who drive from Myrtle Beach and Florence where taking a half day off or a whole day off to drive to my office to have a brief office visit — if a physical exam isn’t needed — is not a good use of the patient’s time. I think there will definitely be a role for continuing telehealth visits after the pandemic.”
When Perron needs to see patients in person, he arranges that at the end of the video visit. “For example, if a patient brings up a rash, back pain or joint pain, I may arrange for an in-person exam.”
MUSC Health psychologist Eva Serber, Ph.D., has seen advantages and drawbacks to telehealth during the pandemic. “My behavioral medicine clinic works solely with medical patients — people who are medically ill. That includes patients who come from all around South Carolina to the state’s only organ transplant center at MUSC.”
Telehealth allows them to get mental health care at home. “People sometimes have to travel anywhere from two to four hours for an appointment with us. Add sickness to it, and that makes it very difficult. Telehealth lets them stay safe in their homes and to continue to get the treatment they need.”
But there are cons, too, Serber said. “There’s a variety of barriers that are widening our health care disparities. Some patients don’t have smart phones or any device that’s capable of video. Some might have video capability but they don’t have good internet service. And some patients just don’t like the video or aren’t comfortable using technology. I have patients who are like, ‘When do I get to see you in person?’”
It’s a reminder that just having technology doesn’t ensure that it works for everyone and every situation. The pandemic has given telehealth a growth spurt with a few growing pains as well.
Gipson, the lawyer who needed hernia surgery, liked that it allowed him to see Evans without leaving Columbia. “That really made it convenient. If I’d come down, I’d have been on the road for an hour and 45 minutes both ways for an appointment that may last a half hour. It’s an important half hour, but she was able to convey all of those things through telehealth.”
Evans said telehealth made sense for her, too. “I reviewed his CT scan, which he got in Columbia, before our video visit. I was able to share my screen and go over it and explain how I was making decisions about planning his operation. We talked about the risks and benefits. He wanted to move forward even though we’d never met in person.”
The surgery was a success. And so was Gipson’s experience with telehealth. “Especially in these times when you have concerns with COVID, it’s a reassuring way to be able to do it.”
