On March 18, 2020, CMS temporarily banned “elective surgeries, and non-essential medical, surgical, and dental procedures ” in order to reserve hospital and ICU capacity exclusively for COVID-19 cases. One month later, these restrictions were loosened and care facilities began to slowly reopen for office visits, outpatient tests, and elective procedures that had been deferred.
Now, as we face another surge in COVID-19 that threatens to be worse than anything we’ve seen to date, hospitals are again starting to postpone or cancel elective procedures to free up space and ensure proper staffing and PPE to care for COVID-19 patients. These actions, while they may be necessary in certain regions, can also have devastating results.
“Deferred Care” Does Not Mean “No Care”
Our Chief Nursing Officer, Lisa Romano, stresses that elective doesn’t mean unnecessary, especially for patients who have cancer or other life threatening diseases or chronic conditions.
During the first peak of COVID-19, researchers found an overall drop of 74% in new cases of breast, lung, prostate, colorectal, and hematologic cancers and melanoma, compared to 2019. This is not because there is less cancer, but because fewer occurrences are being identified as a result of deferred screenings. These patients did not suddenly get better. Many have already begun to experience consequences as a result of delays in treatment and diagnostic testing. In addition, many are suffering clinical and emotional consequences as they wait to have their procedure or test.
In order to avoid worsening outcomes and more expensive care in the future, patients must ensure they don’t put off screenings for too long and that they maintain regular contact with their providers to monitor their conditions. Until these appointments can be rescheduled or moved to another facility, more providers are turning to telehealth to avoid poor patient outcomes.
Here are three areas in which hospitals and health systems are ramping up their telehealth offerings as more elective appointments are deferred.
Care for Patients Whose Surgeries Have Been Postponed
The term “elective” is being applied to everything from non-emergent treatment to preventive medical services for patients of all ages. But to a patient with a cancer diagnosis or a senior citizen in pain waiting for a hip replacement, there is nothing “elective” about their need for treatment, especially when a surgery has been cancelled.
Karen J. Brasel, MD, MPH, a professor and trauma surgeon at Oregon Health & Science University offers this advice to hospitals who have postponed patient surgeries:
“Patients need to know that your surgeons are here for you. In my system, surgeons are seeing patients and answering patient questions through electronic media. They are still working and having both virtual visits and responding both synchronously and asynchronously to patients.”
CipherHealth’s patient outreach solutions let patients know they are still important as they wait for their surgery, without placing any extra burden on staff who are tending to patients affected by COVID-19. CipherHealth enables automated communications that can be used to encourage more virtual appointments and regular communication of patient status to understand when their symptoms may take a turn for the worse and need immediate medical attention.
Care for Chronic Conditions
Patients with chronic conditions such as heart failure or diabetes are beginning to monitor and report their own test results through remote patient monitoring devices, such as a portable EKG monitor or blood glucose monitor. Through telehealth, such as virtual appointments and asynchronous care, doctors can continue to monitor these patients remotely until they are able to schedule an in-person appointment.
Automated patient outreach can also help keep chronic conditions in check as care providers proactively reach out to patients via their preferred method of communication (call or text) to see if they are experiencing any difficulties and need to speak to a clinician. If the patient indicates a problem, she can have the option of scheduling a telehealth visit rather than forgoing care because her provider has deferred elective appointments. CipherHealth’s automated solutions help to identify and address issues that might otherwise worsen if care is deferred, resulting in much more costly and extensive treatment later on.
Home-based care solutions such as HomeCare HomeBase have made it possible for more patients to be treated at home, and more caregivers and family members to participate in the conversations between providers and patients to ensure the patient can continue to receive care at home.
For example, as an alternative to an on-site physical therapy appointment that may have been deferred, a physical therapist could conduct virtual sessions with elderly patients who are at home. These sessions could also be used to teach caregivers how to perform simple exercises and give advice on how to reduce the risk of falls. CipherHealth’s automated solutions streamline communications to strengthen patient and provider connections across all care settings and modalities, including home-based virtual visits.
As the nation braces for the highest surge in COVID-19 cases yet, more hospitals and care facilities will need to cut back on or postpone elective screenings and procedures. At the same time, providers will need to invest in and operationalize telehealth to help reduce the burden on staff while maintaining continuity of patient care. CipherHealth’s digital engagement solutions help to identify and prevent staff burnout and PTSD, as well as improve patient communications pre- and post-visit, whether in-person or virtual.
Maintaining a constant flow of information and ensuring that the needs of all patients and staff members are met during the pandemic will be key to sustaining many hospital operations as we enter the next critical stages of the pandemic.