Telemedicine, telehealth encouraged as clinics look to continue serving patients amid COVID-19 concerns

Northeast Mississippi Daily Journal (Tupelo)

Mar. 18--TUPELO -- State and national leaders are relaxing telemedicine requirements for physicians in an effort to serve patients amid COVID-19 concerns.

Mississippi reported 34 confirmed cases of the virus as of Wednesday, up from 21 Tuesday. The state Health Department said 513 people had been tested in by Wednesday.

On Sunday, the Mississippi State Board of Medical Licensure held an emergency telephone meeting, deciding that while Mississippi is under a state of emergency, the board will not enforce any statutes, rules or regulations that will require physicians to personally examine patients prior to issuing prescriptions or ordering the administration of medication, including controlled substances, according to a press release. Out-of-state physicians must contact the Mississippi State Board of Medical Licensure for authorization to practice telemedicine for patients in Mississippi.

The decision was made to encourage all physicians to utilize telemedicine to help avoid unnecessary patient travel, the press release said.

"It eases patients' access to their physicians using telehealth," State Health Officer Thomas Dobbs said during a Monday press conference.

"(Clinics with advanced capabilities) will be able to access people at the home using mobile technology, which is the main thing we're talking about, so people can get assessments at their home," Dobbs said at the press conference.

Access Family Health Services, with clinics in Houlka, Smithville, Pontotoc, Tremont, Tupelo and Nettleton, has primarily used telehealth for behavioral health but will be looking at options to make broader use of telehealth at this time, said Executive Director Marilyn Sumerford.

She listed using telehealth for wellness visits that don't requirement physical assessments or lab testing and behavioral health services as perfect applications of telehealth during this time.

"I think right now there's a lot of anxiety about people just not wanting to come near a clinic, so you can give some reassurance and at least lay eyes on a person," Sumerford said.

MedPlus Family & Urgent Care, which has clinics in Fulton, Oxford and Tupelo, has been working on telemedicine for the last two years and sees this as a great opportunity to use the service for existing and new patients, said MedPlus Director John Logan. They have already used primary care for the elderly and to renew medications.

"(Through telemedicine) we can see them either through the computer monitor or through their cell phones ... and talk to them," Logan said. "Our providers are trained to treat them through telemedicine."

Both Access and MedPlus offer limited COVID-19 testing and see telemedicine as an opportunity to talk to potential COVID-19 patients before a face-to-face visit and help them determine if they should come in for testing.

Their facilities have changed some of their regular clinic practices as a precaution to keep patients and staff safe.

Both ask that patients coming for COVID-19 testing not enter the physical clinic for their testing. MedPlus tests patients at their cars, while Access asks patients seeking COVID-19 testing to call to schedule an appointment. Clinic staff advise patients where to park and they assess patients at their vehicles. Patients may be escorted to the clinic's designated testing area or swabbed at their car.

Testing is only done for patients who show symptoms of coronavirus, which includes cough, respiratory issues or fever, have traveled to an area with COVID-19 cases in the last 14 days, or been in contact with people who have tested positive for COVID-19. Symptoms of coronavirus can be similar to other conditions such as the flu or strep, so clinic staff test for other illnesses to rule them out.

Tuesday, the Trump administration announced plans to expand telehealth services for Medicare users, which primarily serves those above the age of 65. The Centers for Disease Control and Prevention names older adults among those at higher risk for serious illness from COVID-19.

With the new initiatives, patients can communicate with their doctors without having to travel to a healthcare facility and limit their risk to exposure and spread of coronavirus, said Centers for Medicare & Medicaid Services Administrator Seema Verma. Applicable HIPAA penalties will not be enforced. President Donald Trump also gave states the authority to cover telehealth services for their medical patients.

"This shift is very important for clinicians and providers who, over the coming weeks, will face considerable strain on their time and resources," Verma said.

Gov. Tate Reeves announced the expansion of the state's telehealth coverage on Thursday through a press release, instructing the Mississippi Division of Medicaid to expand and allow additional use of its telehealth services to limit unnecessary travel, clinic visits, and possible exposure through April 30.

Details of the Emergency Telehealth Policy includes allowing beneficiaries to access telehealth services from their home and use their personal cellular device, computer, tablet, or other web camera-enabled device to seek and receive medical care with a qualified distant-site provider. Any limitation on the use of audio-only telephonic consultations is waived.

These enhanced telehealth options will be available in fee-for-service Medicaid, Medicaid managed care, and the Children's Health Insurance Program, according to the press release.

"We're not taking any chances. We are taking every step necessary to slow the spread of COVID-19 and ensure public health throughout Mississippi. This is about protecting our doctors, our nurses, our healthcare workers, and all Mississippians. Increasing telehealth services across Mississippi limits the potential for exposure and helps combat the spread throughout our communities," said Reeves in a press release.

In the future, MedPlus expects 50 percent or more of patients to be telemedicine visits, Logan said. He emphasized the clinics would still be here for other illnesses and continue offering X-rays or anything needed for worker's comp claims, suturing and other services.

"We're obviously here as usual until 7 o'clock every night seven days a week," Logan said.

Access asks patients to not schedule wellness visits until the COVID-19 crisis is over. Patients with scheduled appointments should call when they arrive and wait in their car until their team calls. Patients are taken to designated sick and well areas and encouraged to sit at least six feet away from other patients. The clinic is also doing its normal procedures of cleaning more.

"Primary health care clinics are not unaffected like other businesses would be because we're trying to help our patients as far as medication refills and different things to keep them out of the clinic," Sumerford said. "We can provide services that can help us keep our staff employed."

Sumerford said using telehealth would provide a layer of protection, but recognized "it doesn't work for everything."

"It's not going to replace that person-to-person contact, but I do think that it can make everybody feel safer during this time," Sumerford said.

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Twitter: @Danny_McArthur_

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