Learn What One Doctor’s Experience Means for Widespread Use During COVID-19
by MARY TOOTHMAN
When a patient needs to consult with Bruce Cohen, the high-risk pregnancy physician knows it’s important to be accessible. The Boston resident has developed a system over the past few years that has enabled him to “see” patients in Winter Haven, even when he’s in Massachusetts and vice-versa.
Thanks to video camera enabled computers, Cohen connects regularly with patients who aren’t physically in the room with him.
“I would always go there at least one day a week, as well, so there’s been a combination of onsite and telemedicine,” he says. “This was a way I could keep seeing patients in Boston and at the same time branch out.”
Formerly a longtime faculty member at Harvard Medical School, Cohen operated a maternal-fetal medicine practice based in Naples, Florida, as well. Juggling locations became almost a non-issue once he eased into telemedicine. “I just thought, ‘Wouldn’t it be nice to extend services to those who otherwise would not have access?’” he says.
“Some of my patients are socio-economically disadvantaged — people who otherwise would not have these services.”
A look at Cohen’s biography gives a clear picture of his ability to be in several places at once. From1996 to 2010, he was on the faculty of Harvard Medical School and was an attending physician at Beth Israel Deaconess Medical Center, where he was appointed division chief of maternal-fetal medicine and director of maternal services.
In 2010, Cohen and five of his fellow division members from the Harvard faculty formed Boston MFM, a private MFM group practice. Cohen expanded his practice to New York in 2016 and added his Florida practice in 2017.
He is now chief executive officer of Boston MFM, vice-chairman of obstetrics and gynecology at St. Elizabeth’s Medical Center in Boston and medical director of maternal-fetal medicine at Winter Haven Women’s Hospital.
He sees patients in his practices in Brookline, at Bellevue Woman’s Hospital in Niskayuna, New York, at St. Elizabeth’s Hospital in Brighton, Massachusetts and at Winter Haven Women’s Hospital.
Being set up to address the needs of patients without geographic constraints has allowed for a more far-reaching patient base, allowing them to be provided with otherwise unavailable services.
There is, however, one medical professional in the examination room with patients who are consulting with Cohen. “There is generally a nurse practitioner, a midwife or a physician’s assistant with the patient,” he says.
He can share sonogram images and other test results on the screen viewed by the patient, as well as provide explanations and insight as well as answer questions.
Cohen is certainly not alone in his opinion that telemedicine is key to future healthcare needs — as well as allowing for social-distancing. A quick online search can easily tell you whether your physician offers the option and can offer names of providers that accept your insurance plan.
At evisit.com, an explanation of the process gives details on how telemedicine — or telehealth — can benefit patients.
Telemedicine is defined as the use of technology that enables remote healthcare. It makes it possible for physicians to treat patients whenever needed and wherever the patient is, by using a computer or smartphone.
Here are a few of the situations in which telemedicine can be a great alternative to the traditional health care system:
- Diagnosis of common medical problems such as headache, sore throat, back pain, digestive troubles.
- Inquiries about various medical issues for home treatments.
- Post-treatment check-ins or follow up for chronic care.
- Faster refill of short-term medical prescriptions.
- Holidays, weekends, late night or any other situation when a conventional visit is not possible.
- Patient inability to leave the house due to sickness or bad weather conditions.
Using telemedicine services is a very easy process, experts say. The services use an online account or a toll-free phone number. Patients request a visit and submit basic information on their condition. Then the physician accepts or declines the visit, or they have the option to reschedule it for a future time.
“This has become a new form of medical practice — not just a tool,” Cohen says. “And now that we have COVID, a lot of people are choosing to use video telemedicine.”
Although telemedicine usually can be worked out without special programs on the patient’s side, physicians may use helpful yet basic programs. Cohen uses a program that enables him to access patient records, and share them with practice records and/or hospital records.
Costs will vary among doctors. In Cohen’s case, he has an arrangement with Winter Have Hospital in which he’s paid a flat daily rate, and the hospital handles insurance and patient payment.
“We do not have to worry about that aspect,” he said. “We love our patients, and we love taking care of them. This allows us to focus on doing just that.”
The use of telemedicine solves one specific problem within the medical community quite well: location challenges.
“Doctors are not spread out evenly geographically,” Cohen says. “Sometimes practices are located in wealthier parts of the country, and oftentimes
people from different socially and/or economically disadvantaged areas have less access to certain physicians who can offer good, quality care.
“By using telemedicine, suddenly the geographical boundaries don’t matter anymore.”