The new coronavirus sweeping the world has changed life as we know it. While there is a lot that we don’t know about the virus, we do know that people with heart and other conditions are more likely to get seriously ill from it. At the same time, all of us are concerned about patients getting appropriate care. So, the use of phone calls and patient portal messages to manage patients is dramatically increasing. Remote monitoring of implanted devices will support the chronic disease population, while distributing noninvasive monitoring using weight scales, blood pressure cuffs, and other more standard cardiac monitoring will need to be established to help replace routine nursing visits.
Virtual visits will have to replace outpatient cardiac clinic visits for an undetermined period of time to promote social distancing.
How can a video/telephone visit take the place of an in-person visit?
It is a lot safer because it avoids physical exposure to other patients and crowding. The physician can review all the tests, symptoms, concerns, labs, and medications during the interview just like an in person visit. Patients can ask any questions they have. Also, while it seems distant, the doctor sees the patient, can ask for the vital signs, observes if the patient can respond well, is breathing well, can move extremities, can speak full sentences etc, all the things that would be normally assessed except listening to the heart and lungs.
Does insurance pay for this?
Yes. Because of concerns about COVID-19, most insurances want patients to be taken care of this way.
What about testing?
If tests are needed, such as cardiac testing, X-rays, etc, patients can come in on a scheduled basis wearing masks. Their temperatures are taken, symptoms assessed, and patients are sent in. If the patient needs to be physically seen, he or she can be brought in under similar circumstances.
How difficult is it for a patient who is not very computer savvy?
Most of these apps are fairly easy to use. Patients can use a smartphone, too. Worst-case scenario, patients can do it on the phone.
How long is this likely to go on?
It is unclear, but it’s likely to continue for the foreseeable future or perhaps even longer. A lot of our patients have transportation issues or are in assisted-living facilities, and this would be a great way to keep in touch with your doctor.
What about surgeries and hospital procedures?
Every patient coming in for a test gets tested for COVID, and if negative, proceeds to the planned procedure. The staff will wear masks and gloves. Everyone’s temperature is taken.
Should younger people also take precautions?
It is true that older people are more at risk for more serious outcomes, including death. However, all patients are at risk. And even if they don’t get very sick, they might be able to spread the infection. This is why everyone needs to be careful.