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Editorial: Telehealth rises as robust option

In response to mandated social distancing in place to counter COVID-19’s spread, many health care providers are turning to telehealth, which has long been heralded for its potential to make some services more accessible and efficient.

It’s encouraging then that Hawaii appears to be well-positioned to handle a surge in virtual visits with doctors and nurse practitioners.

In 2016, Gov. David Ige signed a bill into law that requires the state’s Medicaid managed care and fee-for-service programs to cover services provided through telehealth, stating that these programs “shall not deny coverage for any service provided through telehealth that would be covered if the service were provided through in-person consultation.”

During a news conference Thursday, Lt. Gov. Josh Green pointed out that while the state is grappling with many coronavirus-related concerns, the push to expand the reach of telehealth — medical visits through videoconferencing or a phone call — is one of few “silver linings.”

That’s because in addition to addressing the immediate need for remote health care options, moving forward, telehealth can help ease the pain tied to Hawaii’s longstanding doctor shortage. While there are some 4,000 doctors in practice in the islands, the state is more than 700 physicians short of what a similar community has on the mainland.

In response to the threat of curtailed access to prompt services, the medical community is rightly stepping up efforts to expand and fortify its statewide workforce. Telehealth figures in as a fix that can help meet both anticipated challenges, such as contending with a rise in chronic conditions like Type 2 diabetes, and less predictable matters.

Amid the coronavirus outbreak, many of us are learning by trial and error how to navigate apps for videoconferencing of remote workplace meetings as well as casual get-togethers, ranging from pau hana potlucks to exercise groups. Telehealth, too, is ready to go mainstream.

In the wake of many physicians halting the everyday flow of in-person appointments, telehealth comes as welcome relief in that it helps to maintain continuity of some patient care while at the same time, helping to avoid the spread of COVID-19 infection in waiting rooms, clinics and related facilities.

At the Queen’s Medical Center, telemedicine milestones date back to 2004, when the Queen’s Neuroscience Institute secured a federal grant to improve neurological care in rural areas, and affiliate North Hawaii Community Hospital received a grant for telemedicine equipment to upgrade trauma care at its Hawaii island site.

Matthew Koenig, Queen’s medical director of telemedicine, said last week that the coronavirus is spurring a dramatic jump in the center’s telehealth visits, which he described as a 45-fold increase over the previous baseline. Further, Queen’s online find-a-doctor now features includes 250 physicians listed a “telehealth ready.”

Still, while telehealth can be a good fit for a wide range of quick and transactional consultations — from medication management to post-surgery checkups — not everything can be handled by video or phone-in appointments, of course. And the service does not replace the role of a primary care physician.

Before plunging in, health authorities advise, any would-be patient should ask their PCP, nurse practitioner or clinic contact whether conditions or treatments in question are medically appropriate for telehealth. For cases getting a green light, the state has launched a new resource that can help establish virtual connections, www.hawaiicovid19/telehealth.

The COVID-19 emergency is pushing telehealth to the forefront, to play an important role in providing care. It also should retain a prominent role in Hawaii’s post-pandemic future.

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