With telemedicine, avoiding spread of COVID-19

Rachel Bowles, a family nurse practitioner at Family 1st Care, interacts with a patient via the office’s telemedicine platform.

As state and federal leaders expand access to telemedicine options, Gainesville medical facilities are using them to help patients without risking exposure to COVID-19, the disease caused by the new coronavirus.

In a press release issued last week, Gov. Greg Abbott said “As the State of Texas responds to COVID-19, we continue to work to maintain regular health care services and operations throughout the state, and telemedicine is one of the most valuable tools we have to ensure Texans continue to receive the health services they need. Expanding telemedicine options will help protect the health of patients and health care professionals, and help Texas mitigate the spread of COVID-19.”

One local clinic, Family 1st Care, has offered a virtual visit option since it opened last year. On average, the clinic was conducting about two telemedicine appointments a week. As officials began lifting telemedicine restrictions, Family 1st Care’s telehealth visits have risen fivefold, to 25 appointments a week.

“When the crisis hit, we implemented a more user-friendly system that enabled us shift to ‘social distancing’ virtual care services immediately,” said Rachel Bowles, FNP-C and one of the clinic’s founders. “Because we are a private clinic with established patient relationships, we wanted them to know they can still see us, literally, and it will be a doctor they know — not someone they haven’t met or who really doesn’t know them.”

At Family 1st Care, patients without insurance are charged $40 for a telemedicine visit compared to $100 for an office visit.

“Cooke County encourages the use of telemedicine during this pandemic,” Cooke County Judge Jason Brinkley said. “Any tools that can be used to help limit contact with potentially infected individuals and the limit public spread is vital. Cooke County is working very closely with other public entities in the county, including cities, hospitals and community partners to provide the best local response possible to the pandemic and to try to account for various potential scenarios.”

He added that Cooke County is currently not working directly on advancing telemedicine services for its residents, “however, as the situation evolves, all options are on the table.”

Abbott also suspended state rules blocking the use of phone consultations to establish a doctor-patient relationship. Before, telemedicine services only could be provided after the doctor-patient relationship had been established in person.

The Texas Department of Insurance issued an emergency rule requiring state-regulated health plans to pay doctors for virtual visits at the same rate they would pay for an in-person visit. Last week, Blue Cross Blue Shield of Texas announced it would stop charging its fully insured members copays for telemedicine services. Most other private insurers are following suit.

Medicare is also a beneficiary of federal mandates to make telemedicine more accessible. Now, Medicare will pay for office, hospital and virtual visits in patients’ residences. Doctors, nurse practitioners, clinical psychologists and licensed clinical social workers also can conduct online visits with their patients.

In addition, the U.S. Health and Human Services Office for Civil Rights will not penalize physicians for privacy law noncompliance when they serve patients in good faith through common communications technologies such as FaceTime or Skype.

“NTMC is aware of the reduced restrictions on telemedicine and the value it can provide during this crisis,” said Thomas Sledge, CEO of North Texas Medical Center. “We are in process of adding telemedicine capacity at our primary care clinic. Even with the reduced restrictions, we still must be mindful of our patients’ private health information (PHI) and information technology infrastructure security. Therefore, we are making sure that the telemedicine solution we choose meets our cybersecurity standards and is HIPAA compliant.”

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