It might be that insurance coverage of virtual visits may have been unclear to patients, especially at the onset of the pandemic. —Samantha Tam, MD, MPH
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August 2021
Dr. Sykes suggested asking patients about the barriers they anticipate when asked to adopt a new technology. “Some patients can use technologies, but they have privacy concerns or other reasons for being late adopters,” he said.
Given some patients’ challenges with technology, Dr. Moberly said it’s important not to discontinue traditional approaches for scheduling and communicating between patients and providers. “Maintain old-school approaches, because newer methods won’t work for some people,” he advised.
Here to Stay
Dr. Setzen expects telemedicine and the use of other technologies to remain strong long after COVID-19 is a distant memory. “Both physicians and many patients appreciate the ability to communicate this way,” he said.
The big break for telemedicine use came in March 2020, when CMS relaxed its guidelines for using telemedicine and were prepared to reimburse physicians as if a virtual visit were an office visit, consultation, or hospital visit, Dr. Setzen said.
Furthermore, other health insurance carriers went along with CMS and have been reimbursing physicians for using telemedicine. “Hopefully, CMS and insurance companies will continue to reimburse physicians for this important ability to communicate with patients,” Dr. Setzen said. “In the months to come, the use of telemedicine will obviously be less than during the pandemic, but it will continue to be used particularly preoperatively, postoperatively, during emergencies, and when patients are unable to come to the office.”
Dr. Sykes views technology as a way to reduce the costs in time and money, and to increase the convenience of health maintenance in otolaryngology. In some cases, this may mean enabling patients to monitor their symptoms with routine electronic delivery of patient-reported measures and dashboards to calculate significant changes warranting an in-person visit. “I anticipate artificial intelligence will play a significant role in medicine across all specialties,” he said. “We may be able to help outside providers monitor head and neck cancer patients remotely with computer-assisted endoscopic image analysis. I’m optimistic that interoperability of medical records systems will become a priority and increase our ability to coordinate care and appropriately use limited healthcare resources.”
Karen Appold is a medical writer in Lehigh Valley, Pa.
Technologies Enhancing Patient Care
In addition to virtual visits through telemedicine, otolaryngology practices are using a variety of technologies to communicate with and diagnose patients.
Brian D’Anza, MD, medical director for digital health at University Hospitals in Cleveland, Ohio, said that patients in his health system can schedule an appointment with a smartphone or computer using Schedule Me Now, a digital self-scheduling system. University Hospitals also uses the patient portal Follow My Health to send messages to patients. The portal provides a way for patients to message their care team and review laboratory results and notes.
At University of Kansas Medical Center in Kansas City, Kan., Kevin Sykes, PhD, MPH, said participation in the patient portal MyChart is encouraged. MyChart sends patients communications from care teams, test results, billing information, and prescription renewals. It can also be used to schedule follow-up appointments.
Jessica W. Grayson, MD, MS, of the University of Alabama in Birmingham, said patients are asked to complete digital questionnaires either before or at appointments. “This is meant to increase the clinic’s throughput while ensuring paperwork is completed,” she said. “Some patients take pictures of skin lesions or redness of the neck and upload them via a HIPAA-compliant site for evaluation.”
Mobile apps are being developed in conjunction with otoscopes and endoscopes so patients can evaluate their own ear canals, tympanic membranes, and nasal cavities either for self-diagnosis or to send to their doctor via telehealth appointments, said Katie Phillips, MD, assistant professor in the department of otolaryngology–head and neck surgery at the University of Cincinnati College of Medicine in Ohio.