Getting started: Chronic health conditions and telehealth
More than half of Americans have been diagnosed with at least one chronic health condition, according to the Centers for Disease Control and Prevention. Chronic diseases are the leading cause of death and disability, and are also responsible for driving the cost of health care.
The severity and even the occurrence of chronic health conditions can often be mitigated by telehealth care services.
There are many common chronic conditions that can be treated and managed, in part, through telehealth.
Getting a patient’s asthma under control is a top priority, but it can often require multiple appointments to check symptoms, tweak medications, and test breathing levels. This can be difficult for patients to manage if they live a long distance from a doctor’s office or clinic. Some patients also cannot afford to travel, take time off work, or find childcare. Telehealth can help.
There are several ways telehealth providers can help a patient control their asthma to avoid hospitalizations or a life-threatening event.
- Remote patient monitoring with devices such as a pulse oximeter and a peak flow meter
- Follow up appointments to discuss medication, review asthma diaries, or order new medication
- Messaging through a secure patient portal for topics such as nebulizer use questions, identifying triggers, or questions about dosages
More than 37 million Americans have diabetes, according to the Centers for Disease Control and Prevention, and most of them have type 2 diabetes.
Prevention is key to treating patients, as well as promotion of a healthy lifestyle, both of which can be done via telehealth appointments. For patients with type 1 or type 2 diabetes, doctors can also use telehealth to monitor blood sugar and insulin levels. Here are a few ways to manage diabetes via telehealth:
- Diet and nutrition counseling
- Weight loss and exercise counseling
- Remote patient monitoring with blood glucose devices
- Secure patient messaging to check in on progress
- Remote orders and evaluation of diagnostic testing and bloodwork
Researchers are still studying the cause, effects, risk factors, and treatment of long-haul COVID-19, known officially as post-acute sequelae of SARS-CoV-2 (PASC). Post COVID-19 symptoms typically appear three to four weeks following COVID-19 infection. Long-haul COVID can affect anyone who was infected, even those who had mild symptoms or no symptoms at all.
Telehealth providers can be on the lookout for these symptoms of long-haul COVID-19:
- Difficulty breathing or shortness of breath
- Fatigue or lightheadedness
- Symptoms that get worse after physical or mental activities
- Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
- Pain in the stomach, chest, joints, or muscles
- Heart palpitations
- Pins-and-needles feeling
- Sleep problems
- Mood changes
- Change in smell or taste
- Changes in menstrual cycles
Telehealth providers may choose to follow up with long-haul COVID-19 patients more frequently. Telehealth treatment options may also include:
- Referral to a specialist
- Prescription medication for certain symptoms such as cough, headache, stomachache, or trouble sleeping
- Orders for diagnostic testing or evaluation for chest pain, heart palpitations, difficulty breathing, and dizziness
More than 42 million Americans are considered obese, according to the CDC, and are at increased risk for heart disease, type 2 diabetes, certain cancers, and premature death. Talking to patients about their weight can be a sensitive, but necessary conversation.
Using telehealth to manage and treat obesity can help patients feel more comfortable tackling their health challenges from the comfort of their own home. Telehealth treatment options may include:
- Remote patient monitoring using a digital scale that sends automated results
- Counseling with a registered dietician
- At-home exercise plans
- Mental health counseling and/or online support groups
- Secure messaging to share food or exercise diaries and progress updates
There are many other chronic medical conditions that can be at least partially treated or managed with telehealth, including:
- High blood pressure
- Certain cardiovascular diseases
- Respiratory conditions
- End-stage renal disease
- Dermatological conditions
- Rheumatological conditions
- Mental health conditions
- Parkinson’s disease
- Certain cancers
- Oral health
Benefits of managing chronic conditions with telehealth
Telehealth isn’t a substitute for in-person care of chronic health conditions, but it is an important tool in providing consistent, convenient care for patients who need ongoing medical attention.
There are several telehealth benefits for patients:
- Access to more preventative care for rural or low-economic patients
- More access to specialists and subspecialists
- Increased comfort and convenience for patients who have mobility or pain issues
- Increased confidence for patients who may feel embarrassed to be seen often in-person for their chronic conditions
Did you know?
According to the CDC, about 90 percent of the $3.8 trillion spent annually on health care in the U.S. comes from chronic disease and mental health treatment.
Cost savings with telehealth programs
Telehealth for chronic conditions saves money for patients and providers. It also reduces strain on the overall health care industry.
Cost savings for patients include:
- Lower costs in travel, childcare, and time off work for routine follow-up appointments
- Fewer hospitalizations and emergency room visits
- The potential for less medication if their chronic disease is more under control or even eliminated through routine telehealth care and monitoring
Cost savings for providers include:
- Fewer in-person appointments which means fewer in-house resources and expenses
- Fewer missed appointments because patients can’t travel or find childcare
- The ability to see more patients because there isn’t as much turnaround time in exam rooms
- Less need for late office hours to accommodate patients who work during normal business hours
Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and Costs Across Six Networks – Rural Telehealth Research Center
SpotlightDrake University College of Pharmacy and Health Sciences
Drake University’s College of Pharmacy and Health Sciences has partnered with Des Moines-based telehealth company Certintell, and Tabula Rasa HealthCare to improve chronic conditions in patients who live in rural Iowa.
Using a $1.6 million grant from the Health Resources and Services Administration (HRSA), researchers and providers are working to improve and control hypertension, diabetes, and high cholesterol through telehealth. Patients will receive telehealth visits with primary care providers, a medication risk assessment from a certified advisor pharmacist, and remote-patient monitoring. The Drake University College of Pharmacy and Health Sciences pharmacist will participate and assist with patient telehealth care, which will influence future generations of telehealth care providers.
Their goal is to improve patients’ overall health. This will also lead to fewer health problems, such as falls and injuries, as well as fewer emergency department visits and hospitalizations.