By Dr. Jonathan Wiesen, M.D. / Special to Healthcare Facilities Today

High speed internet and affordable smartphones have helped revolutionize the healthcare system in the 21^st century, with the valuation of the telemedicine market on track to surpass $130 billion by 2025. This development comes at an opportune time, given our expanding elderly population and growing need to provide medical services to previously unreachable patients in rural areas. 

With the emergence of the coronavirus and concerns about its spread within healthcare facilities, telemedicine is poised to play an essential role in the management of this potentially devastating, global viral outbreak.

The virus was first identified and isolated in respiratory illnesses in Wuhan, China in December 2019, and in two months has infected 6,000+ individuals worldwide. In a dramatic response, China built two new hospitals in Wuhan in a matter of days to help combat the fast-spreading virus. Nevertheless, the outbreak has depleted resources of front-line hospitals and staff, who have been forced to turn patients away because of a lack of beds and even basic supplies. 

This trend is alarming to the global community, for whom the management and containment of the virus is paramount. The threat of a pandemic, however, has highlighted the benefits of telemedicine and its potential in helping to manage and prevent the further spread of viruses in healthcare facilities. 

A closer look at coronaviruses

A global pandemic involves the rapid spread of a disease worldwide.  The disease in question is often easily transmitted, and its level of virulence determines if it triggers a global crisis or is merely a clinical force to recon with, such as the common cold.  

Coronaviruses are a family of viruses that are well known and have been studied since the 1930’s.   While most are benign, particular mutations can cause an uptake in the virulence of the microorganism, leading to outbreaks of severe disease states. Coronaviruses are the family of viruses responsible for Severe Acute Respiratory Syndrome (SARS), which was responsible for over 700 deaths, and Middle Eastern Respiratory Syndrome (MERS). 

First isolated from a patient with respiratory illness in the Hubei Province, China, the 2019 novel coronavirus has since been identified in thousands of patients in China, with over 600 confirmed deaths, and has spread to over a dozen other countries, including the United States.  

With the virulence linked to this particular virus strand in the context of the global interconnected world, experts are justifiably concerned for wide and rapid spread of the infection.   

The good news is that infectious disease specialists, public health experts, physicians and public policy leaders have stepped in to take meaningful, aggressive measures to combat the spread of the virus. Chinese leaders have quarantined city inhabitants, closed local shops and instituted regulations on mask wearing, hand hygiene and close monitoring for anyone at risk of contracting the illness. Many countries have either limited flights or travel to China or stopped it entirely.  

Likewise, the United States has quarantined a large number of at-risk targets, ceased flights to China and issued a strict travel advisory. U.S. hospitals are stocking up on gowns and goggles and providing refresher courses in infection control. The CDC is recommending that doctors and hospitals adopt a “cautious approach” when treating coronavirus patients in their facilities.

Telemedicine benefits: Key player in mitigating virus exposure

Diagnostics

The initial signs and symptoms of the coronavirus are indistinguishable from more benign viruses such as the common cold and the flu, and it therefore cannot be diagnosed without molecular diagnostics. Individuals who may be concerned about their cold and flu symptoms can use telemedicine to contact a physician and seek advice without having to visit a healthcare facility, where they risk spreading the virus and exposing other patients and health care providers to the potential of a serious illness.   

Addressing exposure fears

Physicians should counsel patients who may need to travel to China about the risks involved. Those who were in the region or potentially exposed should be instructed on proper hygiene and other protective measures because isolation and quarantine can help prevent the spread of the highly contagious illness. 

Patients with potential exposure, and certainly those ill and at high risk for contracting the virus must seek medical attention immediately, alert those who they may have exposed and direct their medical team to rule out the coronavirus via specific diagnostic evaluation.  

Telemedicine may prove to be a useful area of health information regarding the spread of the infection, identifying new areas of infection and serving as a means of containment.  There’s no better clinical service for coordinating and quarantining a disease than a national centralized physician network with expertise in remote communications and cloud-based software reporting.    

Shortage of infectious disease specialists

Infectious disease (ID) specialists, who play a critical role in curtailing the spread of outbreaks, are in short supply. Between 2009 and 2017, the number of academic programs that filled their adult-infectious-disease training positions dropped by 41%, according to a report by Emory University.

This poses a problem for rural or suburban providers who may lack familiarity with a new contagion and available treatment options for their local population. Consequently, more healthcare facilities are seeking to leverage telehealth to treat infectious diseases. 

Part of the demand for ID telehealth is the dearth of specialists in areas other than heavily populated urban centers.  Moreover, a recent study demonstrated improved efficacy and lower mortality when using tele-ID services as compared with traditional care.  ID telehealth builds collaborative relationships for large and small health systems, enabling large facilities to reduce crowding while enabling smaller facilities to retain their patients and improve care through shared knowledge. 

Additionally, tele-ID programs can enable health systems to treat infections sooner, thereby shortening hospital stays and reducing healthcare costs. It can also limit outbreaks by helping doctors recognize and diagnose conditions faster, improve medication management protocols and decrease the risk of harmful infectious spread. 

Not all telemedicine solutions are the same

To address the coronavirus outbreak and fill gaps in care when healthcare facilities face a crisis or are filled to capacity, the best telemedicine solutions offer advanced analytics and technology and utilize sophisticated artificial intelligence (AI)-powered software with clinical and telemedicine input to improve outcomes and lower costs. Expanded care platforms can address gaps in care in conjunction with other technology, ranging from wireless devices and wearables to mHealth-enabled electronic healthcare record (EHR) platforms. The best solutions have worldwide capabilities and offer chronic disease management and a network of medical experts with broad and diverse experience. 

Healthcare leaders should think of the coronavirus as a wake-up call to appreciating the value of telemedicine for the continued management and isolation of the virus, as well as in coordinating care across the vast domain of the global outbreak. 

Dr. Jonathan Wiesen, M.D., is the founder and Chief Medical Officer of MediOrbis.