Pandemic or not, for those who suffer from chronic pain, every day is a struggle to get certain tasks done. That’s why it’s important that pain care specialists stay fully informed on how telemedicine is serving both patients and providers during this time of social distancing and after states start the process of reopening.
The Centers for Disease Controls and Prevention (CDC) advises that telemedicine should be used for many nonessential appointments as “available and appropriate” for the duration of the COVID-19 pandemic. However, in pain management, what constitutes “essential” vs. “nonessential” is not always clear.
There are certain recommendations for musculoskeletal spine physicians and pain care providers on how best to make these tough calls. In sum, to determine what is medically necessary, a specialist should factor in the pain level of the patient and the potential for function loss if a procedure is postponed. For example, there are instances where a procedure may be technically considered elective, but it still shouldn’t be put off due to quality-of-life reasons.
But for most routine medical appointments, the path of care is more straightforward. A commonsense approach should make it easy to determine what is well suited for telemedicine — and why.
Why pain management physicians need telemedicine for their practice
Telemedicine has numerous practical benefits. At its core, much like doctors’ house calls of a different era, telecare services allow patients to stay exactly where they are when they’re sick or ailing, instead of traveling potentially great distances to a clinic or hospital and congregating in common spaces where disease can easily spread.
For certain kinds of patients during COVID-19, telemedicine is turning out to be a far more convenient — and effective — standard of care. For parents with kids at home, caregivers of the sick, and those living in rural or underserved areas, telemedicine can bridge a wide gap to high-quality healthcare. Of particular import to patients with mobility issues from underlying chronic pain, telehealth is making routine medical appointments quicker, easier, safer, and more convenient.
For no other group is this more critical than for the elderly — a population particularly vulnerable to the coronavirus and the complications that stem from it. Among COVID-19 deaths, a jaw-dropping 80% are 65 and older. In other words, for older adults, having access to telemedicine can be, quite literally, a matter of life and death.
So, now that patients are using telemedicine not only for convenience but out of basic necessity, expansion of telecare across the medical spectrum seems both imminent and permanent. How to adapt this reality to pain management is the question. Here are a few ways pain management providers are transitioning and prioritizing appointments for telemedicine.
How pain specialists can deliver care virtually
Many kinds of pain care appointments fall within the guidelines for telemedicine by the CDC. These are conversations that lend well to video, as they’re generally focused on exchanging information, looking at or talking through symptoms, and discussing options on how to move forward.
1. Initial consultations
There’s usually at least one consultation with a patient before drawing up any treatment plan to review their medical records, ask questions, and determine if they’re a good candidate for your care.
Whether the patient is undergoing an upcoming surgery, recovering from a long-term injury, or suffering from pain due to neuropathy, your job is to determine: Are there any other health considerations with this patient? Are there alternative treatments or supplemental therapies you need to explore? Does this patient fully understand their upcoming procedure, medication risks, and/or treatment plan?
2. Basic follow-up care
Follow-ups with patients are routine and generally about ensuring a patient is well on the road to recovery after a procedure — and is suffering no unforeseen complications from their treatment. Such appointments are also a great time for patients to ask additional questions or get clarity over a complex treatment plan.
3. Sensitive, nuanced, or challenging conversations
There are times when discussing matters with a patient face to face is better than a phone call, email, or text. Such as in the case of walking a patient through a challenging diagnosis or to discuss treatment options in further detail. A private video chat can fill this function in times of need.
4. Monitoring medications, chronic pain, or a patient’s mental health
According to new research, 93% of patients would use telemedicine to manage prescriptions or learn more about new medications. Under COVID-19 guidelines, physicians may be able to prescribe, monitor, and renew medications, including those to help harm reduction in cases of opioid use disorder and addiction, virtually. Ongoing treatment plans for chronic pain also need to be monitored — especially when pain medications pose long-term risk for addiction, health problems, or mental health issues. Keeping tabs on these patients’ medication use, dosage, tolerance, etc., is important and easily served by telemedicine.
5. Identifying patients who require an in-person visit
Perhaps most importantly, the function of telemedicine is to screen patients and determine who needs to come in to see a doctor — and who can be treated remotely. During COVID-19, elective procedures are generally being rescheduled; however, the line between “elective” and “essential and urgent” care remains thin.
For example, pain medications via injection can be prescribed on an emergency basis — but ultimately, what constitutes an emergency is up to the physician, the suffering of the patient, and what your training and gut tells you as a specialist.
What are the risks of telemedicine?
Every form of medicine carries some challenges and risks, and telemedicine is no different. The possibility for miscommunication and misdiagnosis — which comes with its own set of issues and liabilities — is slightly heightened, for example. Even telemedicine itself could come under scrutiny as we consider the ways in which technology often fails us: scams, breaches in security, privacy, or issues of noncompliance are all possible — some even caused by user error. You can try to mitigate some of these issues by ensuring your team is well trained on your telecare platforms as well as all accompanying privacy policies.
Finally, choosing the right telecare solution is important, as your platform needs to be easy enough for you, your patients, and your staff to use; present very little friction with user installation and adoption; and, ideally, be able to grow with your practice both during and after the pandemic. Pain management physicians across the country have discovered a solution that’s fast, user-friendly, HIPAA-compliant, and free: VirtualVisit by Doctor.com. Learn more about VirtualVisit here.
The world continues to lean on telemedicine to address an unprecedented demand for remote medical care. And, without a doubt, providers’ and patients’ appetite for telehealth will continue to grow, even as we shift beyond COVID-19 into a “new normal” for healthcare. By getting the right technology in place today, pain management physicians will be far better positioned for what’s to come tomorrow.