The swift adaptation of the Alabama health care system to telemedicine during the virus crisis has been “nothing short of a miracle,” says Dr. Eric Wallace, UAB medical director of telemedicine. “We have seen a massive growth that has decentralized the health care system in a six-week period.”
The UAB Medical Center used to conduct only three visits per day by telemedicine out of a total of 5,700, says Wallace, and “UAB is now doing 59 percent of its ambulatory care this way. We are up to about 1,300 video visits a day and about 1,200 phone visits. The number of video visits continues to increase, as providers have started to get to know the software better and the process continues to be refined.”
The virus and home sheltering drove the change, but it also required changes in attitude, mostly on the part of doctors, and changes in insurance coverage.
“We have made leaps and bounds as far as reimbursement, spearheaded by Blue Cross and Blue Shield, the first in the state to allow coverage for treating patients in their home,” says Wallace.
Less of a hurdle was any reluctance on the part of patients. Rather, doctors had to change from thinking “You as a patient need to come in to see me to personally reassure you,” says Wallace. Many doctors would rather see their patients, but all else being equal, “that decision should be patient driven and not physician driven,” says Wallace. “Giving patients the choice: That’s where the system needs to go.”
UAB has measured patient satisfaction with their telemedicine experience at 90 percent, says Wallace, and doctors are holding tight to this lifeline to their practices.
“Within a week” of the state’s first guidance bulletins, “patients weren’t coming in,” says Wallace. Revenue losses quickly went to 80 percent, so doctors aren’t complaining about the 350-fold increase in telemedicine visits, he says.
What doctors are wanting now, says Wallace, is reassurance that the new system will continue and continue to be covered.
Blue Cross and Blue Shield of Alabama covered telemedicine until June 1, and vice president of Healthcare Networks Services Dr. Darrell Weaver says, “It seems to be working well so far, so we hope to continue after June 1st indefinitely.”
Wallace says he is consulting with the insurers and hoping for at least a six-month extension. “When you’re scheduling patients every three months, you don’t know how to schedule them now for the end of June. If Blue Cross turns it off, it’s a major problem. We’re working with the insurers to see what it will look like after the crisis. We hope we all get enough lead time to design something we can be proud of.”
