Dr. Lin Hogan used to meet with his clients in his office for much of the workday. They would sit on a sofa or chair and chat with him about their mental health needs.
But in the spring of 2020, his routine suddenly changed.
Hogan, a doctor of clinical psychology and a Board Certified-TeleMental Health therapist at Weems Community Mental Health Center, started spending his day on the telephone, which was his new way of counseling his clients. It's a different scenario to which many therapists and health providers are accustomed.
“We’re used to meeting with people in person,” Hogan said. “And absolutely as a counselor, as a therapist, there’s so much dynamic that goes on face-to-face.”
Hogan is one of many healthcare providers who started using telehealth during the COVID-19 pandemic to meet with their patients.
Telehealth is a broad term that refers to any use of electronic information or telecommunications to provide health care or health education, according to Dr. Keith Everett, the chief medical officer at Anderson Regional Health System.
One example of telehealth is a doctor emailing a handout about eating healthy to her patients. Another example of telehealth is telemedicine, which is when a health provider uses technology to deliver care to a patient from a distance, according to the American Academy of Family Physicians.
Local health professionals say telehealth has expanded during the pandemic, which is helping to make health care more accessible for people in rural communities.
Professionals expect that telehealth will continue to be used, and will likely grow, in East Mississippi.
Growth of telehealth during the pandemic
Telehealth has expanded at Rush Health Systems during the pandemic, but it is not a new phenomenon for the health system.
Dr. Fred Duggan, the health system’s chief medical officer, said Rush had already used telehealth in several ways, one of which was Telestroke, a tool that allows stroke patients in the emergency room to see a neurologist.
But when the pandemic hit, use of telehealth became more widespread at Rush Health Systems. Some patients weren't able to come to their doctor’s clinic, so they started meeting with their physician through telemedicine. The federal government gave Rush and other health systems waivers that have allowed patients to video chat with their provider on non-HIPAA compliant software.
Many Rush patients have returned to in-person appointments by now, but some are still choosing to see their physician through telemedicine. These patients use the MyRush portal, which is HIPAA-compliant, to video chat with their provider.
At Anderson Regional Health System, physicians have been holding certain follow-up appointments through telemedicine. Everett said before the pandemic, Anderson used telemedicine appointments sporadically, but the pandemic made these appointments more common.
Anderson and Rush have also both been practicing another aspect of telemedicine called remote patient monitoring, which is when patients use devices at home to measure their heart beat, their heart rhythm or other data about their health. The data is collected over time, and it’s shared with a patient’s physician. Because this data is gathered at home, patients do not need to visit their doctor’s office as much as they had to in the past, Everett said.
Advantages and disadvantages of telehealth
Dr. Jennifer Rodriguez, an interventional cardiologist at Cardiovascular Institute of the South, often meets with patients via telemedicine.
“I think it can help reduce the amount of in-person exams and the inconvenience associated with having to go to a doctor’s office,” she said.
Telehealth allows patients to spend less time driving to or getting a ride to doctor’s appointments, Rodriguez said.
Hogan, the therapist at Weems, similarly said telehealth makes it easier for people to access therapy, as they do not need to drive to their counselor’s office and pay for gas for the trip.
“When we’re talking about rural communities and outlying communities and things like that, telehealth is extremely advantageous,” he said.
Telehealth has its limits, however. Everett noted that doctors can’t conduct a complete physical exam on a patient or do procedures through video conferencing.
Hogan noted that many clients have missed meeting with their counselor face-to-face because of the human connection formed during those meetings. The counselor’s office, where lights are dimmed during sessions, is also an important part of the therapy experience.
“This is a therapeutic environment where they come in and feel comfortable,” Hogan said, “and express themselves and work through issues.”
Future of telehealth
Duggan said Rush plans to continue to expand its telehealth visits, which allow patients to meet with their doctor from home.
Rush also plans to use telehealth to help solve the problem of a lack of specialists — such as rheumatologists and neurologists — in rural areas. One way Rush is already doing this is through the use of Telestroke. Rush would like to continue to expand the kinds of specialty care that it offers through telemedicine, Duggan said.
An upcoming merger will asisst in this effort. Rush announced Thursday it will merge with Louisiana health system Ochsner Health. The partnership is expected to be finalized in mid-2022. There are some medical sub-specialities that Rush does not currently offer, like pediatric cardiology. The merger will allow Rush patients to meet with Ochsner physicians in these sub-specialities over telemedicine, said Larkin Kennedy, CEO of Rush Health Systems.
Everett said some people think the use of telehealth could decrease in the short-term, but he predicts it will grow in the long-term.
“We certainly expect technology to continue to develop capabilities that will make it easier and more reliable as far as the delivery of telehealth and telemedicine,” he said.
At Weems, telehealth has allowed counselors to continue to meet with their clients during the pandemic, Hogan said.
“The good news is we were able to keep up with just about everybody via telephone,” he said.
Hogan said Weems is transitioning back to in-person counseling, and he has started to see some of his clients in person. He is hoping that Weems will be able to offer its clients both in-person and telehealth options after the pandemic ends — including video conferencing, which the mental health center does not yet offer.
“I’m hoping that video conferencing will be a part of our services in the future, too,” he said.