Addiction experts across the country are turning to telemedicine to offer their services to patients amid the pandemic.
Some are saying this method has actually improved the way they’re able to help some patients.
The health and medicine publication STAT recently spoke to several addiction experts about telehealth resources and expanding their services during the pandemic. Among them was Dr. Stephen Loyd, chief medical officer of Cedar Recovery in Mt. Juliet, Tennessee.
Getting patients with substance use disorder to and from the clinic is “a big block to people getting help,” he says. Loyd says using telemedicine has helped him see more patients who might previously have had barriers to access, especially those from rural areas or without a driver’s license.
“When we incorporated this, the percentage of patients that we had showing up regularly for their scheduled appointments skyrocketed,” he says. “I've had multiple days over the past month where I had 100% show rate, which was unheard of before the pandemic.”
Using video conferencing has been able to give Loyd a better glimpse into the living situation of some of his patients. He says he was able to identify a few patients who were homeless and living out of their car or going from hotel to hotel, couch to couch.
He says he was able to broach the subject with them and connect them with available resources.
“It gave me insight that you can't get from, you know, a face that somebody puts on coming into your clinic because a lot of times they're just ashamed,” he says.
On any challenges in prescribing medicine to patients over a video call
“I feel almost guilty for saying this, but it's way better. Most of our clinics that I oversee and that I run, we use medication, buprenorphine, a lot of people know Suboxone, and there are multiple challenges of that. Diversion is a problem. You know, altering prescriptions sometimes can be an issue. But with what we're doing now, it's all done electronically. This was in the process of happening [before the pandemic] just on a really slow pace, but it actually makes prescribing easier.
“I can see a patient, evaluate their needs, hook them up with their therapist or group therapy. And then right after it's over, they get an email with their next office visit without standing in line, leaving the office, waiting on an appointment card — traditionally that's written down with the date and time. And then all the while, the medication goes directly to their pharmacy via e-prescribing. And so we were doing some of that anyway. But now it's every patient. And the other thing is, we've actually worked with some pharmacies that we can actually have patient's medications delivered directly to their door. So we're not even exposing them to be getting out and going into a pharmacy or exposing our pharmacy interaction with our patients.”
On if resources moved mostly to video conferencing, on whether or not the jobs of people who work in clinics would be needed
“The truth is, all of them probably won't be. But that doesn't mean that you can't use them for other things. So a lot of the people that we hire are in recovery themselves. And for some of them, it's difficult to find jobs because of our country's propensity to try to use the criminal justice system for drug treatment. And so they have [past] charges that make it hard for them to find a job. So we're talking about repurposing those folks into recovery coaches, recovery support services, which we know here are very important in all phases of recovery, but essentially the first part of recovery. So now you talk about taking them out of jobs, of checking patients in and out and then moving them into jobs where they can actually start to do some of the things that they've been trained in, because a lot of them are certified peer recovery specialists. So I think you still have the same number. I just think you'd become more able to enhance your recovery support services.”
On whether he sees this system working after patients are able to get back to in-person doctor visits
“I certainly hope so. This is a tool that we've had hopes for a long time. That was probably coming in small increments over the next few years. And the pandemic, obviously, has speeded up. But I certainly hope we have the opportunity to use this tool. And as I said before it's hard to put the genie back in the bottle. Now that it's out there and we know what we can do. And really, whenever you're talking about people with opioid use disorder, it's about access to treatment.
“I live in metro Nashville, just right outside of Nashville, Tennessee, and a lot of my patients are not from metro Nashville. They're from rural areas. And so now you're talking about being able to save them driving distances 30 to 45 [minutes], some patients an hour, each way in their car to and from the office. All these limitations that patients have that maybe you're struggling with jobs and don't have the money for gas and things like that. Now you're able to deliver that care really over the internet. It's really, for me, it has been a godsend for my folks in rural areas. And I certainly hope we don't get that tool taken away from us. But I can tell you, one really positive thing that's already happened in Tennessee is our largest insurer, Blue Cross Blue Shield, made an announcement last Friday that they are going to continue telehealth services even after the pandemic. And I'm hoping that the other insurers fall in line around that because that was such great news. I immediately screenshotted that headline and sent it to my peers that feel the same way I do.”
“... Do I want to replace all of my interactions with my patients with the telehealth platforms? No, I don't. I love the patient interaction. It's why I'm a doctor, you know, and to be honest with you, a lot of times it feeds me in that personal interaction because my patients do well. You know, I was telling somebody earlier today, my favorite visit is the second one, because the second one, I get to see how far somebody came in just a few days, and it's really amazing. I think that that's hard to replace on a computer. And so I think that there still [needs to] be that doctor-patient interaction, but this is a huge supplement and allows us to deliver care in rural areas that otherwise is very, very difficult to deliver.”
This segment aired on May 21, 2020.