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Pandemic Creates Opportunity For Telehealth To Catch On

The coronavirus pandemic has prompted more people in Massachusetts to turn to telemedicine. Here, Dr. Philip Ciampa from the Atrius Health innovation center (left) talks with a colleague (at the top of the screen), in a demonstration of a "virtual visit." (Robin Lubbock/WBUR)
The coronavirus pandemic has prompted more people in Massachusetts to turn to telemedicine. Here, Dr. Philip Ciampa from the Atrius Health innovation center (left) talks with a colleague (at the top of the screen), in a demonstration of a "virtual visit." (Robin Lubbock/WBUR)

The use of telehealth services in Massachusetts has "expanded exponentially" as a result of the COVID-19 pandemic, Health and Human Services Secretary Marylou Sudders said Friday.

Sudders and Hilltown Health Center CEO Eliza Lake joined Gov. Charlie Baker at his afternoon press conference to highlight a new public awareness campaign with the message that community health centers are open and that people, especially those with chronic conditions, should come in for the care they need.

Since COVID-19 arrived in Massachusetts, Baker and health officials have been encouraging the use of telehealth to preserve the availability of in-person care for people struck by the respiratory disease and to protect others from the risk of exposure.

A March order from Baker required insurance coverage for all medically-necessary telehealth services and to reimburse providers at the same rate as in-person care.

Sudders said community health centers have reported that from January to April total telehealth visits for medical services rose from 506 to more than 83,000 and telehealth visits for behavioral health services grew from 517 visits to 22,000. There have been more than 600,000 telehealth visits in MassHealth since March, Sudders said.

Baker said that although telehealth was invented in Massachusetts almost 20 years ago, it has not been "a covered benefit the way it is in so many other places."

"You talk to almost anybody in the provider community and people on the payer side and they'll tell you that the combination of the arrival of the coronavirus and the executive emergency order that we issued on telehealth has brought this in to the mainstream in Massachusetts as a legitimate way for clinicians to support and provide services to their patients that simply didn't exist before," he said.

Lake said health centers throughout the state worked quickly to redesign their operations to meet the needs of the public health crisis. Those changes and "significant decreases in visits across all services" have affected the centers' financial stability, she said.

"The health centers were already struggling with workforce challenges before the crisis, but this challenge has been compounded by reductions in available staffing due to caregiving responsibilities, or by a need to protect vulnerable family members from infection," she said. "Telehealth, therefore, has been a critical piece of our overall response."

Lake said telehealth will help health centers address longstanding challenges around provider recruitment, meet an increased demand for behavioral health services, and deliver care in a way that is convenient for patients.

"It certainly isn't always ideal," Lake said, telling of one patient who parked his car at a public hotspot to have a video visit, a teenager who drove to the top of a hill to get better cellphone reception, and a patient with a large family who had her telehealth call from a shed, for privacy.

Baker said telehealth is among the innovative solutions people have found to replace in-person interactions in compliance with social distancing guidelines and other restrictions.

He said he also expects people to come up with creative ways to celebrate Independence Day this year.

Boston Mayor Martin Walsh on Friday announced that the city will not hold large events like parades and festivals through Labor Day, and the Boston Pops Orchestra said it would not hold its annual Fourth of July concert along the Charles River.

Baker, asked about Walsh's decision, said he's marched in several Boston parades and finds it hard to imagine, "given how popular those parades are, how you would ever deliver on a social distancing standard for one of those." It's an issue he said he plans to discuss with local government officials.

Baker said the past week showed some "encouraging trends" in the fight against COVID-19, but also some "less encouraging" fluctuations in data. Wednesday's report from the Department of Public Health showed the highest daily rate of positive tests since April 22, along with a slight uptick in hospitalizations. Baker said the ups and downs in the data underscore the need for reopening the state in phases.

On Friday, the percentage of all COVID-19 patients currently hospitalized fell to 4 percent, with 3,349 hospitalizations. The DPH reported 1,612 new COVID-19 cases and 150 new deaths, bringing the state's total caseload to 75,333 and the death toll to 4,702.

"There's no way you can just flip a switch and doing so all at once could almost guarantee that we would have a huge spike in infections and more fatalities, the exact result we are seeking to avoid," he said.

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