The physician and the patient relationship have always been about keeping the lines of communication open in order to establish and maintain a relationship.
In PRE COVID 19 days, the face to face office visit is how this relationship was maintained. With the COVID-19 pandemic, that option wasn’t possible in order to prevent transmission and keep everyone safe and healthy, especially patients who are at high risk for COVID 19 like patients with heart and lung disease, elderly, diabetes, cancer, and autoimmune disease.
Telemedicine has become a powerful tool for physicians to use during this pandemic to ensure continuity of care for patients and prevent patients from unnecessarily exposing themselves. Although physicians do miss being in the office and directly speaking to patients about their conditions and medications as well as performing physical exams, virtual health does provide a unique opportunity for patients and doctors to stay connected.
Virtual visits were initiated and the doctor/patient relationship kept going in the midst of this global crisis.
Telehealth is here to stay
Recent studies show that the coronavirus pandemic that has erupted worldwide has pushed telehealth to the forefront. It’s unlikely remote medicine will go away, even after the current crisis fades.
Telehealth involves the remote contact and discussion of healthcare between doctors and patients, most often by way of video consultations, though it can also be used for teleradiology and remote patient monitoring.
While the pandemic has been proving the value of virtual care in a crisis, it has also been demonstrating the effectiveness of ongoing chronic care management. Patients with autoimmune diseases already have a weakened immune system from their condition and the medications they are taking so telehealth allows these individuals to be protected.
Rheumatologists can still monitor a patient’s disease activity by speaking to the patient about change in clinical symptoms, see if joints are swollen or red, discuss medications and their effectiveness and safety profile and order lab and diagnostic testing. Virtual visits have helped the front line healthcare workers by addressing these issues online and not exposing the practitioners or the patient unnecessarily.
This moment will have a lasting effect on the adoption of virtual care and accelerate the shift from in-person care to virtual first engagement for multiple conditions and use cases.
For parents, especially women, it is possible that Telehealth may offer the opportunity to be able to strike a better balance with professional and personal/family life.
TELEMEDICINE AND LUPUS
Many of my Lupus patients are asking about differentiating between COVID 19 symptoms and periodic Lupus flare symptoms. This can be difficult to distinguish because some of the features are seen in both.
Signs of Symptoms of SLE/Lupus flare
- Extreme fatigue
- Shortness of breath
- Hair loss
- Weight loss
- Joint pain and muscle aches
- Rash on face
- Swollen glands
- Loss of appetite
- Chest pain
- Kidney problems (leg and facial swelling or dark or red urine)
- Cough (dry)
- Body aches
- Sore throat
- Loss of taste and smell **
- Nausea and diarrhea
- Respiratory failure
- Blood clotting abnormalities
- No symptoms at all!!
Remember with lupus patients, there are lab testing like blood counts, urinalysis, and other autoimmune labs that can also be done to help with diagnosis. All of this can be done through telemedicine.
For now, lupus patients speak to your physician first, STAY at home unless instructed to come into the hospital for an emergency lupus flare or worsening respiratory symptoms from COVID.
Telemedicine will not replace the physical office visits permanently but they do have a role in clinical care going forward.