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New and Innovative Care Options Are Here to Stay as Healthcare Adapts Beyond the Pandemic

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Although telehealth has been around for about 60 years, the pace of largescale adoption has been slow. That is, until COVID-19 became a catalyst for change. In a study published in JAMA Network Open analyzing data from June to October 2020:

  • Telehealth use for provider visits increased from 0.3% to 23.6% in 2020

  • In-person visits decreased by 37%

  • Behavioral health visits were virtual 46.1% of the time

Today, care at home is more than just virtual visits, it also encompasses the innovative technology that enables physicians to monitor their patients’ health and to provide care from afar.

The PBS Viewfinder program “Healing from Home” (aired June 2 on KVIE), highlighted stories across several hospital systems and practices – including UC Davis and UC San Francisco – on how patient care and the virtual healthcare landscape forever changed during the pandemic.

One segment featured the collaboration between UCSF Pulmonologist Steven Hays, MD., from the UCSF Lung Transplant program, UCSF Health Digital Patient Experience (DPE) Program, and Conversa Health. Working together, they took steps to quickly pivot in-person care to meet the needs of their immunosuppressed post-transplant patients.

When pulmonary labs were closed due to the pandemic, patients still needed to find a way to monitor their lung health daily at home. The pivot? A home spirometry kit.

Patients received a home spirometry device that transmitted data to the patient’s smart device, along with a conversational chatbot tool (powered by Conversa Health) to elicit symptoms and provide feedback.

The platform successfully allowed the lung transplant team to remotely monitor for changes in lung function that may be an early sign of chronic rejection.

Other highlights in the program include the impact of telehealth and digital health innovation in:

  • Counseling
    The pandemic sent mental health spiraling - Viewfinder cited statistics from the Centers for Disease Control and Prevention for anxiety and depression as increased from about 36% to 42%. With online counseling, mental health patients were able to continue their treatment and new patients to begin therapy. Many patients also found teletherapy opened the door to easier conversations about their mental health compared to in-person visits.

    Patients with addiction were another group who sought online therapy from home during a time when most drug or alcohol rehab programs were shuttered. Studies showed treatment of patients in their own homes – where they are usually exposed to the stress of the work/family environment – could be more effective than in a residential program.

  • Clinical Trials
    With about 80% of non-COVID clinical trials paused or interrupted during the pandemic, some transitioned to virtual trials. A breast cancer survivor shared about how participants like herself adapted to the virtual world and found online meetings more cohesive than in-person meetings. Another benefit of virtual meetings included the ability to involve family members if they chose to do so.

  • Geographical Areas with Minimal Services or Specialists
    Not everyone has easy access to care. With telehealth and the advancement of technology, patients who would otherwise not have access to high-level care can now be treated. Specialists can virtually care for patients hundreds of miles away, giving guidance to medical professionals in local hospitals on how to treat patients.

    A segment showed how telehealth also allowed physicians to be by the patients’ side during a medical emergency, when time is especially critical. For instance, stroke patients in facilities with minimal services can be attended to by a stroke robot. This allows physicians to view images of blood vessels to determine the severity of the patient’s circumstance and to make immediate decisions that could save lives.

The documentary surmised that while many physicians don’t see telehealth replacing traditional in-person visits, they believe it is here to stay post-pandemic and beyond. They attest to its benefits of convenience and efficiency, and how it elevates the level of care by empowering patients to take control of their health.

As telehealth continues to soar, the DPE program at UCSF continues to expand too. Since the launch of the home spirometry in May 2020, the program continues to be a success with about 500 patients currently enrolled in the program, a 73% rate of engagement and two-thirds of them submitting their spirometry data. Other programs include virtual care for chronic conditions like and support for patients on dialysis for kidney disease prior to being listed for transplant.

To learn more about digital health innovation at UCSF: