California's expensive COVID-19 predictions were useless for rural areas. Here's why

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Treating patients remotely was a new frontier in health care before the novelcoronavirus pandemic changed the world, but when cases of COVID-19 infection became prevalent in our communities, telemedicine became one of our most important tools in delivering care to patients without putting them at risk.
				What&rsquo;s come of a significantly increased use of consulting patients through phone and video calls, however, is not only a realization that it works but also opportunities to discover new, and potentially better, ways of caring for people.
				Remote medicine has made care more convenient &mdash; a triumph in an era of crisis when in-person care has been a concern &mdash; but perhaps more importantly, it&rsquo;s set the stage for adaptation and innovation in health care that will likely lead to lasting practice.
				Two colleagues of mine, cardiologist Dr. Bryan Martin and ear, nose and throat specialist Dr. Ken Altman, have driven some of these innovations at Geisinger, and their work has the potential to inform fellow providers going forward.
				Dr. Martin, and the rest of the cardiology team in Northeastern Pennsylvania, had been communicating with their patients through what they called &ldquo;e-consults&rdquo; for about nine months before COVID-19 ever reached our neighborhoods.
				What they found was, by using the electronic health record to evaluate patient condition and history when an appointment was initially requested, they could discern whether a patient needed to be seen in person or could be just as appropriately cared for using telemedicine, and whether patients who needed in-person consult should have tests or studies done prior to their visit to make their assessment as fruitful as possible.
				Patients who are at lower risk for experiencing cardiovascular events, like heart attacks or stroke, became the best candidates for virtual care, because their health could be properly managed without in-person consultation. Dr. Martin and team have also learned when bloodwork, imaging and other diagnostics are necessary prior to a visit, leading to a more productive meeting.
				Dr. Ken Altman, chair of otolaryngology for Geisinger, has found that some diagnoses, previously thought to be discernable only through in-person evaluation, could be expedited using telemedicine. For instance,in two of Dr. Altman&rsquo;s patients, hoarse voices prompted in-person visits and imaging that led to cancer diagnoses in remarkably quick time.
				Beyond the more critical diagnoses, Dr. Altman and his team have learned which less-severe conditions, such as tonsillitis and sinusitis, can be confirmed without conducing in-person patient evaluations.
				But he and his team have also realized they can use the electronic health record and patient history to better prepare for patients and to get them to the right specialist as quickly as possible. and when patients need to see that provider in person, Dr. Altman and company have &ldquo;pre-worked&rdquo; the issue to get the right equipment and technology in place to make that visit as worthwhile as possible.
				By having to care for patients remotely, physicians like Dr. Martin and Dr. Altman have been able to improve the efficiency, and in some instances, the quality of the care they deliver. And along with the rest of the healthcare industry, they&rsquo;re looking at a future where seeing a doctor in person is no longer the sole means of keeping their communities healthy.

Telemedicine opens new doors