“No show.” This is one of the common notifications that I have seen in the clinic. There are so many thoughts that come to my mind: is the patient okay? Have they been admitted to the hospital? Did they have to go to the emergency room? Were there life circumstances or barriers in which they could not access care? I may never know the many challenges patients face that make it difficult to access their appointments.
One thing we have learned is that patients tend to attend telemedicine sessions more frequently. Could the convenience of being able to retrieve your smartphone, tablet or computer, wherever they are, play a role in this success? As one of my telemedicine patients put it: “I’m glad I got to talk to you all on video because I have my 6 month old baby at home… I can’t get out of the house, and i don’t have childcare. In this case, a patient’s complicated life circumstances were improved by telemedicine.
The stories and challenges are different, but the COVID-19 pandemic has taught us that telemedicine is here to stay. But how this service will be covered by insurance is still debated. The Centers for Medicare and Medicaid have established guidelines for telemedicine insurance coverage. Coverage is also established at the state level. Providers and patients alike will be grappling with questions about future coverage changes and their impact on patient care. What will happen after the current temporary pandemic telemedicine coverage expires, will my insurance pay for full coverage? Will I still be able to see my nurse practitioner, physician assistant, or my own family doctor or specialist via telemedicine?
The Pennsylvania State Senate bill, introduced by Senator Elder Vogel, Jr., will establish the infrastructure for reimbursement of telemedicine coverage, define which healthcare personnel could provide these services, and require full reimbursement. insurance telemedicine services, much like a personal visit. It is currently on its third sessional amendment, but it has yet to be signed and approved by Governor Wolf. How many more sessions of the State Senate will it take for this bill to pass?
This bill is essential and there is a sense of urgency as many patients, as well as health care providers, rely on its final approval. The COVID-19 pandemic has highlighted the importance of telemedicine services for patients who would otherwise not be able to make an in-person appointment. Let’s start by transforming the clinic visits from “No show” into a “Visit in progress”.
In addition, my colleagues and I wrote a previous article for the Philadelphia Inquirer regarding many people who “still do not have access to fixed broadband service at a threshold speed”. In order for telemedicine services to continue to benefit the people of our state, we must extend broadband infrastructure to these “digital deserts” and not leave those who need telemedicine services out of the equation. I was happy to see progress in this area last year when Comcast offered free Internet service to 35,000 families in Philadelphia.
Recognizing the important value of telemedicine to some of our most vulnerable patients, I urge Pennsylvanians to contact your state officials, including Senator Vogel, in support of the passage of our state’s telemedicine law, Senate Bill 705. Not only will we continue to improve the future of our health care delivery system, but we will join several other states that have already passed their own telemedicine laws. It’s time to come together as a community to support the health of those around us, in essence creating a healthier society for all.
Rolando Vega is a student in the Primary Care Adult Gerontology Nurse Practitioner Program at the School of Nursing, University of Pennsylvania.