Tuesday, July 14, 2020

Is Telemedicine Here to Stay?

I recently submitted an article to MIT's department of athletics in response to their request regarding alum's involvement in COVID-19. Life has been busy and with so many things going on in the news... it has been hard to find time to process, think, and blog. Honestly, by the end of the day, my brain just wants to vegetate. Well, here is what I sent them... I feel it summarizes life since March...

Dr Ellen H Kim ’97 was a four year starter on MIT’s field hockey team during which they won their first ever New England Women’s Eight Conference Championship in 1994. She also made All-Conference team and the National Academic Squad her senior year and graduated with a degree in biology and a minor in music. She went on to receive her M.D. from Drexel University College of Medicine and then completed her residency in family medicine at the University of Pennsylvania, where she served as chief resident. Dr. Kim currently works in private practice at Wrightstown Family Medicine in Newtown, PA and is mom to four kids ages 6,9,10, and 12.

These last few months have been challenging, simultaneously transitioning a busy outpatient practice to essentially all telemedicine while managing four kids ages 6,8,10, and 12. Supervising their “distance learning” was a bit painful. Fortunately, my seventh grader was fairly independent, but the younger ones were easily distracted and needed more direction. The concern was not so much the volume or difficulty of the schoolwork, but so many hours in front of a screen affected their emotional lability and grumpiness. Keeping track of the different zoom calls was a whole other undertaking. My husband, Dr. Joseph Kim, MIT Class ’98, runs his own consulting and CME company, also had to work from home. Imagine the craziness of all six of us accessing our respective laptops and computers to participate in numerous zoom meetings throughout the day!

Our dining room turned into a temporary classroom for my kindergartner, third-grader, and fourth grader.


My seventh grader distance learning from her room.               

My fourth grader submitting homework online

My medical practice cares for a wide range of patients from newborns to great grandparents. We wanted to stay available and offer medical care and treatment to those who need it. However, it was necessary to protect the more vulnerable and not contribute to the spread of COVID-19 that was sweeping through our region. Many who live in our county either commute to New York City for work or have grown children who left the city to quarantine with their parents. There were also folks who returned from travel overseas or returned home from college, which all played a part in our rising infection rate.

Our office hosted a Friendsgiving luncheon for some of our patients in Nov.

At the end of March, the sudden surge of positive COVID-19 cases in our area resulted in schools emergently shutting down. We faced a similar urgency in our practice to separate the exposed with those not infected. During those early days, I recall the frustration of trying to help direct care when there were no concrete guidelines. Disappointed at the lack of testing availability, we felt somewhat helpless but pushed on to formulate treatment plans. We endeavored to help our patients and steer the course of their illness to recovery. Our goal was to ward off the need for emergency room visits which may ultimately result in hospitalization and even ICU admissions.

In order to prevent the healthy and especially the more vulnerable patients from contracting COVID-19, and to not be the vector of transmission ourselves, we converted our practice to mostly telehealth services online. Fortunately, we were able to do this without needing to ever close our doors. Of course, there were some bumps as we switched to conducting interviews virtually rather than face to face. The adjustment was both on our end as well as our patients’ end and it certainly took some getting used to.

At the end of the day, telemedicine provided us the ability to offer care to those needing routine maintenance for their medications and address new issues not related to the coronavirus, while also delivering care to those exposed and fighting COVID-19. It has been busy but rewarding to be able to meet needs. To avert hospital overload and to prevent medical staff burn out, it was crucial for us to help curve ER visits by treating sick patients from home. Telemedicine gave us the means to do so but we also had a physician available for in-office urgent cases that are not sickness related.

Information for COVID-19 constantly changes and recommendations still get revised as research and new data pours in. As primary care, our job is to filter out what is relevant and apply it to the care of our patients. This global pandemic is not yet over and although we are now seeing more patients face to face for in-office visits, telemedicine is still available. It is essential to have for those who may be more high risk, and convenient for those who do not need to come in person or those who have a hard time getting transportation. Some form of telemedicine will likely be here to stay even as the pandemic resolves. Given the way things look, that resolution may still take some time.

My little hockey player giving a virtual presentation about the sport to her class