LAS CRUCES – As New Mexico eases restrictions enacted to keep people physically apart to slow the spread of the novel coronavirus, one distancing measure that may stick around is telehealth, a health care method that could cure some of rural southern New Mexico’s health care provider shortages.
While it can’t be used for all types of health care, some health experts and clinicians see it as more than a band-aid solution for the pandemic. They see it as ongoing treatment for some rural areas of the state with a dearth of hospitals and health care workers.
Due to distancing measures to mitigate coronavirus spread, the accessibility of telehealth, which can include phone calls and video visits, has skyrocketed.
Telemedicine and telehealth use was minimal in the United States before the COVID-19 outbreak, according to insurance claim data kept by the Kaiser Family Foundation, largely due to a lack of uniformity in coverage policies among insurers and states.
But as physical distancing has become the norm, it’s exploded. A recent Morning Consult poll found that 23% of U.S. adults have used telehealth in light of the COVID-19 pandemic.
Perhaps the biggest change that increased accessibility was the federal government’s waiver of previous requirements for Medicare coverage of telehealth services, according to Mei Kwong, the executive director of the Center for Connected Health Policy, a telehealth policy tracker.
Among the changes, Medicare now temporarily allows patients to access telehealth from home instead of having to visit a medical clinic, and it lifted the requirement that only people from rural areas can access telehealth.
Employer-based health plans are increasingly covering telehealth, and New Mexico’s Medicaid program has temporarily made many telehealth visits reimbursable at the same rate as in-person visits until the public health emergency ends.
The relaxed rules have allowed more people to qualify for telehealth services at a time when distancing is key.
That’s helped rural patients of Dr. Melissa Gomez, a doctor who runs a MountainView clinic for wellness and weight loss in Las Cruces.
Gomez is doing almost exclusively telehealth appointments now. She said the transition was smooth since the diet and exercise counseling she does is capable of being delivered in person or via video chat.
Gomez is a big believer in the benefits of telehealth for patients she sees from out of town, who sometimes must drive hours to come to Las Cruces.
“For a lot of our patients it’s just very difficult to travel … From Carlsbad or Roswell it’s hours on the road before they even get to the clinic,” Gomez said, adding her patients can struggle with arthritis, are walker- or wheelchair-bound or have kids they’d need to arrange care for.
Before COVID-19, Gomez set up a clinic in Deming for patients as a midway point for patients to access video chats under the old Medicare rules. She’s wanted to create a telehealth option for her clinic since she started there in 2015.
With the Medicare rollbacks, her patients can be seen at home.
“We really do have a large area of patient care and it’s so much easier for some of these people if they can just do it from the city that they live in,” she added.
Gomez said she could see her practice retaining a clientele that’s about 15% to 20% telehealth post-COVID. She’s excited about the possibility of getting technology to assist in taking vitals remotely, such as a stethoscope a doctor can use to hear heartbeats over the internet.
Telehealth isn’t for everything though.
Dr. Harry Bass, an internal medicine doctor with a MountainView physician practice in Las Cruces, said the practice has switched to telehealth for the time. It was slow at first, but the practice is now up to about half their normal patient volume.
Bass said many types of visits, like physicals or more acute health issues that require physical in-person examination, just cannot be done over the web.
“When you can’t see them, (telehealth) is the second best thing you can do,” Bass said. He added telehealth doesn’t have much of a future for him post-pandemic.
Memorial Medical Center’s Chief Medical Officer, Dr. Dolores Gomez, said while it can be hard for someone to be diagnosed through a phone or video telehealth visit, there’s also some visits that only need to be phone calls.
While telehealth can easily bring care to patients in rural areas, many will still need to travel to a clinic to be physically examined. And for specialty conditions, providers can be scarce in the state, with the closest specialist sometimes being hundreds of miles away.
To increase the number of specialty providers statewide, an endeavor called Project ECHO out of the University of New Mexico has used telehealth to perform “telementoring” for 17 years.
ECHO founder Dr. Sanjeev Arora explained his center trains physicians and nurses to become specialists at rural clinics across the state to treat all types of medical issues, now including COVID-19, using remote video conferencing.
For rural New Mexicans who need to see a specialist in person, ECHO’s goal is to make sure they don’t need to make a 200-mile trek to Albuquerque.
Even Las Cruces is a regional hub for medical care, Gomez said, and offering telehealth to the region would be convenient when patients with an hour or two of travel time don’t need to physically come to the office.
“Most of the Memorial practices do get a good number of patients that come from other areas,” Gomez said. “You can’t find a lot of these sub-specialists in some of these smaller towns.”
On May 13, the federal government announced a $159,000 award from the federal CARES Act to two organizations in New Mexico to broaden telehealth capabilities within the state and train medical professionals in it.
Kwong thinks that the current expansion of telehealth isn’t going anywhere. She said COVID-19 distancing measures will likely stick around through the fall, meaning telehealth will continue to be necessary.
As more Americans use and become aware of telehealth as an option, Kwong said, she believes it will become normalized. She imagines the temporary lax rules becoming permanent, especially as people experience the convenience of it.
“That’s going to be hard, to take that away from people,” Kwong said.