COVID-19 Pandemic as a Driver for Spreading Virtual Care Globally: The Future Starts Now

Rafael Denadai About the author

As the COVID-19 pandemic spreads, healthcare systems are crashing worldwide. Public health authorities are focusing their decision-making processes toward best allocation of resources and personnel for the development of vaccines, establishment of effective treatments, management of affected patients, and protection of citizens and the workforce from human-to-human infection (11. Chen ATC, Moniz CMV, Ribeiro-Júnior U, Diz MDPE, Salvajoli JV, Da Conceição Vasconcelos KGM, et al. How should health systems prepare for the evolving COVID-19 pandemic? Reflections from the perspective of a Tertiary Cancer Center. Clinics. 2020;75:e1864. https://doi.org/10.6061/clinics/2020/e1864
https://doi.org/10.6061/clinics/2020/e18...
). Further, the healthcare workforce should act in alignment with the quickly evolving evidence (22. Moreira LFP. The Importance of Scientific Publications in Times of Pandemic Crisis. Clinics. 2020;75:e1895. https://doi.org/10.6061/clinics/2020/e1895
https://doi.org/10.6061/clinics/2020/e18...
). In this unparalleled healthcare scenario, a pertinent question has arisen: How do clinicians provide the best care for patients with diseases other than COVID-19-related diseases (33. Rosenbaum L. The Untold Toll - The Pandemic's Effects on Patients without Covid-19. N Engl J Med. 2020. https://doi.org/10.1056/NEJMms2009984
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)? The Brazilian Federal Council of Medicine has authorized teleconsultation during the ongoing pandemic (44. Conselho Federal de Medicina: Ofício CFM No 1756/2020 - COJUR. Available from: http://portal.cfm.org.br/images/PDF/2020_oficio_telemedicina.pdf
http://portal.cfm.org.br/images/PDF/2020...
). I believe that timely implementation of virtual consultations can not only promote care provision for these patients in private and public healthcare sectors but also help generate a database that can transform healthcare systems.

The key advantages of telemedicine is its mobility (55. Duffy S, Lee TH. In-Person Health Care as Option B. N Engl J Med. 2018;378(2):104-6. https://doi.org/10.1056/NEJMp1710735
https://doi.org/10.1056/NEJMp1710735...
), and it presents a perfect match for the current public health policy of social distancing and cancellation of non-urgent consultations and surgeries. In light of the current pandemic, countries that under normal circumstances do not permit virtual clinician-patient consultation for virtual care are now supporting the widespread use of telemedicine. This call for virtual technology-assisted care provision exposes a historically wide range of telemedicine-related issues, including legal issues and issues with funding; guidelines; and different degrees of experience in telehealth among countries, hospitals, and clinicians (66. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare. 2018;24(1):4-12. https://doi.org/10.1177/1357633X16674087
https://doi.org/10.1177/1357633X16674087...
,77. Maldonado JM, Marques AB, Cruz A. Telemedicine: challenges to dissemination in Brazil. Cad Saude Publica. 2016;32(Suppl 2):e00155615. https://doi.org/10.1590/0102-311X00155615
https://doi.org/10.1590/0102-311X0015561...
). The differences in regulations and practices may produce uncertainty regarding licensure, data privacy, reimbursement, confidentiality, patient consent, and accessibility that could delay clinicians from adopting telehealth practices. Previously described telemedicine data (55. Duffy S, Lee TH. In-Person Health Care as Option B. N Engl J Med. 2018;378(2):104-6. https://doi.org/10.1056/NEJMp1710735
https://doi.org/10.1056/NEJMp1710735...

6. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare. 2018;24(1):4-12. https://doi.org/10.1177/1357633X16674087
https://doi.org/10.1177/1357633X16674087...
-77. Maldonado JM, Marques AB, Cruz A. Telemedicine: challenges to dissemination in Brazil. Cad Saude Publica. 2016;32(Suppl 2):e00155615. https://doi.org/10.1590/0102-311X00155615
https://doi.org/10.1590/0102-311X0015561...
) aligned with the day-to-day rise in COVID-19-based clinical recommendations (22. Moreira LFP. The Importance of Scientific Publications in Times of Pandemic Crisis. Clinics. 2020;75:e1895. https://doi.org/10.6061/clinics/2020/e1895
https://doi.org/10.6061/clinics/2020/e18...
) could aid clinicians in judiciously redirecting their regular practices toward virtual-based care.

Noticeably, this global crisis, which is marked by uncertainty, could also create a golden opportunity to implement structured workflows for building a virtual consultation-focused database. Clinicians should now recognize that delivering “COVID-19-adjusted virtual care,” aligned toward gathering reliable data, needs to be a priority to support a change toward the delivery of “lessons learned care” and “data-driven virtual care” globally. Data collected at the point-of-care at a provider level could comprise a large key dataset (88. Prewitt E, Biskup E. Looking to the Future to Prepare for Covid-19’s Second Wave. NEJM Catalyst. 2020. https://doi.org/10.1056/CAT.20.0106
https://doi.org/10.1056/CAT.20.0106...
) that can be applied in future telemedicine-focused regulation policy at the government level.

Once this catastrophic COVID-19 outbreak has been overcome, the standard of care may change compared to the pre-pandemic standard, and I expect that the barriers restraining the widespread use of telemedicine (66. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare. 2018;24(1):4-12. https://doi.org/10.1177/1357633X16674087
https://doi.org/10.1177/1357633X16674087...
,77. Maldonado JM, Marques AB, Cruz A. Telemedicine: challenges to dissemination in Brazil. Cad Saude Publica. 2016;32(Suppl 2):e00155615. https://doi.org/10.1590/0102-311X00155615
https://doi.org/10.1590/0102-311X0015561...
) could also be overcome, or at least a pathway to achieve this goal may be demarcated. In a post-COVID-19 era, a possible change in healthcare could see “in-person health care as option B” (55. Duffy S, Lee TH. In-Person Health Care as Option B. N Engl J Med. 2018;378(2):104-6. https://doi.org/10.1056/NEJMp1710735
https://doi.org/10.1056/NEJMp1710735...
). The future starts now, and clinicians should act accordingly.

REFERENCES

Publication Dates

  • Publication in this collection
    29 May 2020
  • Date of issue
    2020
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