Philadelphia Medicine Summer 2020 - 16

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feature

Something Good Coming
out of the Pandemic:
Telemedicine Getting
Its Closeup
By: Alan Miceli, Editor

ally, a 70-year-old woman who did not want to be identified
for this story, said that the other day she watched what seemed
like a TV interview in which her rheumatologist was the star.

"I was offered a teleconference visit, instead of my scheduled office
visit and I said, ok."
She said the doctor normally sits with his laptop, asks questions,
types in answers and occasionally examines a problem on her body by
touching it. She felt the telemedicine visit wasn't markedly different,
except for the touching part, of course.
"We had a very good connection," she said. "He asked me how
my foot was doing. I told him, and he asked to see it. I showed him
and he was satisfied with what he was able to see."

Sally said she felt her doctor did a fine job understanding her
concerns, then gave her some advice and renewed her prescription.
To her, it was a picture-perfect visit.
Such visits have been the norm for millions of people since the
outbreak of the pandemic. By using technology that already existed
and devices that most people already have in their homes, telemedicine
is transforming a critical element in medical care.
For more than four months, since the coronavirus plagued communities across our nation, most patients have been either unwilling
or unable to get to a doctor. And there is the overriding concern
that many patients have of spending a long period of time sitting in
the waiting room with the possibility of someone else in that room
able to transmit the infection.
Through an internet connection, patients can safely show body
parts to a physician who can then recommend treatment or order a
test or prescription without the patient taking any risks.

16 Philadelphia Medicine : Summer 2020

Dr. Corina Graziani, a Philadelphia family physician and clinical
assistant professor for the Department of Family and Community
Medicine at Thomas Jefferson University Hospital, said the technology
is a breakthrough for patients. "Telemedicine has been a wonderful
tool to be able to use during the pandemic. It's here to stay."
She said the system went through a rough first couple of weeks,
because it was not ready to take on the extremely heavy load brought
on by the pandemic.
"We were having all kinds of connectivity problems. Things
freezing, patients not being able to see me, or I not being able to
see them. Not being able to hear each other. Audio and/or video
cutting in and out."
But after the shakedown cruise, everything started to click. Part of
the initial problem was the intricacies of a HIPPA-compliant system
that is not allowed to make use of such popular sites as FaceTime
and Zoom.
Shortly after the onset of the virus, Dr. Graziani's office contacted
patients who were scheduled for visits and encouraged them to agree
to a televisit. Staff members would then walk the patient through
the process.
"The goal was to drastically reduce in-person visits. Normally, we
would have four doctors in the office each day. We reduced that to
one doctor, with everyone else at home doing telemedicine."
Dr. Graziani said even the doctor in the office saw very few patients
in person in the early phase. Typically, that doctor would have about
two in-person visits and more than 20 televisits.
She said telemedicine does not work for every patient. "It is not
a perfect substitute for seeing and physically examining a patient.
However, if we consider that most of the information we get from a

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Philadelphia Medicine Summer 2020

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