20210717-LOC-Telehealth

After pausing nonessential services early in the COVID-19 pandemic, most local health care providers have reintroduced them. But, that isn’t stopping many patients from continuing with telemedicine instead.

“The pandemic has taught people that health care can be delivered by telehealth in some situations, and that’s not likely to be reversed,” said Phil Wyzik, CEO of Monadnock Family Services in Keene and Peterborough. “... It’s a tool that is proven to be very effective, so I don’t see the days where we will go back.”

Telehealth, or telemedicine, refers to patients and doctors connecting virtually through video conferencing or telephone conversations. Nationally, it has long been part of strategies to increase access for patients, including those living in rural areas.

Last March, Gov. Chris Sununu issued new temporary guidelines to expand access to teleheath services, requiring they be covered by insurers.

Because of this, many health care providers across the state have introduced or expanded their telehealth services amid the pandemic to continue serving as many patients as they can.

The video software used is secure and compliant with HIPAA, a federal law that contains patient-privacy provisions, to prevent patients’ medical information from being tampered with.

At Monadnock Family Services — the region’s community mental health center — Wyzik said about half of its services each month are still done remotely. This is down from last summer, when he said about 85 percent of clients were using telemedicine.

“If they have transportation problems or if their other treatment is elsewhere, telehealth is a really useful tool,” Wyzik said.

Jill Burns, associate executive director at Maps Counseling Services in Keene and Peterborough, said she isn’t sure what percentage of clients are still using telehealth, but that only those who “really need to be in the office” have shifted away from it.

“We’re taking it slow and with everyone’s comfort in mind,” she said.

It’s gotten easier to use telemedicine throughout the pandemic, Burns added, but there are still challenges, like trying to read a client’s body language over a computer screen.

“We do recognize, as some of us are getting back into the office, how much different [telehealth] is than being in person,” Burns said. “We get to see the whole person instead of just their headshot, which tells a lot more.”

Both Burns and Wyzik said clients continuing with telemedicine are doing so out of convenience rather than concern about contracting COVID-19.

But for some, telehealth isn’t a plausible option.

“Everyone’s situation is a little bit different, and some people don’t always have a private space in their home to provide the quietness or privacy that they might want to have when they are talking with a therapist,” Wyzik said.

Dr. Michael O’Shea, medical director and vice president of ambulatory care services at Cheshire Medical Center in Keene, said between 5 and 7 percent of patients are using telehealth. At the height of the pandemic, he said that number was upwards of 25 percent, and has steadily dropped since.

He said every specialty in the hospital, an affiliate of the Dartmouth-Hitchcock Health system, has a telehealth option, though some lend themselves to it better. For example, he said primary care is much easier to handle virtually than, say, a general surgery consult.

The hospital will continue to “embrace” telemedicine moving forward, O’Shea said, but it boils down to what its patients want.

“I think we’d all prefer to see much more of it,” he said, “but ... so much of it is dependent on patient preference.”

Monadnock Community Hospital in Peterborough has about 14 percent of patients still using telehealth, down from around 30 percent around February and March, according to Telehealth Coordinator Hannah Ladeaux.

Once the colder months hit, she said, the hospital plans to encourage more people to again use telehealth because of bad weather and cold and flu season.

That way, Ladeaux said providers and patients aren’t “trying to battle the snow and ice to come in” and can still keep appointments.

Dr. Aurora Leon, co-owner of Monarca Health in Keene, reported a much smaller share of patients using telemedicine — about 2 percent.

Monarca Health, which opened on West Street in late September, is a direct primary-care facility — a model that allows patients to pay a monthly fee directly to their provider, rather than the provider billing the patient’s insurance for services.

By design, the clinic has a smaller patient load, so Leon said people have been comfortable coming in to see their doctor in person, even when COVID-19 cases were high. Those who are choosing to use telehealth, she added, are doing so because they don’t live near the office.

Similar to the local mental health providers, the doctors interviewed by The Sentinel said that telehealth, while convenient, isn’t without its faults.

“The downside is we can’t see all of you or check for things like your blood pressure ... so we don’t have a lot of the data we would get in person,” Leon said.

Ladeaux and O’Shea echoed this, both adding that the lack of reliable Internet in the Monadnock Region is also a huge hurdle.

“We battle against it almost every day, whether you’re in Greenfield and the wind is blowing or you’re in Rindge and it’s snowing, all of that stuff really can affect it,” Ladeaux said.

Despite these issues, providers agreed that, overall, telehealth is a useful tool to not only keep up with current patients, but to increase access to services.

“I definitely think there [are] a lot of great things about being in person, but I don’t want that to be a barrier,” Burns, of Maps, said, “because any treatment is better than no treatment.”

Olivia Belanger can be reached at 352-1234, extension 1439, or obelanger@keenesentinel.com. Follow her on Twitter @OBelangerKS.