In March 2020, Johns Hopkins Medicine admitted its first patient with a confirmed case of COVID-19, just the beginning point of a pandemic that would change medicine and the world in ways we couldn’t have imagined. To help reduce the spread of COVID-19, and accommodate patients who did not want to travel for care due to exposure risk, it was essential to create flexible and innovative alternatives to traditional care models.
The critical flexibilities government granted during the COVID-19 pandemic allowed providers, like those at Johns Hopkins Medicine, to be nimble and rapidly transform how care was delivered. Systems nationwide quickly scaled remote services to maintain vital connections to patients who otherwise would have delayed or skipped needed treatment.
Telemedicine has been an established care option for some time. That said, prior to the pandemic, Johns Hopkins Medicine recorded 86 telemedicine visits for the month of January 2020 at its six hospitals in Maryland, DC and Virginia as well as more than 40 community physician locations. By April 2020, the number of telemedicine appointments exploded to more than 90,000 – accounting for more than half of all outpatient care at Johns Hopkins Medicine at the time.
Since the start of the pandemic, Johns Hopkins Medicine has conducted nearly 850,000 telemedicine visits for patients in Maryland, Washington, DC, Florida and across the country. In a survey of 700 Johns Hopkins Medicine patients, 88% stated they were moderately to extremely likely to use telemedicine after the pandemic. During the last 12 months, telehealth helped reduce the spread of the virus by enabling virtual access to essential care for patients.
For example, one patient story illustrates how people have benefited from telemedicine care. The Florida resident is a patient of Carol Ann Huff, M.D., associate professor of oncology and medicine at the Johns Hopkins University School of Medicine and Medical Director for the Johns Hopkins Kimmel Cancer Center. Although the patient receives her lab work and treatments close to home, due to her cancer and chronic inflammation illness, which has left her immunocompromised, she trusts and relies on Dr. Huff and other Johns Hopkins Medicine experts to coordinate with her local doctors for care guidance.
Virtual access to Johns Hopkins’ experts became crucial when she contracted COVID-19. The patient arranged a virtual visit with Howard Lederman, M.D., Ph.D., director of the Immunodeficiency Clinic at the Johns Hopkins University School of Medicine, to discuss treatment options for coronavirus. Lederman was able to provide her with important information about possible treatments such as monoclonal antibody infusion therapy.
The patient says, “I wouldn’t have gotten treatment without Dr. Lederman’s communication. My doctor [in Florida] is good but wasn’t aware I could get this treatment outside of a clinical trial and wouldn’t have recommended it – I was fortunate to find out about it through my connection with Dr. Lederman, which started with a telemedicine visit. I got to the hospital on the first day they were offering the treatment. It saved my life.”
This story mirrors many patients’ experiences with telemedicine care during the pandemic. Her ability to seek virtual care was due, in part, to federal and state governments granting emergency authorization to temporarily relax restrictive licensing laws that previously limited doctors’ ability to serve patients living across state lines. The benefits of the emergency authorization of state licensing reciprocity to provide this flexibility in care have proven to be undeniable.
However, this is not a permanent solution. Looking ahead, the Bipartisan, Bicameral Temporary Reciprocity to Ensure Access to Treatment Act, or TREAT Act, S. 168/H.R. 708, is a temporary federal solution to address the patchwork of state licensing laws to ensure equitable access to treatment, and a chance to continue to offer care in the ways patients need now.
The reinstatement of regulations generating telemedicine restrictions in certain states has already begun to alter patient care. Due to state restrictions, within the past month, Johns Hopkins Medicine has been forced to cancel hundreds of telemedicine appointments and further restrict the scheduling of established patients who happen to live out of state, sometimes only miles from their provider.
The ongoing COVID-19 pandemic has brought unprecedented demands on the nation’s health care system, and it has changed the way people want to and can receive care. Brian Hasselfeld, M.D., medical director for digital health and telemedicine at Johns Hopkins Medicine is available to further discuss the critical need for continued access to virtual care, as well as the important role the TREAT Act will have in the continued effort to deliver innovative care during and beyond the COVID-19 pandemic.