When Hurricane Harvey hit Houston, Nemours Children’s Health System was eager to help out through its CareConnect virtual care platform. All it needed was the green light for Nemours providers, who aren’t licensed in Texas, to practice medicine in the state. Then Gov. Greg Abbott declared a state of emergency.
“Once that [barrier] was lifted, it basically took five minutes to flip a switch on our technology platform to where we could have our providers available in the state of Texas,” says Carey Officer, administrator of telehealth for Nemours CareConnect.
In the midst of torrential flooding and winds that destroyed homes and displaced thousands of people along Texas’ Gulf Coast and parts of Florida during Hurricanes Harvey and Irma, telehealth was a lifeline for people needing nonemergency care.
Telehealth vendors provided free consultations, monitored patients and refilled prescriptions as governors in Texas, Florida, Georgia, North Carolina and South Carolina declared emergencies that eased restrictions on out-of-state providers.
Frequent requests included fevers, rashes, cuts and abrasions, infections and medication refills, but people also sought help for anxiety and stress. David Romano, an Orlando-based psychologist and the American Psychological Association’s Disaster Resource Network coordinator in Florida, says people living through disasters need “enhanced psychological first aid” to deal with the uncertainties of their situation, such as help connecting with community resources that can assist in their recovery.
Getting the word out
More hospitals and health systems are moving toward telehealth to increase access and improve the patient experience, but most aren’t hardwired internally to provide the service using their own clinicians.
With the experience gained from Hurricane Harvey and 2016’s Hurricane Matthew, Nemours was prepared when Irma hit. Five days before landfall, Nemours reached out on social media and news outlets to say free on-demand care would be available. The post went viral.
Over the next four days, “we saw a significant increase in downloads of the [CareConnect] app, what we typically see in about three months,” Officer says.
The health system also set up CareConnect carts at shelters within Orange County, Florida close to areas where nurse managers and providers had access to Nemours pediatric specialty care. When Hurricane Maria sent evacuees from Puerto Rico seeking refuge on the U.S. mainland, Nemours stood up carts at the airport in Orlando and several other sites as well.
Officer says telehealth is integral to Nemours’ disaster preparedness program. “I see a huge opportunity for really leveraging technology as one of the tools in our handbag as we plan for these types of disasters,” she tells Healthcare Dive. That process includes deciding which offices and facilities will close, ensuring those that remain open will be adequately staffed and notifying patients and families that they can access their pediatrician through CareConnect.
“There’s a lot of integration” Officer says. “Even though [people] couldn’t physically come in, they could still have a point of connectivity to Nemours and to pediatric care.”
Telehealth vendors were also on the front lines during the hurricanes.
Teladoc’s response team assessed the needs before, during and after the Harvey and Irma events and then adjusted offerings as appropriate to best meet the need of storm victims, says Lewis Levy, chief medical officer at the Dallas-based company. In the days leading up to both events, the vendor reminded clients and members to consider telehealth in their emergency preparation. During the hurricanes, Teladoc launched a free general medical services hotline to all storm victims, not just Teladoc members, and provided routine medical care to those in Red Cross shelters.
The company is also providing free online counseling for up to three months for those impacted by Hurricane Harvey, according to Levy. All told, between the two storms, Teladoc says it has helped more than 1,000 people.
“We’ve built redundancies into our operations and call centers and have the inherent ability to scale tenfold, so we were ready with call center operations that would be up and running and with more than enough physicians to handle the capacity,” he tells Healthcare Dive. “The nature of telehealth and our operations enabled at least one of our physicians who is a Florida resident to evacuate, yet still take calls and provide care.”
American Well and many of its partners, including Carolinas Healthcare, Nemours Children’s Health System, Capital Health Plan, UnitedHealthcare and Anthem, also offered free online doctor visits to victims in the storm regions.
For example, Anthem and Amerigroup outfitted a mobile clinic with a console kiosk to provide medical services in Texas and drove it around to shelters, says Mary Modahl, chief marketing officer at Boston-based American Well. Amerigroup is a large Medicaid insurer and had many members affected by the storms. “Having an individual backup battery to recharge a personal phone can become a vital tool of survival in the case of natural disaster,” Modahl tells Healthcare Dive.
The storms underscored the value of investing in telehealth technology.
In addition to causing damage to doctors’ offices, flooding and debris made it harder for patients to get to their providers or clinics, notes Chris Stenglein, CEO of Provider Web Capital, a national healthcare finance solution.
While direct-to-consumer telehealth providers were able to step in during these disasters, having basic telehealth capabilities could help primary care providers stay connected with their patients in future disasters.
Officer agrees. “As we are faced with these very devastating, impacting emergencies, telehealth should really be considered as another tool in the handbag,” she says.