![]() ![]() The COVID-19 pandemic period, with its reliance on virtual care, provided an opportunity for a natural experiment in shifting some prenatal care to phone and video. “Also, the latest guidelines for prenatal care suggest it is not necessary to be seen in person for every prenatal visit, and some care can be delivered effectively remotely.” “Integrating the use of telemedicine in prenatal health care provides an alternative to exclusive in-office care for people living in underserved areas or facing access barriers,” Ferrara said. The results suggest that remote care could have an ongoing role in replacing some prenatal in-person visits, increasing convenience for those who want to be seen at home, without harming disadvantaged people, said lead author Assiamira Ferrara, MD, PhD, a senior research scientist with the Division of Research. These findings address concerns that people who may have less access to technology for video care might have poorer health outcomes. The study also found no significant differences in the uptake of telehealth prenatal care and how it affected people from varying racial and ethnic groups or socioeconomic backgrounds, and those using a language other than English or living in a rural area. Pregnant patients who received some of their prenatal care during the COVID-19 pandemic in a combination of virtual and in-office visits - known as multimodal prenatal care - had similar health outcomes as those who were seen mostly in person before the pandemic, according to a large new study of more than 150,000 births from the Kaiser Permanente Division of Research. March 7 in the Venetian, Palazzo E.Kaiser Permanente researchers found prenatal care telehealth use nearly doubled during the pandemic There’s a whole other way of communicating and this is it.”Īri Melmed will be speaking in the session, “Chat with a Doctor: On-Demand, Asynchronous Physician Advice,” at 4 p.m. There’s a rampant conflation of telehealth with video visits and the two should not be thought of as synonymous. “Everyone is focused on video, video, video. ![]() “I think chat is really under the radar,” he said. But for some reason people expect healthcare to be different. Even outside of healthcare, consumers text one another more easily and more frequently than they use services like Skype. Our satisfaction is through the roof.”Īs for chat, Melmed said that it’s the natural way people communicate in 2017. It’s just unprecedented in most people’s healthcare experience. They’re just not used to having instant access to a physician. “We’ve found that this is very surprising and highly satisfying to the members. “One of the unusual things about this program is we put the physician up front rather than having the members go through a screening process of some sort,” Melmed said. He attributes the traction to two things: direct connection to doctors and the ease of the chat format. ![]() Melmed said the program now sees 100 to 200 visitors a day. “Someone thinks they’ve got flu or UTI or sinus infection we can help them determine whether or not they in fact do, and if they need antibiotics or an inhaler or a prescription for something we can enter that into their Kaiser medical record and get that sorted out.” “What we’ve found is somewhere around two-thirds of the issues, we can resolve right there on chat,” Melmed said. If the condition is more complicated, they connect the patient to a staffer who will schedule an appointment. The doctor can assess simple things and prescribe some medications. If they do, they’re connected directly to a Kaiser doctor who is chatting with a maximum of three other patients. And we are able, via a chat service that allows for uploading photos but doesn’t use video, to resolve a huge percentage of these encounters.”Ĭhat with a Doctor works like this: When patients go to Kaiser’s main website or to book an appointment, they have the option to use the chat service instead. “Predominantly, it’s people who either know they have something straightforward or are not sure if they need to be evaluated in person or if their condition is something serious. ![]() “We trialed this as a mechanism by which we would be able to help our members avoid unnecessary ER visits, but it has turned into something far bigger,” said Ari Melmed, MD, an ER doctor at Kaiser Permanente Colorado, oversees the Chat with a Doctor program. But Kaiser Permanente Colorado has discovered that, for the integrated system, a simple text chat is an easier sell - as its impressive uptake numbers demonstrate. When people think about direct-to-consumer telemedicine, they often think of video visits or phone calls. ![]()
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