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Coronavirus (COVID-19)

Virtual Care, Telemedicine Visits, and Real Connection in the Era of COVID-19Unforeseen Opportunity in the Face of Adversity

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To identify the key insights or developments described in this article
1 Credit CME
JAMA
February 2, 2021
Editorial
Donna M. Zulman, MD, MS1,2;
Abraham Verghese, MD3
Author Affiliations
  • 1Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
  • 2Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California
  • 3PRESENCE and The Program in Bedside Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California
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Ensuring Quality in the Era of Virtual Care
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It is a truism in health care that reimbursement shapes practice. The coronavirus disease 2019 (COVID-19) pandemic in its early months has been an exception. Health care shifted substantially and fairly suddenly to virtual visits to meet the needs of patients without compromising their safety during a shutdown, while reimbursement was still uncertain.1,2 Recently, the Centers for Medicare & Medicaid Services reported that between mid-March and mid-October 2020, more than 24.5 million of 63 million eligible patients received a telemedicine service covered by Medicare.3

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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Health Care Delivery Models Health Policy Mobile Health and Telemedicine Coronavirus (COVID-19)
Article Information

Corresponding Author: Abraham Verghese, MD, Department of Medicine, Stanford University, 300 Pasteur Dr, S102, Stanford, CA 94305-5110 (abrahamv@stanford.edu).

Conflict of Interest Disclosures: Dr Zulman reported receiving research grants from the US Department of Veterans Affairs (VA) Health Services Research and Development, the VA Office of Rural Health, and the Gordon & Betty Moore Foundation, outside of the submitted work. Dr Verghese reports receiving royalties from Simon & Schuster and Knopf Random House and serving on the speakers bureau for LeighBureau.

References
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Hollander  JE , Carr  BG .  Virtually perfect? telemedicine for Covid-19.   N Engl J Med. 2020;382(18):1679-1681. doi:10.1056/NEJMp2003539PubMedGoogle ScholarCrossref
2.
Patel  SY , Mehrotra  A , Huskamp  HA , Uscher-Pines  L , Ganguli  I , Barnett  ML .  Trends in outpatient care delivery and telemedicine during the COVID-19 pandemic in the US.   JAMA Intern Med. 2020. doi:10.1001/jamainternmed.2020.5928PubMedGoogle Scholar
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Centers for Medicare & Medicaid Services. Trump administration finalizes permanent expansion of Medicare telehealth services and improved payment for time doctors spend with patients. Published December 1, 2020. Accessed December 28, 2020. https://www.cms.gov/newsroom/press-releases/trump-administration-finalizes-permanent-expansion-medicare-telehealth-services-and-improved-payment
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Rosen  CS , Morland  LA , Glassman  LH ,  et al.  Virtual mental health care in the Veterans Health Administration’s immediate response to coronavirus disease-19.   Am Psychol. Published online October 29, 2020. doi:10.1037/amp0000751PubMedGoogle Scholar
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Hunt  TL  II , Hooten  WM .  The effects of COVID-19 on telemedicine could outlive the virus.   Mayo Clin Proc Innov Qual Outcomes. 2020;4(5):583-585. doi:10.1016/j.mayocpiqo.2020.07.001PubMedGoogle ScholarCrossref
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Mehrotra  A , Bhatia  RS , Snoswell  CL .  Paying for telemedicine after the pandemic.   JAMA. Published February 2, 2021. doi:10.1001/jama.2020.25706Google Scholar
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Herzer  KR , Pronovost  PJ .  Ensuring quality in the era of virtual care.   JAMA. Published February 2, 2021. doi:10.1001/jama.2020.24955Google Scholar
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Cooley  L. Fostering human connection in the Covid-19 virtual health care realm. NEJM Catalyst website. Published May 20, 2020. Accessed December 28, 2020. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0166
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Shankar  M , Fischer  M , Brown-Johnson  CG , Safaeinili  N , Haverfield  MC , Shaw  JG , Verghese  A , Zulman  DM . Humanism in telemedicine: connecting through virtual visits during the COVID-19 pandemic. Annals of Family Medicine COVID-19 Collection. Published April 12, 2020. Accessed December 28, 2020. http://hdl.handle.net/2027.42/154738
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Academy of Communication in Healthcare. Telehealth communication: quick tips. Accessed December 28, 2020. http://www.achonline.org/Telehealth
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Verghese  A , Brady  E , Kapur  CC , Horwitz  RI .  The bedside evaluation: ritual and reason.   Ann Intern Med. 2011;155(8):550-553. doi:10.7326/0003-4819-155-8-201110180-00013PubMedGoogle ScholarCrossref
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Society of Bedside Medicine. Telemedicine five minute moments. Accessed December 28, 2020. https://bedsidemedicine.org/telemedicine-5m2
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Blandford  A , Wesson  J , Amalberti  R , AlHazme  R , Allwihan  R .  Opportunities and challenges for telehealth within, and beyond, a pandemic.   Lancet Glob Health. 2020;8(11):e1364-e1365. doi:10.1016/S2214-109X(20)30362-4PubMedGoogle ScholarCrossref
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Zulman  DM , Shah  NH , Verghese  A .  Evolutionary pressures on the electronic health record: caring for complexity.   JAMA. 2016;316(9):923-924. doi:10.1001/jama.2016.9538PubMedGoogle ScholarCrossref
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