No Time to Wait: How to Flatten the COVID-19 Curve Faster

May 10, 2020

Triage via text messaging can help providers reach patients in a shorter amount of time, the author says.

We are in the midst of a war against an invisible enemy. As of this writing, there are nearly 1.9 million confirmed cases of coronavirus worldwide. Here at home, we’ve passed the 550,000 mark and have not yet reached the top of the curve. The White House coronavirus task force projects that between 100,000 and 240,000 Americans could die despite mitigation efforts1 and New York City’s coronavirus death toll topped more than 4,000, exceeding the number killed in the 9/11 attacks.2 A grim milestone indeed.

The nation is scrambling to contain and combat the virus. The president has invoked wartime powers in an effort to support our frontline troops, healthcare workers, desperate for life-saving medical equipment. At the same time, lawmakers have the historic and unprecedented CARES act, a $2.2 trillion coronavirus stimulus package. It’s the nation’s largest-ever rescue plan that includes, among many other things, $200 million earmarked for the FCC to subsidize telehealth services and devices to help medical providers continue to provide connected care during the pandemic.3 Funding, the press release notes, will be processed on a rolling basis.

Don’t get me wrong. Broad based support for telehealth is long overdue. The FCC’s program together with CMS relaxing key regulations to help providers respond more nimbly to the crisis are steps in the right direction. But best-case scenario, we’re still looking at solutions that could take weeks or even months before they’re ready for go-live. And that’s assuming providers are ready to hit the ground running, having already thought through vendors, workflows, integration, onboarding and many of the other pieces laid out in the AMA’s 138-page Telehealth Playbook.4

The reality is most telehealth systems are complex. Clinical integration remains a struggle. Many telehealth solutions don’t integrate with EHRs and broadband for video is still lacking in many rural communities. At this time of crisis when many of our frontline healthcare workers are facing long hours under highly stressful conditions, without adequate supplies, personal protective equipment or staffing, a telemedicine system risks completely overwhelming hospitals’ existing capacities.

To flatten the curve of infections, providers need a simpler and more direct telehealth solution, one that has the power to reach patients anytime, anywhere, and can be deployed in a matter of hours. Text messaging can be that solution, aiding providers in 5 key ways:

Triaging: We need to think outside the big-systems box. Telehealth doesn’t have to be daunting. A text-based telehealth platform, for example, is an agile and affordable alternative that can keep patients, providers and their teams safe while also keeping practices running efficiently and effectively.

Screening: Text-based telehealth allows providers to pre-screen patients and provide pre-visit instructions through HIPAA-ready text messaging all while minimizing exposure for patients and clinical staff. Instead of going onsite for screening, patients can text their symptoms and travel history as well as text any images or documents that could help the provider determine the next best action. Texting also allows for non-essential yet important activities to be managed remotely, such as scheduling an in-person visit, paying for a virtual consult or authorizing a prescription refill.

Communicating: Healthcare communication largely remains very traditional, relying on telephone calls, voice messages and answering services. This one-to-one method of communication produces bottlenecks, delays and frustration for providers and patients on good days. Leveraging a texting platform allows providers clinical staff to triage questions from 6-10 patients at the same time. Call centers answering coronavirus-related questions are getting thousands of questions per day (about two calls every minute)5. It’s impossible to manage the volume on a phone line. Text messaging can streamline and standardize responses, even translating conversations in speakers’ native language. If someone does require a call, it’s because the provider has triaged it through text message first.

Monitoring: Once a patient has been identified as having COVID-19 or is at risk due to data collected during the screening, the clinical team needs an efficient way to start monitoring the patient's health. Leveraging a patient texting solution allows staff and patients to conveniently and privately relay critical data to their provider without impacting other care in process at the facility. This approach allows the patient and the care team to be safe from possible spreading while still maintaining an ongoing conversation over text.

Connecting: Many people living in rural settings may have limited internet or no internet at all. Therefore, options such as video teleconsults or even logging into an EHR portal aren’t an option. Using a text-based telehealth platform means your rural population can use their cellular service to stay connected, report issues and keep up with care plans. While these critical access hospitals are having to prioritize the very ill in their emergency department, the typically understaffed facility still needs to keep chronically ill patients on track with health and treatment plans.

Conclusion

A HIPAA-compliant texting platform helps help flatten the curve of COVID-19 by managing physician-patient interactions without physical contact, thereby complying with federal and state health department advisories to have high-risk patients remain at home. Many integrate with a practice’s EHR system and offer the ability to conduct virtual consults so practices can securely engage with patients via two-way texting at any time from their mobile device. This includes remote consults, answering clinical questions, paying for treatment, retrieving medical records, refilling prescriptions and more.

A text-based telehealth platform is also good for patients because it’s easy to use and understand, and it doesn’t require them to download an app or log into a portal. With 8 out of 10 Americans6 owning smartphones, texting is not only widely accessible but even preferable. Simple texts are opened more than 99 percent of the time, with most texts being opened within three minutes of receipt.7

These past few months have put a magnifying glass to how we use telehealth tools in the fight against the coronavirus. What’s become clear is the need for expedient solutions. Text messaging checks all the boxes for ease, convenience, efficiency and security — all of which we need to triage so many people.

References

  1. The Washington Post. “White house task force projects 100,000 to 240,000 deaths in U.S., even with mitigation efforts.” https://www.washingtonpost.com/world/2020/03/31/coronavirus-latest-news/. Accessed April 8, 2020.
  2. AP News. “NYC virus deaths exceed 4,000, topping toll for 9/11 attacks.” https://apnews.com/6e506c4f105670b8fa8eb5531aadf2c1. Accessed April 8, 2020.
  3. Federal Communications Commission. FCC Adopts $200 Million COFIC-19 Telehealth Program. News Release. https://www.fcc.gov/document/fcc-adopts-200-million-covid-19-telehealth-program. Accessed April 8, 2020.
  4. American Medical Association. Telehealth Implementation Playbook. https://www.ama-assn.org/system/files/2020-04/ama-telehealth-playbook.pdf. Accessed April 8, 2020.
  5. ABC News. “Answering the call: Working a coronavirus hotline.” https://abcnews.go.com/Health/answering-call-working-coronavirus-hotline/story?id=69985750. Accessed April 8, 2020.
  6. Pew Research Center. Mobile Fact Sheet. https://www.pewinternet.org/fact-sheet/mobile/. Accessed April 8, 2020.
  7. Tatango. SMS Open Rates Exceed 99%. https://www.tatango.com/blog/sms-open-rates-exceed-99/. Accessed April 8, 2020.