From the CMO

MD Life – November 2020

By Frank Astor, MD, MBA, FACS,  Chief Medical Officer for WITHmyDOC.

These are the facts: over eight million positive COVID-19 cases have been reported so far this year in the US, with at least 200,000 deaths attributed to the virus. The word pandemic takes a real and immediate meaning in our daily life.  Physicians, including myself, never imagined witnessing a pandemic of a scale and scope as large as the 1918 influenza epidemic.

The year 2020 started in a traditional way, as we celebrated with loved ones, unaware of the news that would follow…the appearance of a novel corona virus manifesting SARS-like symptoms. The virulence associated with it, as well as the severity of illness and complications observed in affected patients, immediately triggered concern and warnings from the NIH, CDC and the World Health Organization. In a matter of weeks, the novel coronavirus genome was successfully identified, and medical scientists realized that our global population lacked significant immunity to this virus. Medical science could not offer a vaccine, nor had effective treatment to combat its devastating clinical manifestations. Health authorities opted for time-proven effective public health measures such as lock downs, face masks and social distancing, all previously quite successful.

Currently, the learning curve to defeat this virus has been lightning fast: Rapid assays were developed, treatments with immunomodulators, antivirals and dexamethasone have been successful in avoiding hospitalization, ICU admissions and the use of ventilators. Vaccines are currently in Phase III testing, faster than any previously researched medications. These innovative treatments, measures and strategies have prevented hospital admissions in many patients that could be monitored remotely from their home.

Thus, the awareness and role of telemedicine and remote patient monitoring (RPM) has exploded during the COVID-19 pandemic to better serve those patients who would be safer convalescing at home, but still requiring close observation. With good clinical judgement, providers can decide who can be safely followed at home. The benefit being two-fold, since the patient avoids the risks of hospitalization, while the system opens capacity for the very sick patients who need to be in the hospital. RPM improves access of care, offering integrated real-time patient monitoring of vital and physiological measurements. RPM keeps the patient at home, away from unhealthy and risky environments, vulnerable populations with comorbidities, and even the healthy. In the meantime, providers can interact with their patients by video, phone, email, or text message.

RPM and remote provider-patient interaction are here to stay, more relevant than ever since they improve access to care and drive down healthcare costs while increasing medical practice capacity, all of which are good. This is the “new normal” along with working at home, home schooling, outside dining and other modalities successfully implemented during the pandemic.

It is evident that RPM is a win-win solution as the next logical step in the future practice of medicine. This care modality is patient-centered, evidence-based, and can be applied in a clinically safe, convenient, effective and humane environment.

Remote Patient Monitoring (RPM) is the closest thing to a real office visit. The physician sets the target parameters for each patient’s vital signs and patients take their vital signs at home every day. An ideal RPM program triggers a critical alert if a patient’s vital signs fall out of their normal range. These critical alerts serve as proactive intervention to address any health issues that arise, in an effort to keep patients out of the emergency room and prevent readmissions.

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