Q&A: Providing alternatives to telemedicine

Q: Telemedicine may not be the best fit for all patients. How can case managers help facilitate in-person visits for those patients that cannot engage in telemedicine visits?

A: If both in-person and telemedicine visits are available, it may be helpful to communicate with the providers to help educate patients on which might be more beneficial to their situation, says Diane Iverson, RN, BSN, BS, ACM, CCM, a Baltimore-area case manager.

In addition, case managers should also consider whether the patient has any social determinants of health that might interfere with their ability to meet follow-up care recommendations after discharge. 

“If the patient's needs are more along the lines of the social determinants of health or something that a social worker might more readily pick up on, I like them to be seen in person,” says Iverson. “I don't think our technology allows them to have more than one person on the videoconference. If they come in person, there is a whole multidisciplinary team that sees them.”

This inability to have multiple providers meet with the patient may result in more fragmented care and care gaps. High-risk populations may also require further support to make sure that they are getting the care they need once they leave the hospital. For example, some patients rely on public transportation and are reluctant to use it now because it’s difficult to socially distance on a bus, and there is a higher chance that they will be riding with others who are at greater risk for contracting COVID-19. This may include frontline workers and people living in more densely populated areas.

“It becomes more important for the case manager to link the patients with community health workers who can help make sure transportation needs are addressed,” she says.

For more on this topic, see January's issue of Case Management Monthly.