Is Telehealth the Future?

By Maddie Whipple

https://mhealthintelligence.com/news/medicare-expands-telehealth-coverage-to-curb-coronavirus

The coronavirus was declared a Public Health Emergency by the World Health Organization a

little over two months ago. Since then, people have been afraid to leave their homes for simple errands

like groceries and laundry, but what about if you have a serious medical emergency? Many clinics in the

area are closed, so families without private health insurance have to rely on the emergency room as their

primary care, endangering themselves further by being in close contact with sick people. Thus far, the

solution has been telehealth. Telehealth is a worldwide movement of online health services and

counseling. The coronavirus affects us all in different ways, but practitioners no longer being able to see

their patients face-to-face is increasingly becoming a problem.

 Shobhna Shukla, nurse practitioner, says that “the big goal of this initiative is to keep healthy and

sick families out of clinics to stop the spread of the virus.” Shobhna is a certified family nurse

practitioner, working mainly with mental health and reproductive services and can work with her patients

from birth to death. She works for Catholic University School of Nursing, where she is contracted to the

Wheaton High School Wellness Center. Any Wheaton student can go to the clinic, and kids with private

insurance are sometimes assigned to the wellness center. Since schools are closed, clinics are also off-

limits to Shobhna and her coworkers. “It’s just not safe to go to the clinic anymore,” she says, “there are

too many sick people moving in and out. We’re now practicing telehealth.” She describes the difference

between telehealth and telemedicine, where telehealth is “phone based advice and counselling with

clients” and telemedicine consists of “audio

and visual appointments” where there can be

actual diagnosis through services such as

doxy.me, a free video service used by

providers to contact clients.

https://intouchhealth.com/how-to-sell-your-team-on-telehealth/

While telehealth is a promising step towards flattening the curve, many important aspects of

medicine are lost. Shobna explains, “When a patient is not physically sitting in front of you, you can’t

listen to their lungs to hear if they are having an asthma flare or push on their tummies to feel for

abnormalities. One problem especially prominent with Shobhna’s patients is privacy. Considering

Wheaton’s 88.3% (School Digger) minority population, Shobhna mainly works with underprivileged

families. Some of her patients live in one-room homes, where a phone call cannot be private. This limits

what can be discussed, as most teens aren’t comfortable discussing topics like sex and drugs in front of

their parents or siblings. When closing the door is no longer an option, important things get left unsaid.

While some physical aspects are lost, not all are impossible. Diagnosing a concussion can be done as
easily through a screen as in person, as a few verbally directed tests can indicate the capacity of a person.

“There are a few tests that can be done just as easily over a video call, but I’m always going to prefer to

see my clients face-to-face. There are a lot of things that I need to be present for.” she says.

Telemedicine calls aren’t always easy to attend. Something that a lot of us take for granted during

in-person appointments is the space is which it is conducted. If feeling uncomfortable, you can look at

your feet or read the posters on the wall of the office. On a video call, it’s hard to escape the eyes of your

provider. It can make appointments intense and uncomfortable. Shobhna says she can feel when a patient

is feeling overwhelmed and tries to help them feel more at ease. “Everybody gets overwhelmed

sometimes and it would happen at the clinic too, but this is a different feeling,” she says, “It’s foreign to

me, but I’m working to make my calls more comfortable.”

https://mhealthintelligence.com/news/coronavirus-gives-people-a-reason-to-use-telehealth-but-doubts-remain
 Efficiency is another piece of the telehealth puzzle that needs to be considered. While Shobhna

can’t look for ear infections or examine wounds, telehealth calls are easy to arrange and routine pickups

like birth control refills are as easy as ever. All it takes is a phone call to your provider, and they can

arrange a prescription refill for anything you might need to be picked up the same day.

Seeing as telehealth is conducted online and mostly independently with little accountability thus

far, there is opportunity for defrauding the system. How are providers supposed to know if a patient is

being truthful in the amount of painkillers they say they need? Shobhna sighs and says, “People will

continue to defraud the system as much as they can. It’s up to the providers to continue to track opioids.

Pain is subjective anyway.” Programs that track medication can be used to keep up with when and where

prescriptions are refilled. “Crooked providers will stay crooked,” she says.

Another possible flaw in telehealth is the unbalance of access. While most have access to the

internet and phones, not all have computers or tablets with cameras for the more interactive telemedicine

visits. Shobhna says a visual “must be provided” in order to make an accurate diagnosis. Many of the

families that she works with are in a position where devices must

be shared between family members and so visual calls can be

hard to arrange and conduct. “This is just another one of those

situations where the more fortunate will always come first,” she

says. “I work with a subset that will never be able to be fully

served.”
https://thedo.osteopathic.org/2016/08/telemedicine-in-2016-3-key-takeaways/

So far, most clients seem to be okay with the way telehealth is being conducted. “Teenagers to

people in their 40s tend to prefer technology already, and if all you need is a check up, the quality of care
you receive through a screen is no less than what you might get in person,” Shobhna explains. Her clients,

who are mainly teenagers, have reported that they are just as happy talking to her over the phone.

So, all things considered, is telehealth the future? Shobhna says she’s not sure. She explains that

while it is definitely safer to distance ourselves in a pandemic like the one we are experiencing, there’s

too much that cannot be done over the internet and underprivileged families will always come second

when technology is involved. Bottom line, she says, “It comes down to what the insurance companies

want.” If they aren’t making as much money as they could be through telehealth, they will shift into a

system that will be more lucrative, no matter the human cost. ⧫

 Journalist’s Name:
_________________________________________________________________________

Feature Headline:
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Feature Story Rubric

Short Story Components Publishable Sophisticated Adequate Needs Unsatisfact-

Development ory

Writing Style 10 9 8 7 6 5 4 3 2 1

Author uses creative and
effective use of rhetorical and
stylistic devices, the “Show,
Don’t Tell” technique, Point of
View, and dialogue to enhance
the reader’s experience.
Comments on Style: Super powerful end line. The opening line (and a lot of the
article, really) is a little too newsy, not feature-style. Reads like a good in-depth
article. To be more like a feature piece, it would need more narrative writing (heavy
description, personal stories/anecdotes) and subjects with fleshed-out backstories.

Research/Process 10 9 8 7 6 5 4 3 2 1

Author demonstrates that they Comments on Research: Obviously a well-researched piece. Shobna (? you spell her
have deeply researched all name differently throughout the article...) sounds like a good interview.
aspects of the topic with rigor
and have spent significant time
on their reporting, including
interviewing experts and
relevant parties. At least 3
interviews have been conducted.

Subject Development 10 9 8 7 6 5 4 3 2 1

Author captures a universal Comments on Subject Development: We didn’t get any real “characters” in this, like
aspect of the human condition in I kind of mentioned above-- we don’t know what anyone looks like, or what their
their reporting. The characters personalities are like. Again-- great for a regular news story, but not for a feature
are portrayed fairly and piece.
accurately. The subject is
presented in full, with multiple
perspectives represented.

Insight/Bias 10 9 8 7 6 5 4 3 2 1

Author provides the reader with Comments on Insight/Bias: Very fair. You let your subject do most of the talking, as
a nuanced message regarding is traditional. That choice was totally up to you.
the subject. Any bias is implicit,
not explicit. Any biases are
backed by or supported with
facts that are clearly explained
and presented.
 Short Story Component Publishable Sophisticated Adequate Needs Unsatisfact-
Development ory

Mechanics 10 9 8 7 6 5 4 3 2 1

Author uses AP Style and their Comments on Mechanics: Some minor ap style errors (and don't use in-text citations
copy contains no grammatical or in journalism). Would have liked to see a subhed. Loved the use of a gif.
spelling errors. Feature is an
appropriate length. (1000-1300
words).

___47__ /50 Total Grade