When there’s a hurricane between you and the hospital, telemedicine could save the day
One of the more frightening features of climate change is the way it compounds risks to public health. People who live through a powerful hurricane, for instance, endure severe mental and emotional stress, which can drive up the risk of heart attack or stroke. At the precise moment when they most need a doctor, they may find their local hospital is without power or can’t be reached because severe flooding has shut down roads, bridges and railways.
“Following a major disaster, there are always victims with new, urgent healthcare needs,” said Lori Uscher-Pines, a senior policy researcher at the RAND Corporation, a nonprofit health policy organization. “At the same time, the healthcare system is not functioning at 100%. So you have greater demand for healthcare resources and less capacity. Given that this is a common problem, it’s exciting when new tools or services emerge, that can address these challenges.”
Enter direct-to-consumer telemedicine, a viable way of delivering medical care in the aftermath of a natural disaster via smartphones, laptops, and tablets. New research suggests the technology proved valuable during hurricanes Harvey and Irma and could become even more so as climate change produces more severe weather. Dangerous storms, prolonged drought, intense heat waves, and destructive wildfires can worsen chronic health issues and threaten lives.
The RAND scientists examined the experiences of Doctor on Demand in the weeks following Hurricanes Harvey and Irma in 2017 and found that use of the service peaked three to six days after the hurricanes made landfall. The most common health complaints during the first month following the storms were largely not disaster-related and included acute respiratory illnesses and skin problems. This trend was similar to that seen among all patients treated nationally by the telemedicine service, the researchers said.
“Patients typically sought care for the same types of minor, acute conditions that direct-to-consumer telemedicine services routinely address,” Uscher-Pines said. “In other words, patients were appropriately utilizing these services and not requesting visits for conditions that required immediate care in an emergency department – for example, a serious fracture.”
During the days immediately following a storm, however, hurricane victims sought treatment for chronic conditions, advice, counseling and refills, back and joint concerns, including injuries. The RAND analysis found that more than 2,000 people affected by Harvey and Irma used Doctor on Demand. Around 60% of those were first-time users of the service.
Physicians located outside the affected states handled slightly more than half of the visits.
More importantly, when doctors’ offices and hospitals are shuttered, telemedicine can help patients coping with a possible health emergency by assessing its urgency, she said.
A number of telemedicine companies now provide 24/7 access to patients with minor illnesses via telephone or videoconferencing, according to RAND. The use of these companies has grown rapidly, with more than 1.2 million visits reported nationally in 2015, according to the organization.
While RAND studied the experiences of only one such company, at least five different telemedicine services offered free services to consumers during the 2017 hurricane season, the organization said. Consumers typically pay for these services. But some telemedicine benefits are covered by private insurance, Medicare, state Medicaid programs, and the Department of Veterans Affairs.
