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The Doctor Is Always In: How COVID-19 and Video Visits Are Changing the Way We See the Doctor

Teladoc and telehealth visits have soared, Blue Shield's early efforts in Butte County are paying dividends for members across the state
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Doctors and technicians test PMG Connect, a telemedicine service unveiled last year to members of Paradise Medical Group after the Camp Fire devastated the community.

The outbreak of the coronavirus has led to a seismic shift toward telemedicine, and Blue Shield of California’s partners are quickly ramping up capacity, almost certainly leaving a lasting impact on the way healthcare is delivered .

Amid lockdowns and business closures going into effect in mid-March, Blue Shield’s members turned to virtual doctor visits by the thousands. Members logged more than 21,000 visits over a 17-day stretch ended April 6 with Teladoc Health, a telemedicine provider that Blue Shield works with. That is about six times recent historical volume, which was about 7,000 to 8,000 virtual visits per month.

The visits are not so much driven by the spike in Californians with symptoms of COVID-19, but the need to receive basic medical care—including behavioral health—in the wake of the lockdown. Visiting medical facilities is out of the question, except for medical emergencies and services deemed as essential. Telemedicine has stepped in to fill the void, in a big way.

“We’re here to help,” said Lewis Levy, chief medical officer at Teladoc, in a video posted by the company on Twitter on March 27. “If anyone is having symptomatology, or just merely dealing with the stress of what is going on with regards to this pandemic, we are absolutely here to and encourage you to reach out.”

A surge in visits

Members are doing so in increasing numbers. As of April 8, members logged nearly 49,000 visits year-to-date via Teladoc. About 1,600 were suspected for COVID-19, roughly 3 percent of all visits. Earlier this month, Blue Shield expanded its coverage for behavioral mental health via telehealth services, including waiving cost sharing for Teladoc telehealth through May 31.

The surge in virtual visits continues a pattern that had gone on for weeks, as anxiety and concerns rose over the spread of the COVID-19 in the United States. As of mid-March, Teladoc, based in Purchase, N.Y., had already reported unprecedented volume in virtual patient visits, around the time many states started announcing lockdowns in earnest. The service reported on March 13 a volume of 100,000 virtual medical visits by patients in the United States for a one-week period, an increase of 50 percent from the previous week. Traffic has increased since then, and has been described by Teladoc as “unprecedented.”

The company has raced in order to absorb the rush, recruiting doctors, especially from non-essential specialties, such as allergy and endocrinology, according to Blue Shield’s work with Teladoc. Average wait times initially were problematic given the surge, but Teladoc has aggressively expanded its provider panels to handle the volume, according to Blue Shield executives. By early this month, wait times had fallen to about 30 to 45 minutes to see a provider.

Lessons from the Camp Fire

As telehealth services ramp up in this pandemic, the crisis shows how vital virtual visits can be. After the devasting 2018 Camp Fire, Blue Shield collaborated Teladoc and a medical provider in Paradise to help members displaced by that disaster. Paradise Medical Group has worked with Teladoc to create PMG Connect, a digital platform that allows 11,000 patients to their doctor connect via smartphone or computer. Virtual visits rose to about 298 for the first 10 days of April, compared with 274 for all of March, according to Altais, a technology and administrative service which Blue Shield of California is an investor.

PMG Connect’s rate of visits so far in April is triple that of the previous month, and historically, monthly tele-visits averaged around 40. During the pandemic, the platform has greatly helped members in Paradise and Chico and well outside PMG’s area, with some patients conducting virtual visits from out of state.  

While COVID-19 will eventually subside, the way members rely on healthcare will likely have shifted. “There is much more comfort with telehealth than there was prior to COVID-19,” says Malaika Stoll, senior medical director at Blue Shield of California. “This will open minds to other virtual health applications, such as remote monitoring, to manage overall health.”

Members are encouraged to visit http://blueshieldca.com/teladoc, or download the Blue Shield of California app on their smart phones to sign up for the service. Blue Shield also eliminated member cost sharing for Teladoc telehealth services through May 31, and telebehavioral health services coverage has been expanded to all members.