Virtual health: From Camp Fire to coronavirus

Paradise Medical Group in Northern California began using telehealth almost exclusively after the deadly Camp Fire in 2018, an adaptation which has become instrumental in allowing the group to care for patients during the new coronavirus crisis affecting providers and people worldwide.

Paradise is running a virtual practice as the federal government today announced expanded access to telehealth services as a way for providers to care for patients while practicing social distancing protocols.

In November 2018, it was the Camp Fire that threatened people, wildlife and buildings in Butte County. The morning the fire spread to the Paradise Medical complex, all were sent home and told to start evacuating. Even as people were leaving, ash was falling in the parking lot and the fire sounded like an arriving freight train, said Dr. Richard E. Thorp, president of the Paradise Medical Group.

The Camp Fire killed 85 people and destroyed 14,000 homes. Two of the practice's three buildings were destroyed. Thousands of residents were displaced.

Three weeks earlier, Paradise had begun working with Blue Shield of California and Teladoc Health on test strategies to implement a virtual option. 

Blue Shield and Teladoc have been working together for about six years, helping other practices establish telehealth, according to Peter Long, senior vice president of Healthcare and Community Health Transformation for Blue Shield of California.

"Then the fire happened, and that changed everything," Long said.

The idea of telehealth became a virtual reality for patients now scattered in various outlying towns.

For six months, a Blue Shield/Teladoc team worked with Thorp on the telehealth platform for all of Paradise's patients, regardless of their health plan. Blue Shield covered the financing.

WHY THIS MATTERS

Telehealth allowed the practice to continue operating, even though it is now on a smaller different scale than before the fire. This helped displaced patients looking for stability in the medical provider they may have had for years.

"Having telehealth, we kept patients," Thorp said. "It gave us a way to connect with people, as long as people didn't change their residence out of California. It's amazing to me how many people needed that connection. They're so used to talking to their doctor about their problems. It was a dramatic time of everything else being lost. It was a stabilizing force."

Paradise lost 40% to 50% of its patient base and about half of its physicians. Before the fire, the medium-sized group had about 20 physicians. It currently has about nine.

CORONAVIRUS

By May 2019, one of the destroyed buildings reopened, and Paradise is on the verge of opening the second building.

About 100 new homes are under construction in Butte County, according to Thorp. The cleanup is 95% done. Most people are again in permanent housing, with just a few in FEMA homes.

Some have dispersed permanently, going to live in other communities.

Telehealth is now embedded in the practice, along with additional innovations such as virtual assistance, e-consults and a community health advocate.

With the arrival of the coronavirus, "it is very providential we have this platform that many of the practices in the area don't have," Thorp said. "We're able to direct patients who are symptomatic to the telehealth platform."

Those who want to be tested for the coronavirus are interviewed virtually and then are tested in Paradise's parking lot, where the staff is protected with appropriate gowns and masks. As of March 12, there were no positives for COVID-19, and the nationwide test kit shortage has not been a serious concern, Thorp said.

THE LARGER TREND

Providers are being given unprecedented flexibility to use telehealth during the coronavirus pandemic.

On Friday, President Donald Trump declared COVID-19 a national emergency, opening up billions in funding and giving states the ability to waive regulations. He also promised physicians and hospitals the ability to conduct telehealth visits by waiving certain licensing requirements.

On Tuesday, the Department of Health and Human Services announced expanded Medicare coverage for telehealth visits, the waiving of potential HIPAA penalties for good-faith use of telehealth during the emergency and the flexibility for providers to reduce or waive beneficiary cost-sharing for telehealth visits paid by federal healthcare programs.

Teladoc Health said it is experiencing an increase in daily visit volume in the United States as the novel coronavirus continues to spread.

Volume has spiked 50% week-over-week and continues to rise. The company had been handling visit demand consistent with peak flu volumes, but last week began to see that number accelerate to as much as 15,000 visits requested per day. 

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com