The record damage and human misery inflicted by Hurricane Harvey in Houston this past week may have produced one positive impact on digital healthcare. Namely, using telehealth in disaster planning.
Beginning this week and extending into next week and possibly beyond a number of big telehealth services providers, including American Well, Doctor on Demand, MDLive Inc. and Teladoc Inc., are offering victims of Hurricane Harvey access to free digital doctor visits via telehealth. Most of the telehealth visits involve treatment for minor issues such as treating infections, skin and eye issues, sprains and bruises, back pain, vomiting and diarrhea, colds, coughs, and congestion, migraines and urinary tract infections.
But the bigger need for services are providing telehealth services for behavioral health issues given the severity of Harvey, which slammed into Texas and essentially overwhelmed Houston, the nation’s fourth largest city with a population of about 2.3 million residents. Harvey could cost Houston as much as $50 billion in property damage costs and lost economic activity, the Greater Houston Partnership and Moody’s Analytics estimated in a report from the Houston Chronicle. As many as 30,000 to 40,000 homes have been destroyed in the Houston area and Harvey also destroyed about 300,000 to 500,000 vehicles owned by individuals, according to Cox Automotive.
The storm, which dropped a record amount of rain fall on Houston and other parts of the Texas and Louisiana Gulf Coast, has caused the death of 14 people, although other injury and sickness statistics have yet to be compiled and released by public health officials.
Telehealth service providers also either will not issue specific numbers or are still in the process of collecting them. But business is brisk for free telehealth visits from storm victims impacted by Harvey. “We haven’t tallied the numbers yet but what we know is that every day we’re getting heartfelt stories and feedback from our physicians who are taking the calls and talking with these who are going through an unbelievable experience,” says Teladoc chief medical officer Dr. Lewis Levy. “Parents are seeking help for their children and themselves—the need is great among all ages and populations.”
Teladoc, which is getting the word out for free telehealth services via a toll free phone number and on Twitter and Facebook, will offer services for the near future for conditions such as sinus problems, respiratory infection, allergies, cold and flu symptoms and many other non-emergency illnesses, Levy says. “We have not set an end date and our current plan is to keep the hotline open as needed,” Levy says. “We haven’t taken the time at this point to do a thorough assessment, but in general what we hear is that the conditions are consistent with the non-emergency conditions we regularly treat like upper respiratory infections, cold and flu.”
Doctor on Demand, a San Francisco-based telehealth vendor, began offering free digital doctor visits last Friday. A chief benefit of telehealth in a disaster situation is that digital doctor visits can provide some level of consistent care when regular healthcare services are severely disrupted, says Doctor on Demand CEO Hill Ferguson. “Last year we covered visits during Hurricane Matthew in Florida, Georgia, North Carolina and South Carolina and during significant weather events, patients are often unable to access healthcare due to road closures, flooding, or office closures,” Hill says. “The services allow patients to access medical care without traveling into severe weather situations.”
Doctor On Demand is offering video visits and appointments from smartphones, tablets, and computers and via a toll-free phone number. Among the biggest need of telehealth services is for Harvey victims in need of counseling. Hill says. “There is a need for mental health professionals in the region and our company’s physicians are trained to treat stress, anxiety, grief, and depression,” he says.
Telehealth is also being used to help patients refill medications or fill a new prescription when possible and offer tools and geo-location services to find the nearest available pharmacy in the storm damaged area. “We’ve heard from patients affected by the hurricane that they’ve lost medication in the flooding and we’ve been able to make sure they receive the care they need including refilling their medications,” Hill says. “Also, we’re hearing of pharmacies being closed due to flooding, patients are able to choose a pharmacy in our app to have their prescription order sent to outside of the flood zone.”
American Well is giving free telehealth visits for people in Texas and Louisiana affected by Hurricane Harvey. Residents in need of immediate assistance can see a doctor on demand from the American Well app, for both medical needs and psychological counselling by using a special code, says American Well medical director Dr. Sylvia Romm. The American Well app and telehealth platform also has geolocation tools that providers are using to help patients after a digital doctor visit fill a prescription at a pharmacy at the nearest closest convenience.
The use of telehealth as a new disaster planning tool will become more mainstream, Romm says. “In a hurricane when normal healthcare delivery is interrupted and there is only so much that can be done because of the storm disruption, telehealth plays a role,” Romm says. “Telehealth puts healthcare in the hands of people when and where they need it.”
In May the Texas legislature expedited the use of telehealth across the state by passing a law that says a patient-physician relationship can be established without an in-person visit. That law, in turn, made it easier for telehealth service providers such as American Well and others to set up operations and begin offering digital doctor consults.
With less roadblocks to offering telehealth, American Well was positioned to offer help for Harvey victims relatively quickly “because we had the infrastructure in place, Romm says.
Telehealth services are especially helpful as residents and public health officials deal with illness from storm-related conditions, says MDLive chief medical affairs officer Dr. Deborah Ann Mulligan.
Those conditions include:
- Sewage systems often spill over, and the water can dredge up infectious materials from human waste.
- Bug bites, such as those from bees, fire ants, mosquitoes and Zika and West Nile are currently a threat in Texas.
- Animal bites such as those from feral cats, dogs and snakes.
- Rashes and wounds exposed to flood waters can become infected.
- Behavioral health/mental health issues. A hurricane intensifies stress levels, anxiety and depression.
As Houston and other impacted storm areas struggle to rebuild healthcare services, telehealth is one digital health delivery channel that offers some level of consistency, Mulligan says. “There are well known conditions unique to post-hurricanes/floods, of which virtual care can serve as a valuable resource.” Mulligan says. “Given the recovery process is now just beginning, the number of “walking wounded” in need of medical/behavioral care is expected to rise.”