Telemedicine’s Moment

THE STATISTICS ON TELEHEALTH DURING THE PANDEMIC have told a consistent story—within the first few weeks of the global pandemic, virtual visits more than tripled in the United States and continued to growth after that. But while telehealth is likely to have gotten a permanent boost from the pandemic, its most significant growth may be from the thousand small inventions that were born out of necessity.

“One of the greatest tragedies we saw was the isolation that COVID-19 patients faced,” says Lee Schwamm, executive vice chairman in the Department of Neurology and the director of the MGH Center for TeleHealth. “Only staff were allowed to enter their rooms, and they wore several layers of personal protective equipment, including masks and goggles and often face shields. So patients' experience in the hospital was one of no visitors, and only seeing the eyes of a few people.”

The solution at MGH was the virtual intercom—a low-tech hack that involved stringing an iPad to an IV pole and positioning it by a patient’s bedside. “The clinicians could spend 10 minutes in the room with the patient doing certain physical maneuvers, and then 40 minutes talking to the patient—face uncovered and unmasked—outside the room. It was a face-to-face interaction. Patients found this extraordinarily meaningful. And it helped our staff keep themselves safe.”

Dr. Schwamm discusses that and other innovations at MGH, including virtual rounds and new ways to virtually connect patients to emotional support and translation services. He also explores the bright national future of virtual care—and the danger that this will miss vulnerable populations that aren’t digitally equipped or savvy. “How do we make ourselves an open space where people can equally share in the benefits of the wonderful medicine we have to offer?” he says.

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