Devices in demand

During the height of the COVID-19 pandemic, Dr. Arnold Pallay of Consensus Health received call after call from patients around the country who had seen him before, seeking guidance from a doctor they trusted. On those same days, he would handle dozens of COVID-positive individuals.

Without the mass adoption of telemedicine that happened so quickly over the course of the pandemic, that wouldn’t have been possible, he said.

Pallay spoke alongside three other panelists at NJBIZ’s virtual Health Care Technology panel discussion on Aug. 31.

The panel, moderated by Health Care Institute of New Jersey Chief Executive Officer Dean Paranicas, also included Grassi Healthcare Advisors Partner Joseph Tomaino, New Jersey Innovation Institute Senior Vice President and General Manager Jennifer D’Angelo, and RWJBarnabas Health Chief Innovation Officer and Vice President Jordan Ruch. The group addressed how advances in health care technology have been accelerated by the COVID-19 pandemic.

“It’s hard to understand the amount technology has become critical in the suddenly arriving pandemic. Our country was not fully set for the kind of rapid response we had to engage in,” Pallay said. Electronic health records allowed him to connect to patients situated at various hospitals, thus allowing him to better support their needs and the needs of their families.

According to D’Angelo, telemedicine, mobile device management and hardware requests were all significantly affected early on in the pandemic, and the facilitation of telemedicine faced challenges of mobile device management and hardware requests—making sure that the right materials were available and that they were working properly.

Technology also allowed for the mobile management of personal protective equipment supplies and helped systems develop protocols around managing it, according to D’Angelo. Hospitals and health care facilities across the state were fighting PPE shortages earlier in the pandemic, resulting in several New Jersey manufacturers retooling to produce it locally and the state launching a PPE Supplier Registry to connect suppliers of PPE to potential buyers.

D’Angelo recommended companies take a chance now to evaluate if they have the bandwidth to sustain remote communications and telehealth services, noting that when COVID arrived, it was difficult to get the equipment necessary to sustain them.

Pre-pandemic, RWJ Barnabas was in the midst of rolling out Epic, it’s electronic health records system that would work seamlessly across its facilities. Ruch and his team were right in the middle of the Epic build when COVID-19 began to rapidly spread across New Jersey, and they decided to take a strategic pause on parts of the project that required the attention of the now-otherwise-engaged front line clinical staff.

To keep the project going, they built what they could with teams that were still available to work on it, such as the revenue cycle team. The strategic pause allowed them to keep the project moving forward.

“It is both important for patients and cost-effective to society and it’s the intelligent thing to do to put this [technology] in the hands of patients,” Pallay said on telemedicine and the use of technology in health care.

He noted that while what goes on in exam rooms is helpful for some health care, the delivery of behavioral health through telemedicine has “made a substantive difference.”

“This type of technique has been amazing,” he said.

He also acknowledged that he didn’t originally see telemedicine as useful when working with the elderly, but that changed during the pandemic. And, reason for a visit notwithstanding, being able to have a video consultation with a patient without putting on PPE has been helpful, noted Ruch.

One of Tomaino’s clients has been able to monitor COVID-positive patients at home through telemedicine, not just how they feel through video chatting but also the level of oxygen in their blood by a pulse oximeter. His client is able to call a patient up and tell them, “you’re deteriorating and need to go to the hospital.”

Telemedicine has expanded medical access across the country; and unlike before the pandemic, providers can practice telemedicine across state lines, which allows doctors in places where COVID-19 numbers are under control to assist doctors and patients in places where they are high. However, it’s currently limited in some places due to broadband access or lack thereof, explained Tomaino.

Ruch and D’Angelo said that in those locations, or anywhere people don’t have access to an internet-enabled device, some health systems have started to work with local community spaces like grocery stores to offer a telehealth kiosk, where people can get help without and in-person appointment or a personal device.