The COVID-19 pandemic accelerated the adoption of telehealth. Dr. Nick Patel, Chief Digital Officer of Prisma Health, believes it’s a trend set to continue – so long as a crucial criterion is met



When Henry McMaster, Governor of South Carolina announced last April that the state’s public schools would close for the rest of the academic year to curb the spread of the novel coronavirus, campuses did not vacant immediately. Huge queues could still be seen during lunch hour as students went back to eat their meals. “For many of these children, the school lunch is their one proper meal a day,” says Dr. Nick Patel, Chief Digital Officer at Prisma Health.

While waiting in the car park, many parents would use the school wifi to download their children’s assignments for home-based virtual learning. “For the adults, this is probably the only time of the day when they have access to the internet,” Dr. Patel adds. Tapping into the opportunity, Prisma Health began a new community outreach effort to offer families telehealth visits during school lunch hour.

“Health disparities have existed for a long time – the COVID-19 pandemic just made it more visible,” says Dr. Patel. “We don’t want the availability of broadband, wifi, webcams and speakers to aggravate the situation. If anything, telehealth should break down the access barrier to care for those living in remote areas or in poverty.”

Dr. Patel believes providing a seamless service is crucial in helping to bridge the equity gap and make telehealth sustainable in the long run. “I think of it as more of a continuum of services,” he says. “One can start with an asynchronous visit or an e-visit and escalate it to a nurse practitioner via a phone call before deciding if a walk-in examination is needed. We can also conduct an enhanced video visit, whereby patients are given digital devices in their palms to check on their hearts, lungs, vital signs and oxygenation levels. In short, the ability to easily schedule an appointment, launch a video and integrate the conversations with the electronic health records are extremely important for both healthcare providers and patients.”

Prisma Health is now working to make its telehealth service even more comprehensive to include remote, wearable-driven physical examinations and monitoring. In fact, as the largest non-profit health provider in the state, Prisma Health have completed more than 170,000 COVID-19 screening chats in South Carolina, since the start of the pandemic.

To facilitate the process, it set up an automated chatbot backed by the CDC guidelines. A patient will indicate the symptoms they are experiencing before the chatbot sorts them into the green, yellow or red category accordingly. They will then be advised if they need a COVID-19 test and where they can get the test done based on their zip code.

Despite the convenience, there are concerns that telehealth can never be carried out effectively. Dr. Patel admits telehealth provides limited help when it comes to acute symptoms like chest pain, injuries or other conditions that need hands-on and even life-saving attention. However, many chronic disease patients tend to be more stable. Unless new complaints are being made, they do not need additional medical assistance other than routine follow up and these can be done virtually.

“Putting aside the 80% of ambulatory cases, the rest is perfect for telehealth,” he says. “Adherence and no-show rate will improve when patients don’t need to arrange for transportation or to leave their homes for medical appointments. More importantly, I can request patients to readily show me the medications they are taking at the moment or to have their family members join the visit.”

Nonetheless, Dr. Patel is keen to emphasise that telehealth is not just video visits. It requires an integration of various systems and services to be effective and efficient. Prisma Health provides patients with the same, secured telehealth platform and it’s linked to the same electronic health records. In reality, interoperability remains challenging. “I don’t think telehealth will ever reach 100%,” he says. “It will always be part-virtual and part-physical.

“Yet, it doesn’t mean we cannot push for more virtual visits. What we hope to see one day is instead of patients reaching out to fellow physicians when they are sick, physicians will jump ahead, with the help of technologies and data accumulated from all the telehealth visits, informing patients that they are about to fall sick because their blood pressure or blood sugar levels or vital signs are going the wrong direction. This is what healthcare needs if we are truly serious about getting better outcomes.”


Dr. Nick Patel will be speaking at AIMed’s virtual multi-track CME-accredited event, ‘Surgery, ICU and Neurosciences’, on 30 March at 12.10pm EST

View the full two day agenda and book here