The doctor can (virtually) see you now

Before we went into a nationwide lockdown, I went to see a great movie with some friends.

After the coronavirus hit, I had to start homeschooling my kids.

For Greg Orr, the before ended up causing problems in the after.

“Right before everything started closing down, I’d gone skiing with my family,” says Orr, vice president of digital health for Walgreens Boots Alliance. “But a few days later, right around the time the first cluster of coronavirus cases appeared in my hometown of Seattle, I started noticing my toes were all red and itchy. It felt sort of like an ingrown toenail, except there was no ingrown toenail.”

He dismissed it, but the area kept getting more painful, to the point where he could barely walk. Then the same symptoms started on his other foot. But in the early days of the COVID-19 outbreak, in the first U.S. hot spot, the last thing he wanted to do was go to urgent care or an emergency room.

So Orr, who was instrumental in developing the Walgreens Find Care® platform, decided to take a dose of his own medicine. He grabbed his phone and clicked on one of the telehealth services available through the Walgreens mobile app, and submitted a few photos of his toes and a short description of his symptoms.

The next morning, Orr awoke to two text messages. One was from Walgreens Find Care, letting him know that a physician had completed his treatment plan.  A board-certified dermatologist had diagnosed Orr with a condition common in cold, damp areas like the Pacific Northwest, and suggested ways to alleviate the symptoms, including a prescription ointment. The other text message was from Walgreens, informing Orr that a prescription for the ointment had already been filled and was ready for him to pick up.

For Orr, this was a perfect illustration of the power of Walgreens Find Care – a service more useful than ever as the country suddenly grapples with a historic pandemic.
 
New tools in the telemedicine chest

Walgreens Find Care isn’t new: it has been connecting Walgreens mobile and online customers to an array of telehealth services since July 2018. The platform displays care options based on a user’s location, helping them find leading health systems and telehealth providers in their area to treat their common health and wellness needs. Patients also can use Walgreens Find Care to support chronic conditions such as diabetes, high blood pressure, and sleep disorders through diagnostics, therapeutic solutions and connected devices.

Because there already was a growing need for telehealth services, Walgreens Find Care™ recently expanded to provide access to more leading regional and nationwide health care providers. There are also new tools specifically addressing the COVID-19 pandemic: a risk assessment tool, powered by Microsoft Healthcare Bot service, which can help users determine their risk of COVID-19 based on CDC guidelines; and the Find My Clinical Trial program, which allows users to identify and apply to participate in COVID-19 related trials.
 

“Our goal, long before COVID-19, was to use digital technology to provide an integrated health care and pharmacy experience, and the recent expansion of services and providers through Walgreens Find Care™ is another way we’re making it easier for patients to get care when and how they need it,” says Orr. "But as people turn to digital solutions specifically to help minimize exposure to coronavirus, it’s more important than ever to have a seamless way of connecting them to telehealth services that can support the direct and indirect health repercussions of the pandemic.”

These solutions couldn’t come at a better time, with both public awareness and demand for telehealth services skyrocketing. Use of the Walgreens Find Care™ app is up 22 percent compared to the same time last year. And according to MDLIVE, a longtime partner and provider on the Walgreens Find Care™ platform, in March alone, they provided care to nearly twice as many patients per day as they did during the entire 2019-2020 flu season.

The front (phone) lines of care

Cynthia Collins, MD is a Tennessee-based physician and full-time telemedicine practitioner through MDLIVE. She worked every day in March, seeing about 200 patients a week for common complaints such as strep throat, allergies, stomachaches and sinusitis, as well as concerns over possible COVID-19 exposure or symptoms.

While they may not be on the front lines physically, telehealth doctors are playing a key role in keeping our health care system running during the pandemic. For every patient Dr. Collins triages, that’s one fewer case to tax the already overloaded emergency rooms, allowing them to focus on the most critical patients.

“Sometimes I’ll finish my day and I have to tell my family that I need some personal time, to just sit quietly– I'm just so tired of talking,” says Dr. Collins. “But at the same time, it has felt so purposeful. Patients are so grateful, saying, ‘This saved me from having to go to the ER,’ and, ‘I never knew you were there before until this happened.’”

Aside from the obvious reasons people are trying telehealth (social distancing and temporary shutdowns of physical doctor’s offices as the health system focuses on COVID-19), there may also be a psychological component that’s making virtual visits a more attractive option.

“Since we’ve historically had a bias towards physical presence in medicine, some people (pre pandemic) believed that services using telehealth would be ‘second rate.’ The data now suggest otherwise,” says Ann Mond Johnson, chief executive officer of the American Telemedicine Association.

But as we all learn to embrace social technology, from Easter Bunny visits via teleconference to online group workout sessions, we’re letting go of the notion that virtual means impersonal.

“We’re all finding that our sense of community and our ability to interact with people is very much based on our ability to talk to them over the phone or video conference, which is what most of us are only able to do at this time,” Johnson explains.

This doesn’t come as a surprise to Dr. Collins, who embraced telemedicine before it was a necessary part of the “new normal.” Even when she worked in a traditional brick-and-mortar setting, she felt she could almost always diagnose a patient without touching them.

“It’s really about being a good listener, delving in and getting more details about what's going on with them,” she says. “We request photos, we can do video chats, but it’s amazing how much we can learn just from listening to someone’s voice.”

New not-so-normal

All around the world, people are coming to terms with an uncertain and unfamiliar future. Silver linings can be hard to find. But Johnson says a new willingness to embrace telehealth might be one of them.

“The idea of being able to provide services to people who need it regardless of where they are is a really important step for society,” she says. “Not just for people who don’t have access to specialists in rural communities, but also people in urban settings who need to take multiple bus rides to get to a clinician, aging populations, even postpartum moms who are being monitored at home for hypertension. Now that the floodgates are open, people are seeing how technology can step in and provide enormous value.”

As for Orr, his toes are back to normal. But that wasn’t the end of his story: weeks after the condition cleared up, he got another notification from the telehealth physician who’d diagnosed him.
 
“She wanted to alert me that there have been reports of a condition with similar symptoms to mine, that could be a sign of otherwise asymptomatic COVID-19 – people have recently begun referring to it as ‘covid toes’,” he explains. After conferring with local health officials, due to the fact that he had no other symptoms and no known exposures, Orr did not pursue further testing. But he appreciated the physician reaching out, nearly a month later, to follow up – and felt this experience reinforced how powerful telehealth can be.

“I’m doing video calls with my parents almost every day,” Orr says. “I didn't do that before, but now it’s become a habit. I very much agree with others who prefer the phrase physical distancing instead of social distancing. Because we still have access to many of the things we need. We can still access loved ones. We can still access health care. We can still access a lot of these things without actually being physically close to each other.”