Opinion: The Modern Equivalent of a House Call

There is a quiet yet fundamental transformation taking place in health care. It’s telehealth.

No longer do patients have to go to see their health care providers. Now, their health care providers can go see them. It’s like the old fashioned house call, just rebooted with new technology.

How many of us have delayed or even forgone the care we needed because we couldn’t get to our health care provider’s office? We may not have had transportation. We may have had too many work and family obligations to get in during regular office hours. Or we may not have had a provider anywhere near where we lived, especially for those of us in rural areas.

Through telehealth communications, health care providers can now make virtual house calls; and this means that many more patients will be able to get the health care they need. This includes, but is not limited to, primary care, specialties as diverse as dermatology and nutrition, and support for homebound patients.

There are different ways for health care providers to make these virtual house calls, and telehealth technology puts patients in the driver’s seat of choosing how they prefer to communicate with their providers. They can video chat (synchronous) or have a patient-provider conversation through electronic messaging (asynchronous) as telehealth platforms must be secure and HIPAA compliant. Health care providers can deliver the health care services needed by patients, just as long as the providers can get all the relevant clinical information. If an in-person visit is needed, providers will work with their patients to ensure they get the right type of care.

We are supporting Senate Bill 402/House Bill 448, sponsored by Sens. Cheryl Kagan (D-Montgomery) and Clarence Lam (D-Howard) and Del. Sandy Rosenberg (D-Baltimore City), because it will support telehealth by providing a consistent regulatory framework. Nurses and physicians work side by side with other types of health care practitioners, such as occupational therapists and social workers. All health care practitioners would have to follow the same rules focused on consumer protection, just as they do for in-person care.

We are concerned by an amendment proposed by the Board of Physicians that would take telehealth backwards. Health care providers could not establish a patient-provider relationship through robust asynchronous communication, even though this communication tool is already used in Maryland and many other states. This prohibition would undermine the preferences of patients, it would undermine health care providers’ judgment to choose the best tools for safely delivering care, and it would undermine the telehealth innovations already in place in Maryland.

The board proposes to limit the use of asynchronous prescribing to birth control to new patients. The rest would have to be studied. If this limitation were implemented for all providers, Maryland would be unnecessarily limiting access to medications to prevent HIV infection, treat skin conditions such as poison ivy, and manage common illnesses such as colds.

We support expanding birth control access, but we also support expanding access to all the other health care services available through telehealth. Our patients deserve to be able to utilize the best technology available to communicate with all their health care practitioners. We should be opening every door, whether virtual or in-person, for our patients to get the care they need.

— KAREN NELSON AND ELAINE CRAIN

The writers are, respectively, president and CEO of Planned Parenthood of Maryland and CEO of the Maryland Academy of Advanced Practice Clinicians.

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