The Leader • Saturday, April 11, 2020 • Page 1B
Telehealth takes off during pandemic By Betsy Denson betsy@theleadernews.com
Heights resident Dr. Diane N. Roche, a licensed psychologist and clinical director at Roche + Associates, said her practice already had a protected online platform which in addition to managing medical records and appointment scheduling, offered secure video therapy sessions. But the video component was not often used. “For a handful of young adults, that was their preference,” Roche said. With the social distancing mandated by government officials on account of the COVID-19 pandemic, however, telehealth technology is the only way that Roche + Associates is currently offering therapy to the busy professionals it serves, except in cases of emergency. The demand for telehealth services is on the rise, according to a recent survey from customer experience IT vendor Sykes that found two-thirds of respondents are now willing to try virtual care. And in March, the U.S. government set aside many of its restrictions on telehealth. It also said it would relax enforcement on elements of the health privacy law, known as HIPAA, which oversees providers seeking to deliver care remotely. For Houston-based Legacy Community Health, a full-service, federally qualified health center with 12 standalone clinics, including Northline and Montrose locations, the government’s move opened the way for two new telehealth/telemedicine programs that are based on service lines. Legacy began offering virtual therapy for both adults and children three weeks ago, and a virtual pediatric clinic opened last week. While telehealth was also a service that Legacy provided on a small scale before COVID-19, primarily for behavioral health virtual clinic visits, it now makes up a large part of its current appointments. Dr. Jeanette Valdivieso, Legacy’s chief operating officer, said that in a a typical day, they see a total of 2,600 patients at all of their clinics. While those in-person appointments are down by at least half, they’ve “seen” 3,500 clients in their behavioral health clinic and a few hundred in the pediatric clinic during the last two weeks. This also includes their Spanish-
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speaking clients. “It’s new for the parents and the kids,” Valdivieso said. “We had to have extra support, but the kids have an easier time getting going.” Roche said she has been pleasantly surprised with the success of telehealth therapy, even with her older clients, but allows that she has to work harder to maintain the human connection during virtual sessions. Roche is often more taxed at the end of a session than she is during an inperson visit. “Brittany Baker, (a licensed clinical social woker), has been providing telehealth services since the time of her training, but I was practicing a long time before telehealth was an option,” Roche said of her associate. “So for her, it’s easier.” How it works Heights Dermatology CEO Daniel Salvato said his organization, which consists of nine clinical locations, is using telemedicine to serve existing patients and for the more urgent evaluation of those concerned about melanoma and other worrisome skin lesions. Patients can visit their website at www.heightsskin.com and access the Telemedicine Login to select a series of rotating providers and then go
through the screening process. The appointment happens over video chat with pictures sent through the HIPAAcompliant platform. “It’s been one tool in our tool chest,” Salvato said. “We’ve used more than one (platform) over the years.” Salvato said while telehealth services could not sustain the clinic fulltime, it is a particularly useful tool now for clients in rural areas like Gonzales and Columbus. The dermatologists normally visit them monthly. Valdivieso said Legacy’s pediatric service uses a Zoom platform specifically geared toward health care, and patients see either a nurse practitioner or a pediatrician depending on the type of appointment made. “It’s a collaborative process,” Valdivieso said of the appointment itself, in which the patient and their caregiver use the technology on their device to provide needed data to the medical professional. “It keeps them out of the (physical) waiting room.” For students at YES Prep and KIPP schools in Houston, Legacy’s clinic allows them online access to their school-based healthcare givers, employed by Legacy, that they used to see at school. “This is open to the kids and to all their friends,” Valdivieso said. One possible downside Roche sees
is that although the need for mental health services is probably greater during a pandemic, some people might be more willing to put off initiating a virtual appointment. “When every single thing about people’s lives change, it is completely overwhelming and they are less likely to reach out for other services,” Roche said. To be a support to healthcare workers, Roche + Associates is offering a free consultation and a discount on subsequent therapy services. “They have every possible stress (and) are unlikely to reach out,” Roche said, “even though they’d benefit from a completely confidential place to dump all of (the anxiety).” What’s next? Salvato said he hopes telemedicine becomes a mainstay. “I think we are all looking forward to getting back to a new normal,” Salvato said. “But (telemedicine) is one of those positive pieces of technology that will help redefine how we approach care in the modern world and how we provide a higher quality of care.” Added Valdivieso: “It minimizes the barriers of time and transportation. It is one of the ways of the future.”
Use nutrition therapy to support immune system IV Ozone therapy are new treatments under review in addition to the autoimmune and anti-viral protocols currently in use. For now, changing lifestyle habits such as diet, hygiene, stress and sleep are all powers within your control. Through these modifiable factors, reducing your risk may reduce the risk for our community.
By Shana Tatum sstatum@wellness-collaborative.com
While there are no known cures for COVID-19, the disease caused by the new strain of coronavirus, scientists are working overtime to come up with protocols to treat it and a vaccine to prevent it. You likely have read about supplements, herbs or adaptogens to take to avoid catching this novel virus. Without oversight from the FDA to regulate supplements, consumers may be influenced by marketing and the intense desire to prevent the disease. Taking supplements without knowing proper dosage or possible interactions may set up your immune system for trouble. Please be wary of unapproved and unbranded products claiming they can treat or prevent the virus. Along with decreasing your risk for exposure by staying home, practicing social distancing, frequently washing hands and wearing a face mask in public, here are a few things to focus on nutritionally: How to be stronger now • Eat a whole foods diet rich in vegetables. The antioxidant power with anti-inflammatory action is what the immune system needs to be strong. Not only do we benefit from the fiber vegetables provide, building a healthy gut microbiome, we also gain phytonutrients that are positively associated with reduced risk of chronic disease. It provides the vitamins and minerals essential to help promote a desired immune response. • Reduce consumption of sugar. I know this feels like a hard one. So many of my patients are reaching for food to calm the stress. Sugar aggravates the immune system and creates more inflammation at a time when we need the body to be calm and not in a reactive state. Researchers looked at the ability for white blood cells to react to bacteria after consumption of 100 grams of sugar (the amount you might find in a caramel-whipped iced coffee drink). Their results showed a 50 percent reduction in the ability to engulf bacteria. • Stay hydrated. Water transports so many biochemical nutrients in the body. Without it, our immune systems are at a disadvantage. Drink half your body weight in
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OAK FOREST - 2227 LAMONTE Stock photo A variety of food sources provide nutrients that aid the body’s immune system. A strong immune system can help prevent serious complications from COVID-19.
ounces daily, unless on a shanatatumrd for an easy fluid-restricted diet. recipe) and kimchi. • Include supportive • Sleep. Make it a pribio actives: ority. For those deemed Vitamin C is found in non-essential and officbroccoli, oranges, toing from home, you may matoes and kiwi fruit as have gained time back well as red, orange and in the schedule with reyellow bell peppers. Conduced commuting. Put sider supplementation as this toward your sleep well if working with a bank! Sleep loss has healthcare provider. been linked to cardiovascular risk, diabetes and Zinc is a mineral that Tatum increased risk of obeplays a key role in the sity. Notice a theme here? immune system and a mild deficiency can lead to a weaker im- These are some of the high-risk mune response. Sources of zinc categories for COVID-19 complicainclude seafood, shellfish, animal tions. • Stress less. This one is hard, protein, chickpeas, pumpkin and and I definitely haven’t mastered sunflower seeds. Some studies have shown that it! With homeschooling, the recent Vitamin D can reduce respiratory loss of a loved one, and a decreased infections and plays a role in pre- revenue in my business, my only venting influenza. Look for Vitamin advice is to take it one day at a time. D first from sunlight, but eggs, forti- Please know, we are all doing this fied dairy and mushrooms are good for the first time and that no one food sources. Supplementation is has it “all figured out” even if they advised if you know you are low look like it on social media. Instead, or deficient, when working with a I cling to what I do know. Funny movies, cooking with my children, healthcare provider. Probiotics help as the immune walking barefoot in the grass in the system starts in the gut with up to backyard are ways I slow down. 60 percent of the immune system Find your own way and make it a housed there. A good intestinal mi- priority. Immune support should be adcrobial balance is key to immune function. Lactobacillus and Bifido- dressed year-round, but when panbacteria are two species found to demics strike, we employ strategies show benefit. Sources include cul- to improve our health in the motured yogurt, kefir and fermented ment. Less conventional therapies foods such as sauerkraut (follow @ such as high-dose IV Vitamin C or
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