Routine healthcare visits declined after COVID-19 made an appearance in Colorado. Now doctors worry the road to recovery could be slow.
Dr. Gregory Berman, VP of acceleration and enablement at Kaiser Permanente recounted the sudden changes of healthcare when the pandemic began.
In March 2020, Gov. Jared Polis issued an order preventing care providers from performing voluntary or elective procedures. According to a Colorado Health Institute study, weekly visits from patients dropped to 36% of the equivalent time frame a year earlier.
Although patients were not able to visit their doctors in person, telehealth appointments became increasingly more popular and utilized, Berman said.
Virtual appointments allowed doctors an insight into the lives of their patients that was not possible before, however, it had its own challenges.
“That was the first pathway for those with chronic disease or acute concerns to continue to get care,” Berman said, adding “that’s not always preventative, some of that is acute needs and a mix of care.”
By June 2020, care volumes rebounded to 76% of pre-pandemic levels, according to the Colorado Health Institute study.
“Though coronavirus case rates were relatively low in Colorado during the summer, there was no surge in visits to make up for previously missed appointments,” the study states.
Although telehealth offset decreases in healthcare visits by offering a crucial line to patients, it didn’t fully replace all the lost in-person visits.
For those who missed visits, true consequences can be seen today.
“One national survey found more than half (57%) of those who postponed care reported negative health consequences due to the delay. The health impacts were most immediate and apparent for Coloradans with chronic conditions that require frequent touchpoints with providers, such as diabetes or hypertension, and for Coloradans with new or existing behavioral health needs,” according to the study.
Berman said that it is not unusual to see a growth in diagnoses when people go long periods of time without preventative care for example cancer diagnoses.
“... these guidelines are in place to keep large populations healthy and we had to — and many people chose to — not necessarily do those,” he said. “We are back to doing those. We are increasing our hours and trying to get as many people in because those are critical for your health.”
Additionally, Berman has seen routine problems become worse because some people have put off getting care, further complicating how the problem is addressed medically, often making the issue more complex, he said.
For some chronic conditions such as diabetes, chronic obstructive pulmonary disease and high blood pressure, Berman describes chronic care management as a journey — on which some people lost ground.
“I think for some patients, they fell behind and were catching up and were making the downstream implications of poor blood sugar control, poor blood pressure control, that we are sort of back on it,” Berman said.
“Patients with chronic conditions are at risk of adverse outcomes when their regular care schedule and lifestyle modifications are upended in this way. For example, patients with diabetes may experience complications like eye disease, kidney disease, and nerve damage,” the study stated.
Berman said all is not lost though. He believes that getting on track is highly dependent on communication between providers and patients while also getting back to normal preventative routines.
For Kaiser Permanente, that communication includes text messaging, phone calls and emails to keep patients on track with their healthcare plans. The Colorado Health Institute also recommends care providers and insurers make a concerted effort to reach out to patients with chronic illnesses and check on their health status.
“In the broader healthcare landscape, it is all about communicating with patients, helping navigate patients and really educating patients …,” Berman said.
