72 - Telehealth in Pain Medicine: Lessons Learned During the COVID-19 Pandemic

University of Utah, Salt Lake City, UT, USA. VASLCHCS, Salt Lake City, UT, USA

Purpose
Three selected cases of Pain Medicine clinical encounters are presented to illustrate three lessons learned during the conversion of face to face care to telehealth care (via video and telephone) mandated during the COVID-19 pandemic emergency situation. These lessons are described in three general categories. Those are: 1) care processes, 2) clinical impact, and 3) administrative to include costs. Lessons learned are important for improving clinical outcomes, conveying new information to clinicians planning to implement telehealth, conveying new information to clinicians utilizing telehealth, conveying new information to administrators promoting the use of telehealth and payers considering reimbursement for telehealth services. Care processes involve patient, staff, clinician and administrative perspectives.
Methods
Experience implementing telehealth services in three different health care systems in the state of Utah are the source of material to be described. Since the onset of the COVID-19 pandemic in the United States, different health systems have had different approaches to the implementation and acceleration of telehealth services. This senior Pain Medicine clinician has been practicing in these health systems for over twenty years and has made observations of the different approaches to implementing telehealth particularly since the COVID-19 pandemic hit the state of Utah. Three cases are chosen to illustrate the lessons learned from this experience. She has engaged with patients, other clinicians, and other administrators to share their observations of the impact of telehealth services on pain medicine care.
Results
There are differences in the outcomes of telehealth pain medicine services that depend on multiple factors. These factors can be divided into patient related, clinician related, technical and systems related factors. Some of the outcomes are positive and some may be negative.
Some of the positive outcomes of telehealth pain medicine were surprising.

The illustrative case reports are chosen to highlight both the positive and negative aspects of delivering telehealth pain medicine services.
Conclusions
Given the uncertainty of the COVID-19 pandemic in terms of changes to health care in the United States and the duration of the pandemic, we can expect to be using telehealth pain medicine in our care of patients well into the future.
The lessons illustrated in these cases categorized by care processes, clinical impact and administrative issues will be very important to carry going forward. Additional lessons will likely be learned as we continue to provide telehealth pain medicine services.