The silver lining of the pandemic: Why a Utah doctor says virtual visits are the future

Editor’s note: This article is part of a series where we thank the Unexpected Heroes who put themselves at risk to help keep Utah running during the coronavirus pandemic. Every Monday, we will highlight a different industry, and we'll ask you to write in to thank the workers in that industry for their service. During the week, we'll profile someone who works in that industry. Every Friday, we will publish some of your submissions and send the messages of thanks to those in the field.

MURRAY— Dr. Mark Lewis was taken aback.

The Murray-based director of gastrointestinal oncology for Intermountain Healthcare was on a video call with a patient from Idaho when something happened he definitely wasn’t expecting — a cow wandered into the frame.

“That was an interesting aspect of the visit I wouldn't have normally had,” Lewis said.

With the novel coronavirus pandemic continuing its spread through the country, doctors have had to get creative with how they treat patients. Like other businesses, they are turning to technology to help.

Not surprisingly, the pandemic has taken precedent in hospitals across the country. But that doesn’t mean other ailments have simply gone away.

“I’ve never seen so many patients concerned and anxious,” Lewis wrote in a recent essay for The New England Journal of Medicine. “I found myself and my patients navigating between two threats — cancer and COVID-19.”

Lewis has had to play a balancing act. His cancer patients are, according to some studies, five times more likely to face serious effects of the novel coronavirus. For Lewis, that means not only treating them for the disease they have but also keeping them safe from the new virus, all while helping them cope with living in a world where both are a threat.

Enter telehealth.

"It just makes a lot of sense to allow people to remain in their homes when they're sick, rather than bringing them to a doctor's office or to a hospital," Lewis said.

More than ever, doctors are meeting with patients over online video meetings — and it’s not just for chats.

“I think the silver lining of this whole pandemic might be that we do more of this after the virus has gone,” Lewis said. “To a surprising degree, there's a lot of things that we do that don't actually require the patient to be sitting in front of us.”

Lewis said doctors can assess a patient’s eligibility for chemotherapy, can do most of a physical exam, and have the ability to draw labs using the home health care network. Intermountain is also in the early stages of being able to do drug infusions at home, Lewis said.

“It really is interesting to see how this will change the landscape of medical treatments and cancer, in particular, moving forward,” Lewis said.

His patients, especially during a time of pandemic when cancer treatments may have made them more susceptible to the trials of COVID-19, are appreciative.

“The majority of them, I think, are really embracing it,” Lewis said. “I think there's probably two things: No. 1 is the convenience of it; No. 2 is the minimizing of risk to them. The scary thing to think about is hospitals and clinics can become modes of viral transmission because that's where patients are congregating, and health care workers. The last thing that we want to be is vectors of disease.”

But Lewis knows that video chats can’t replace everything. Not by a long shot.

Traditionally in oncology, it’s a five-year span from the time of diagnosis to when patients exit the clinic. Relationships are created, bonds formed. One of the patients in Lewis’s care recently apologized that she couldn’t bring him cookies like she normally would. It’s those things that Lewis has missed as visits have become more and more virtual. He also stated how he's had to break tough news over video calls and wishes he could have done that in person.

But it also has allowed him to see different sides of his patients.

For example, Lewis didn’t know one of his patients lived on a farm until he saw a cow on his screen.

“Sometimes I'm getting insight into their lives that they wouldn't otherwise have,” Lewis said.

While virtual house calls have helped allow patients to remain inside while still receiving care, they also serve another purpose: they help provide comfort for the patients during a particularly troubling time. Many of Lewis’s patients rely on family and friends to help during stages of their recovery. With social distancing, those visits from loved ones haven’t been as common.

“I think that's the hardest part, right now, that people aren't seeing,” Lewis said. “People, in particular, are keeping their distance from patients who they know or expect might be sick. But unfortunately, that ends up being quite isolating. I think calls and videos from us, the oncology team, hopefully, are helpful and let people know that they might be out of sight, but they’re not out of mind.”

The video chats might prove to be the future of medicine, but, for now, they’re just about helping the patients already dealing with uncertainty deal with a little more.

“Statistically speaking, the likelihood of me surviving cancer is about the same as the likelihood of me dying from COVID-19, and I’ve been feeling fine about life as a cancer patient,” Melissa Inouye, who is receiving chemotherapy during the pandemic, said in a prepared statement.

Lewis hopes to keep her feeling that way.

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