With the entry of telemedicine into the multiple myeloma care toolkit, there are some real benefits to the cost of care visits. Dr. Sarah Holstein outlines some of the financial benefits that she’s seen for her patients – and how the logistics of scheduling appointments has changed.
Dr. Sarah Holstein
So, there’s definitely quite a bit of financial toxicity associated with being a patient who has myeloma. There of course is the cost of the drugs and treatments themselves, but there’s also the personal time cost. So, the cost that it takes to perhaps take a half day off of work or a full day of work to see your provider in person, and the flexibility that telemedicine allows, namely being able to do your appointment from either the privacy of your own home or in some cases the privacy of your own office or even your own car, really allows patients to keep going about their business without having to take all that time off to come travel. There’s the cost associated with gas mileage in some cases, costs associated with parking, although thankfully, that’s not a cost that’s occurred here at Nebraska Medicine. But I certainly know that that can be an issue at other institutions and can really add up for patients over time. So, it’s really been so much easier for patients to get in to see me even when my schedule is fairly full, because they don’t have to think about, “Well, I don’t need to leave work an hour, try to go over my lunch break,” or something like that, they can just schedule it and do it from their office.
I think it’s been a good thing for patients and hopefully is cutting down costs for them.
What can multiple myeloma patients expect for the use of telemedicine as part of their long-term care? Dr. Sarah Holstein shares her experience of using telemedicine for those with MGUS and those managing controlled disease – and her thoughts about the future of telemedicine.
Dr. Sarah Holstein
So, I think telemedicine is a really good fit for patients for either long-term survivorship issues or for patients that perhaps you’re just following with the precursor to myeloma, so for example, MGUS (monoclonal gammopathy of undetermined significance) where overall the risk is low that there’s actually going be a progression to myeloma over their lifetime.
So I have a number of patients who I see perhaps on an annual basis for those types of visits, and of course, over the last year, I’ve been doing a number of those visits via telehealth, and I think they’ve gone really well. It still allows me to ask my entire review of systems where I check through and make sure that there’s no subtle signs that I might be missing that somebody’s plasma cell disorder is progressing. They’ve had their blood work or scans or other testing done, and we can review those, but again, in those types of situations where the risk is low and somebody is doing well and it’s a fairly routine visit, I think the need to do a full physical exam, it’s pretty low, I think whether or not you’d hear anything on the lung exam in somebody who’s doing well and it’s just there for an annual basis exam, I don’t think that lung exam is going to add a whole lot, but really having the ability to still talk to each other, go over laboratory studies, really make sure that I’m not missing any subtle signs that might suggest concomitant lite amyloidosis or progression to myeloma can still very readily be done via telehealth.