Dr Asante Le Blanc



The COVID-19 pandemic undeniably forced a change in many things we do socially. The need for personal distancing a significant measure implemented to slow the spread of the coronavirus has left various establishments and institutions having to revert to a remote way of doing business. Healthcare was not exempt. From a visit to your general practitioner, psychologist, or counselor—virtual appointments or telemedicine was now the current go.

But online research by Guardian Media found the practice was nothing relatively new. It’s been well exercised around the globe for decades, making its debut in the late1950s.

According to the research, telemedicine became quite popular immediately among the elderly and differently-abled. Even for people living in rural areas where healthcare was inaccessible, a virtual doctor’s visit seemed like a heaven-sent.

The research also showed people who accessed virtual doctor visits, found it to be more cost-effective—an attraction to patients utilising the service. Other pros of the resource noted were the sharing of real-time information between patient and physician. And for a diagnosis and treatment, it was found telemedicine software significantly cut the lengthy wait for appointments.

But as much as there are positives, telemedicine does come with a few disadvantages. For health providers, it can be both costly and time-consuming to set up and implement the new system. Cost continues to be a factor in the retraining of healthcare workers who would now be required to operate by the virtual system. And technology as unpredictable as it is, at times allows for many vulnerabilities like the risk of patient confidentiality becoming compromised.

In T&T, although new to some in this time of COVID-19, experts and people who have used the system told Guardian Media it’s been around.

In a telephone interview with a primary healthcare provider, Dr Asante Le Blanc, she confirmed telemedicine or telehealth, though not previously officially branded telemedicine; was always a practice in T&T.

She explained patients have long called their doctors after hours with medical concerns and doctors would consult for free.

The consultation she said, however, would not be an extensive one as per a personal visit, nonetheless, the practice was always there she reiterated.

Le Blanc said with COVID-19 however; while doctors were essential as general practitioners (GPs), people did not need to essentially see their doctor for a diabetes or hypertension checkup during the first phase of the COVID-19 lockdown.

She admitted however it was a very confusing time for GPs.

“We were at a loss at what to do, most of us. We wanted to know how do we operate. Do we open our offices because we are doctors and we’re essential?” Le Blanc asked.

She said it was eventually recognised by doctors, it would be risky to let their older patients or those considered high risk to come out to see the doctor for something that could most likely be resolved or addressed over the phone or by video.

She said providing this service was more convenient and stress-free for such patients who would otherwise have the fear of contracting the virus, should they have to leave their homes to go to the doctor’s office or the to the hospital.

“There is a lot we can tell from the virtual medical interview and also what we see on the patient’s face. And you know you’d be surprised, just seeing their regular doctor and hearing their voice, it was quite reassuring for most patients as we have seen as primary practitioners,” Le Blanc said.

While this may have made patients happy and set their minds at ease, Le Blanc said, however, with this almost compulsory transition due to the pandemic, doctors were concerned about compensation, patient privacy, and how best they can help patients understand that they were in an actual consultation environment—although not physically with their doctor, they were at a doctor’s appointment.

Asked if telemedicine was objectively cost-effective for a patient, speaking particularly to this period of a pandemic, Le Blanc said the cost would be practitioner specific.

“For me, if it is a new patient, the cost is the same. But in their case, they get allotted three, to five further interactions for that cost,” Le Blanc explained.

She said, this would not be the case with an in house visit, as a patient would most likely have to pay for each consultation.

With telemedicine now necessary because of the virus, Le Blanc said it forces health care providers to practice the service in a more structured way in the Caribbean.

One of those structured approaches, she noted, was the retraining of the triage process, where staff would now be required to assess accurately if the patient needs telemedicine or an in house consultation.

She added this would also now require the patient to feel comfortable enough to discuss what the issue is so that they can be properly assessed based on their issue.

Le Blanc said it was even more important to have triage retrained in assessing patients because although telemedicine was a help during this crisis in terms of healthcare delivery, it still could not replace a doctor’s visit as some things doctors just have to touch see or engage the use of tools. And a precise assessment would determine that.

“I would prefer to see and talk to all my patients in person but this pandemic has made everybody rethink how they do things and it was a matter of finding a new norm,” Le Blanc resolved.

She reiterated, however, in finding that ‘new norm’ as it relates to telemedicine or telehealth, proper management was key in its success and a starting point was to have good telemedicine software.

She explained the software, which is used in North America, was a platform used by providers practicing telemedicine and telehealth to connect with patients and share video and images. It also does the scheduling and contact of patients and has a medical database. She said, unfortunately, it was not yet used in T&T.

“If you have a real good telemedicine software, the patient has to call in, they’re in a virtual waiting room and they go into their doctor’s appointment,” said Le Blanc.