Military Hospitals to Cancel Appointments, Shift to Telehealth in COVID-19 Response

Military treatment facility patients will likely see some of their scheduled appointments canceled and moved to telehealth instead as Defense Health Agency (DHA) officials look to "scrub" the schedule and clear the way for coronavirus patients.

"What we have asked the military treatment facilities [MTF] to do ... is to go in and what we call 'scrub the templates,'" Regina Julian, who oversees coordination between the DHA and the military services, said during a Facebook-based town hall with Pentagon health officials. "That means look out forward at our scheduled appointments and see what can be done virtually."

Patients whose MTF appointments are canceled will receive a notice and a phone call, she said.

 "If that happens, you may get a cancellation notice, but soon after that you should have someone from the MTF trying to reach out to you at the numbers that you have given us to schedule a virtual phone visit with your provider in lieu of that face-to-face visit, where that's feasible," she said.

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Other patients may be notified of new precautions for visits that can be done only in person, she said.

"Some visits are only feasible face-to-face, and so if the military treatment facility wants to limit people coming in because of potential exposure, they will give you processes and procedures for dealing with that," she said.

Officials are also looking to offer telehealth appointments to active-duty patients.

"If you're active duty, you're expected to receive care from [the] direct-care system so we're able to set you up with a virtual visit from your own provider or another primary-care provider in your military treatment facility," she said. "If you need to go to urgent care in the [civilian] network, you will need a referral first because this is tied to your own medical readiness. You can receive a referral through the nurse advice line or you can obtain it, preferably, through your own provider."

MTF patients who have elective procedures on the upcoming schedule may be asked to postpone those, said Col. Neil Page, deputy of DHA's clinical support division. Those delay decisions will be made based on the current coronavirus patient load on a facility-by-facility basis, he said.

"These procedures and appointments are your benefits. You worked for them; you earned them. And recognize that we don't take it lightly to cancel them," he said. "However, in this current environment, some of those appointments are not as necessary as, say, taking care of a whole bunch of sick people up on the ward or diverting equipment and personnel to the emergency rooms. ... Over the coming weeks, we'll see that evolve, and there will be more and more cases and MTFs that will sort of restrict some of those routine appointments and routine and elective surgeries in consultation with you."

In some cases, Julian said, those with canceled appointments could instead be reassigned to providers outside the MTF.

"If we do have to cancel an appointment for any reason ... we will reschedule you for your appointment," she said. "If it's something you need sooner, we can always refer you to the network if necessary."

Tricare users can also receive doctor help via telehealth app services or from their community-based civilian provider, she said. Although users will have a copay, Tricare covers consultations from apps that provide HIPPA-compliant and video-based care, she said.

Consultations from apps or community-based providers that are via text or phone only are not covered, she added.

-- Amy Bushatz can be reached at amy.bushatz@military.com.

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