“Alone we can do little, together we can do so much” Helen Keller
We all want to “get back to normal”, but are afraid and uncertain about COVID-19. We have expanded the use of telehealth to protect the safety of both patients and providers. The new role of telepresenter will enable providers to efficiently utilize telehealth, while reducing their frustrations and burnout.
COVID-19 Trends
As states begin to “open up”, public health experts are concerned that they are opening too soon to do it safely. So, how do Americans feel about “getting back to normal”? Many have been sheltering at home and are worried about catching the virus. On the other hand, they want to get back to their jobs and get a paycheck.
During the past month, New York state has seen a significant reduction in new COVID cases. However, the rest of the country is continuing to see a significant number of cases. Health systems have deferred elective cases, resulting in large financial losses and staff reductions. Our unemployment rate has skyrocketed to 15% and may go higher. During these turbulent times, telehealth can help us to get our lives back.
Family Physician in Virginia
Dr. James Anderson is CMO for Team Care Medicine, LLC. They pioneered the TCM Model, training MA’s as Team Care Assistants (TCA’s). These TCA’s stay with the patient during their entire visit, document the visit in the EMR, and ensure the patient understands the doctor’s instructions. Providers can significantly reduce their computer time and pajama time at home, resulting in lower levels of frustration and burnout.
Dr. Anderson works with a large health system in Virginia that has temporarily closed many of its primary care clinic locations. His clinic has been temporarily closed, forcing him to work from home. He is triaging patients to decide if they should go to a clinic seeing people with COVID symptoms or a clinic for people without symptoms. He is working 100% virtually with patients, using either telehealth or phone call visits. The transition to video visits has been smooth, but some people have needed to arrange a phone visit because of technical issues. With increased reimbursement for telehealth, he believes that “telehealth is here to stay”.
Primary Care Physicians Across the Country
I interviewed Family Medicine and Pediatric physicians in the Mid-West and on the West Coast. These physicians have: 1) Reduced their visits by 25-50% along with significant financial losses, 2) Continued to see patients in their offices, 3) Screened patients for COVID symptoms before they came into the clinic, 4) Used telehealth to protect the safety of both providers and patients, and 5) Worried about getting the virus themselves and bringing it home to their families. One clinic had staff greet patients at the front entrance and screen them for COVID-19 symptoms. Because of IT technical difficulties, a family physician was forced to convert many scheduled telehealth visits to phone visits.
Re-Organizing the Telehealth Team
The new role of telepresenter ensures that telehealth visits go smoothly, particularly for the first visit. Ideally, they have clinical background as well as an understanding of telehealth technology. They ensure that the patient knows how to connect and use the telehealth system. They gather information they can share with the provider and document the visit in the EMR.
Team Care Assistants make excellent telepresenters, staying on-line to document the visit in the EMR. Prior to the COVID-19 crisis, health systems generally encouraged their PCP’s to see more patients and improve the bottom line. However, burnout has become far too common with 50% of PCP’s experiencing burnout. As we “get back to normal”, TCA’s can help their providers increase patient visits without the additional burden of EMR documentation
We are using telehealth to protect provider and patient safety. In addition, millennials want easy access to cost-effective health services, people in rural communities want to eliminate long travel times, and elderly people with mobility issues want health services at home. In our new normal, we will re-organize telehealth teams to improve productivity and reduce burnout.
Summary
Expanded use of telehealth is here to stay, protecting the safety of both patients and providers. Team Care Assistants can successfully assume the telepresenter role, improving access to quality telehealth services. Enhancing our telehealth capabilities will enable us to efficiently handle our backlog of deferred services and handle our next wave of COVID-19 cases.
Bruce Korus is the Founder of Korus Health Innovation. Powering up primary care teams to better utilize telehealth and shift services from hospitals & clinics to homes & smart phones. Send your comments to bruce@korushealthinno.com