Healthcare providers in New York City have found themselves on America's front line in the battle against COVID-19. As such, they've also had to change the way they treat patients. It's difficult thinking about launching a new service for your medical practice during a global pandemic, let alone needing it up and running virtually overnight. Fortunately for an integrated medical clinic in Manhattan with 50+ providers, that's what they were able to accomplish.
Dr. Matthew Pabis is the director of St. Mark’s Place Institute for Mental Health, Inc., also known as Unitas. Due to the pandemic he found his practice in dire need of a telehealth solution. State and city governments approved the expanded use of telehealth and teleconference solutions for treatment on March 13th and Dr. Matt didn't have a way to reach patients remotely. He describes the moment he urgently reached out to InSync Healthcare Solutions saying,
"We got the message through the news that said anyone that has telebehavioral services can now start using it. The email was sent out and I immediately called [InSync] and was like, what are we going to do how are we going to get this?!"
Luckily for Dr. Matt and his practice, his current EHR, InSync, has integrated telehealth services . Within a matter of minutes he was on a teleconference call going over everything he needed to know regarding the software's capabilities for telebehavioral, telepsychiatry, and telemedicine.
"Within 10-15 minutes after that we had [...] our people who are the most tech-savvy, they were the quickest to immediately just start using it. It was very nice to have such a quick turnover. I'd say within 24 hours 99% of the staff was comfortable using tele-stuff."
New and Returning Patients in a COVID-19 World
Since activating telehealth services, Dr. Matt's practice has seen a surge in both new and returning patient visits. COVID-19 concerns are a primary chief complaint and patients feel safer with a telehealth option, as do new patients needing to come into the practice.
"As COVID goes on we're getting a lot more anxiety, PTSD, depression patients, and new ones, coming on board."
Telehealth is also helping patients with substance abuse issues by allowing on-demand therapy sessions, a revolutionary technique for counseling those with addiction.
"Now they can actually reach out to the therapist whenever they can and we can do a session. Whereas before we would say, Ok come on in, and it's a lot to come in for someone who's about to start using substances again."
Quantity Over Quality
A side effect of telehealth services is that the efficiency allows for the total numbers of appointments per day to rise. We asked Dr. Matt if he feels there is any concern about the ability to still retain the same quality of care.
"Yes, there's always a concern of that but then again that's the same thing with badly run clinics and offices, it's the same exact thing. You can have a doctor who spends two minutes with you in the office and out the door you go. Or you can have a quality doctor that spends ten minutes, thirty minutes with you, however much time you need. The same thing goes for tele-services. You can have someone who's just going to keep abusing the system and telling people to call-call-call-call-call-call-call and any little thing they do they use the tele-system to get reimbursed, but if you have high-quality providers they're not going to abuse the system [...] it's going to be helpful."
He poses the question,
"How did this provider go from seeing twelve [patients] a day to now seeing thirty a day? Well that's because now patients are no longer not showing up. Patients are no longer cancelling appointments. Patients can now get appointments that day because it's a lot easier for a therapist or a provider to stay late if they know they don't have to catch a train, catch a bus, go home. They can stay a little longer at the office or maybe do [the visit] from home as well."
Easing the Public Health Risk of Using Public Transit
Being located in Manhattan, travel times for patients could take over an hour in one direction. Through telehealth, Matt's practice has removed the burden of travel and also exposure risk for those patients. In New York City, the current number of active infections (at the time of this writing), is 261,785 and public transit is a major source of transportation for individuals moving through the city center.
"We have people commuting an hour and a half to two hours sometimes. An you think it's nothing because it's Manhattan, how bad could it be? Well, if you live in upper Manhattan or in Brooklyn you have to take one train down, it's only the local by your house, so that's going to be a while. Trains are delayed, you don't catch your connecting train. You know, it could be a real mess."
One potential benefit of the statewide lockdown is that the burden of cross town commuting is, at least for the time being, temporarily halted for patients with anxiety issues.
"Imagine you had a severe PTSD patient. Just started getting relapses, more acutely ill than she's ever been. And now you're going to ask her to get on a crowded subway to come see her therapist. Wait in a waiting room, go into the therapist's room, have a great session, come out and have to get almost traumatized again by going through the lobby, getting on a crowded train and going back."
Confidence and Telehealth
With an office in the Empire State Building, Dr. Zlatin Ivanov is board certified in psychiatry and neurology and specializes in addiction psychiatry. He is also a member of the American Academy of Addiction Psychiatry. In his practice he provides a warm, welcoming environment so patients feel comfortable sharing their concerns.
How does he recommend that providers set up their space when unable to practice out of the office?
"I never put the emphasis on external things like the office. Don’t get me wrong, my office in the Empire State Building has the most incredible view of the city but I think that even the most inspiring environment is far away to the key factor of how a patient feels. That’s why I put my attention on the person. People feel the sincerity of such an attitude. When I began practicing, I was advised like many other doctors to exhibit all my diplomas and have the usual impressive book shelf behind my back. However, I believe that all this is very insignificant. A psychiatrist can impress only by using his / her knowledge to resolve patient’s problem or at least make somebody’s life better."
On the matter of telehealth for therapy sessions, Dr Ivanov echoes Dr. Matt's sentiment saying,
"I definitely think that especially for teletherapy it is a breakthrough moment because many people are giving it a chance now and they do realize that they will save a lot of traveling time. Another important part is that people feel much more confident in their own environment and this will affect their perception and even bring confidence. This is sometimes crucial for the therapy."
If your practice needs an EHR with integrated practice management and features like telemedicine software and e-prescribing, Dr Matt believes that the InSync platform is a great choice.
"Because InSync makes it so easy, you literally just have to schedule a tele-session and press enter and the rest is done. The client literally gets an email that says, "Click here now." and a tele-session starts, so there's very little room for error."
For more information on how telemedicine can help your practice, download Five Ways Telemedicine Enhances Patient Care. To learn more about InSync's EHR software, schedule a brief discovery call with one of our specialists.