Healthcare providers across the country have had to drastically alter the way they conduct business and practice medicine. With the coronavirus spreading around the globe as a full-blown pandemic, many businesses have been forced to close, meaning job cuts and work from home for many individuals. Medical practices are no different, with many small practices closing their doors and as many as 41% of providers surveyed say they've switched to a telehealth service since the COVID-19 outbreak hit the United States. With so many people and businesses across the country affected by the pandemic, we spoke to healthcare practices to hear how they've dealt with the rapid shift to telehealth.
It's easy to think that not every type of medical practice can function with the same degree of efficacy when using telehealth, and for some very specialized exams you'd be right. But we've found that many providers are finding new ways to provide the same level of patient care remotely that they would in-person.
Rethinking the Way Specialties Practice
The Scoliosis Specialty Center is a pediatric physical therapy specialty practice operating in New Jersey's hardest-hit areas of the pandemic. We spoke to President and Founder Marissa M. Muccio PT, C/NDT on operating such a specialized practice via teletherapy. Her practice has never used telehealth for one-on-one patient therapy in the past, citing they would use it for the occasional consultation or lecture.
On teletherapy efficacy for pediatric therapy, she said, "We suspect not just within our practice patient populations, but across the board it certainly has, there's already established literature on its efficacy."
One area of concern for Muccio is patient education saying, "We are not Peloton." Patients that were in the beginning or middle of their treatments have had fairly smooth transitions, but when it comes to new patients, her practice is taking more of a foundational approach. Using staff meetings and patient volunteers to problem-solve, there's a definite sense that trailblazing taking place around Muccio, who's been practicing physical therapy for decades. She stressed that when it comes to patients and equipment for therapeutic mediums as they relate to teletherapy.
"Your physical therapy skill is in your head and your hands. You should be able to treat with just those two things. If you're not, perhaps you want to make sure that you haven't grown a clinical thought process that relies too heavily on a specific piece of equipment."
In addition to getting used to visiting the physical therapist remotely, patients also to acclimate themselves financially when it comes to the perceived value of care and teletherapy. Muccio's practice has had a few patients struggle with the idea of paying the same rate for remote based care versus the traditional in-person services provided.
"We are billing out of network. We are accessing the codes. We have not adjusted our fee schedule and we've only had a small handful of patients who somehow, perceive the fact that because we're doing this remotely we should, in theory, charge less."
Patient Satisfaction with Telehealth
Columbus Ohio's Central Ohio Primary Care (COPC), with 425 physicians and 76 office locations, represents the larger end of the spectrum of medical practices adapting to telehealth. What may surprise you is that prior to March 15th, they had not conducted a single telemedicine visit. Today however, in a post COVID-19 environment they see as many as 2,000 telehealth visits per day.
Dr. Bill Wulf is the CEO of COPC and spoke with us recently about making such a drastic transition to telemedicine and how COPC patients are responding to it.
"We've surveyed 3,200 patients that have done a video visit and overwhelmingly patients like it."
The work that Dr. Wulf and his colleagues are doing at COPC is resulting in positive reviews from their patient population, with 91% of patients seen via telehealth checking the box "highly satisfied". Of those that were unsatisfied?
"...Less than 1%."
When patients at COPC were asked how the telehealth visit compared to a typical in-person visit, 84% responded that it was just as good or better. All the providers we spoke to had plans for integrating telehealth before COVID hit, and Dr. Wulf candidly admitted that he was embarrassed that it took a global pandemic to push telehealth visits to the forefront of his practice.
"It was a priority this year to launch it. But never to this degree. The truth is, there are visits that could have been, and should have been accomplished via video and this will move us to that."
Dr Wulf and his team estimate that in the future the practice group will be conduct 30% of visits via video. Telehealth has what is perhaps an unseen benefit in the ability to ease the burden of an already stressed healthcare system during and after a pandemic. At COPC they offer an "after hours" program with a call center staffed by nurses that are actively triaging callers. This program then sets patients up to be seen via telehealth where they otherwise would've had to go to an emergency room for care. Their primary care providers can be "on call" for telemedicine or the patient can be seen by another doctor on staff. This eases the overflow of patients that would have been told to go to the ER due to a lack of availability from non-emergency healthcare providers.
Telehealth "Bedside Manner"
What can healthcare providers do when working remotely to represent themselves and their practice with the highest degree of professionalism? Whenever possible make sure you have a closed and quiet space with appropriate lighting. For physical therapy, Muccio recommends enough space to move around for therapists who may need to demonstrate a position or movement.
Patience is also key. Regardless of specialization, patients and providers are getting accustomed to something new. With physical therapy for example, this can mean asking the patient to repeat a movement and to adjust the camera for a better view. Technology too, requires our patience when an internet connection is spotty.
Dr. Wulf, Marissa Muccio and their colleagues across the country are considering guidelines now that will determine exactly what constitutes in-person visits vs. via telehealth in the future. These guidelines will ensure that patient care and safety are at the forefront when it comes to scheduling.
Is your practice unhappy with your current telehealth services? InSync Healthcare Solutions has an EHR with integrated telehealth capabilities that seamlessly combines practice management and patient charting into one cohesive application. Visit the telemedicine software page today to learn more about the available solutions and schedule a brief discovery call to see if the InSync EHR system is right for your practice.