Adapting to Telemedicine During a Pandemic

Russell Libby, MD | Virginia

We’ve had to encounter incredible change in our operations and had to institute telemedicine in a way that I don’t think anyone could ever have anticipated. As a primary care pediatrician with four offices and a large array of clinicians, the COVID experience tumultuously decreased our ability to contact and deal with, or work with, the needs of our patients. We had used telemedicine in a limited capacity before for behavioral and a few other kinds of clinical situations. But, for the most part we were not necessarily anticipating conversion like we saw going from the second to third week of March this year as COVID lockdown ensued and really inhibited people and their ability and willingness to come into a clinical setting. We were probably doing 900 visits a week or so in the offices prior to the middle of March, after which that number fell off to somewhere closer to 100. Our telemedicine visits might have gone from 10 visits a week to somewhere close to 300. Literally, overnight.

That change and opportunity was incredibly useful, and we quickly adapted and started to use telemedicine in a very positive way. And as one of my advice nurses said to me, at first, it was very hard to convince someone that this was a valid and good way to see your clinician, but within a week or two, the whole expectation and attitude changed 180 degrees, to where they were actually asking for telemedicine visits and wondering why they would need to come into the office for an actual hands-on physical visit.

Telemedicine has been expanded significantly within the practice. We have some of our older doctors who might be at risk for serious COVID disease entirely using telemedicine as their vehicle by which to continue to care for their patients. We’ve set up all kinds of, let’s say, optional care paradigms for our patients, whether it’s immunizations on a drive-by basis, dealing with those who have COVID in outdoor settings, and a number of other methods by which we are able to provide comprehensive and complete care through a telemedicine platform. It has been a life saver, and I really think that it has a great place in the future of our practice. We need to incorporate it into a number of paradigms of care, I think it will help to improve outcomes, create a better dedication to seeing our clinicians rather than going to ERs or urgent cares, as well as being able to demonstrate the quality and better outcomes and savings for our payors and our value based contract.

So telemedicine is here, it’s here to stay in my practice, I am looking forward to using it in ways that will be creative and innovative so that we can start to have a much wider use and application and opportunity with our patients for years to come.

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