Sharing means caring for physicians during pandemic
We recently spoke with Dr. Stebbins of Pediatric Physicians in Georgia and Misha Moore, Ph.D., Executive Director of Green Tree Pediatrics in Michigan, who shared advice and best practices for those enmeshed in one of the most pivotal crises to face the healthcare industry in the 21st century.
Adapting in times of crisis
Telehealth solutions or short-term stop-gaps (like a recent athenaOne mobile app integration with Facetime for providers to initiate video calls) were enacted quickly across the industry starting in mid-March. But in addition to virtual measures, Stebbins and Moore shared myriad creative physical solutions, too.
Like Moore, many practices across the network that have more than one office have split physical locations into “well” and “sick” offices in order to maintain routine appointments. Pre-screenings are an important component, says Moore. “Our mantra right now is ‘Every sick visit starts with a telemedicine visit,’” she said. “If we keep a family at home, that’s a win. But if we find that we do need to bring them in, we want a clinician making that decision and we want to be able to create a safety plan for how to see the patients on site.”
For some practices like Stebbins’, this includes seeing patients in cars or in special tents set up outside. As an active participant in athenahealth’s User Groups, Stebbins has been able to learn from and share best practices for how to set up safety precautions and clinical workflows for those circumstances. Another helpful tip was setting up a default setting to change the place of service to enable full insurance payments for out-of-office visits.
Embracing new collaboration and communication strategies
Good communication enabled by technology helps, both doctors say. Using athenaText messaging daily keeps staff informed and engaged in a time that’s most challenging. Those who answer the phones at Green Tree are now offsite, so they text to notify on-site providers about the need to unlock doors and screen visitors for COVID risks.
“We’ve had to really adapt to how we provide guidance for providers,” said Moore. Those daily check-ins can be as simple as eschewing jewelry on the wrists or hands, bringing an extra set of clothing to work, or making sure lunches are in disposable bags.
An active participant in athenahealth User Groups (including the “mushrooming” telehealth group), Moore says, “Our lives and our landscape change almost daily.” She makes time to connect with others on the network for moral support, and for information on “constantly changing guidelines,” including source documents from the American Academy of Family Physicians and changing rules for Medicare and telemedicine.
Telehealth has some unexpected benefits, says Stebbins. “This has been a baptism by fire here and it’s been surprising in a good way,” he said. “With social distancing it’s really easy to feel alone. Conference calls are a way to feel less alone. I’m struck by how much of a connection you can have through telemedicine. When you see the patient’s face pop up on the screen and they look happy to see you, it’s nice to see theirs lit up with a smile.”
Maintaining operations when it’s anything but “business as usual”
Stebbins recommends a proactive approach when it comes to maintaining wellness visits and those for asthma and seasonal allergies. His practice uses its patient portal to connect about symptoms due to pollen exposure versus COVID-19. Pediatric Physicians also pivoted to “put a big-old button on our webpage” to allow patients to easily schedule telehealth visits. His practice uses a third-party solution from one of athenahealth’s Marketplace partners to allow patients to fill out paperwork from home before telehealth or in-person visits. Some screenings also include mental-health check-in questions, which has been especially helpful to combat social distancing effects.
Moore’s practice also uses a proactive approach via EHR reporting to determine who has a depression diagnosis and hasn’t been seen in 90 days. Those patients are then contacted for billable follow-ups.
Both have adjusted to using previously unutilized after-hours appointment times for non-COVID-19 telehealth visits, in order to maintain practice profitability. “It’s good for revenue, but it’s also good for patient care. Using telehealth to keep patients out of urgent care is good for public health” during COVID-19, said Stebbins.
To hear more from Dr. Stan Stebbins and Misha Moore, Ph.D., watch this webinar.