ON THE COVER
APG Member Spotlight Pivoting to Telehealth—Overnight BY B I L L W U L F, M D
Prior to March of this year, Central Ohio Primary Care (COPC) did not provide telehealth visits. In preparation for a slow launch of video visits in 2020, we increased our broadband capabilities in early 2020. Fortuitously, an upgrade from eClinicalWorks (eCW) in January improved our ability to deliver a satisfactory video visit. The plan was to pilot telehealth mid-year with a slow launch in the third quarter. Then, COVID-19 came along.
IT AND TELEHEALTH RESPONSE In response to the emerging pandemic—and in accordance with directives from the state of Ohio’s Department of Health—we asked our physicians to limit in-person visits to emergencies or those deemed clinically necessary. We instructed our physicians that no wellness exams be performed in person, for patients of any age, beginning March 23. In just one week, starting March 17, the COPC Information Services Department enabled 380 providers to perform video visits. In the six weeks between March 23 and May 8, our staff web-enabled over 16,000 patients who had not previously been accessing our portal, thus enabling an upcoming video visit for these individuals. Our physicians used eCW, Updox, and (rarely) FaceTime technology for video visits. Patient volumes were maintained at a 65% level compared with 2019, and 65% of all visits were done by video during the six weeks following March 23. COPC care management staff reached out to nearly 4,000 high-risk patients to meet both social and medical needs. These patients were identified based on age, chronic conditions, past emergency room utilization, and on whether they lived alone. If needed, care management staff went to the patient’s home with an iPad to facilitate a video visit with a physician. During this time, an after-hours video visit system enabled over 500 video visits during evenings and weekends. Our triage system found that nearly half of these patients required a visit within four hours, and all were done via video. These visits were “picked-up” by waiting physicians within one minute of being placed in a queue by an after-hours call center nurse. As of June 18, COPC had completed over 90,000 video visits this year. Despite now seeing patients in person, we continue to use video for more than 20% of our over 3,500 daily visits.
SURVEYS SAY…TELEHEALTH IS HERE TO STAY We surveyed over 8,000 patients following their video visit, as well as our primary care physicians. We found that: • 98% of patients were either satisfied or highly satisfied with their video visit. • Only 36% of patients said they would prefer their next visit be in-person. 14 l JOURNAL OF AMERICA’S PHYSICIAN GROUPS
Summer 2020
“The plan was to
pilot telehealth mid-year with a slow launch in the third quarter. Then, COVID-19 came along.”
