Clinical Taking on Telehealth

Taking on Telehealth

Developing and implementing a successful telemedicine strategy

The coronavirus pandemic has changed the way doctors, nurses, and other healthcare professionals interact with patients and one another. During the pandemic, every face-to-face encounter between healthcare professionals and patients presents an opportunity to spread the virus that causes COVID-19, or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To safely treat patients and stop the spread of COVID-19, a growing number of hospitals, clinics, and doctor’s offices are turning to telehealth as a means of social distancing while providing care. Capital Digestive Care, the largest independent GI group in the mid-Atlantic states and a Physicians Endoscopy partner, made a quick transition to telehealth, stabilizing office volumes via “virtual visits” for their 56 physicians. We sat down with Cara Reymann, CMO and Director of Practice Development for Capital Digestive Care, to discuss their telehealth strategy and what they have learned while implementing it.

Meredith Jayne (MJ): What caused the integration of telehealth, and how has Capital Digestive Care incorporated it into their overall strategy?

Cara Reymann (CR): We had been evaluating telehealth solutions since 2019, but the crisis with COVID-19 necessitated an accelerated implementation to maintain the safest environment possible. We not only canceled all the elective procedures in our endoscopy centers, we also canceled all the elective appointments across our 13 office locations.

We had already chosen a platform that was HIPAA compliant and were in the midst of integrating that platform with our electronic medical record (EMR) system. We had not planned on launching telehealth until May to give everyone ample time to go through training and learn all of the capabilities available through the program. Instead, we hit the hyperspeed button in March and were able to finish our integration, get everyone loaded into the system, and train users in about 8–10 days. It was a massive effort on everybody’s part.

MJ: Can you tell me about the transition to digital medicine and any hiccups?

CR: With every new technology comes technical challenges, and we definitely had those. Our first week was a bumpy one. However, I think that had more to do with the fact that the entire country was moving every business, every school, every communication onto these digital platforms, so that overload on the technology ecosystems across the country was

problematic as a whole. It didn’t matter what digital healthcare platform you were using; everybody experienced some disruption. 220 Patients Seen Daily a computer or a telephone, if there’s a particular app that they should download—those kinds of things. If you can address these items during Our platform had to spend Capital Digestive Care sees about 220 patients a day via scheduling, then it will several days of very intense telehealth across its 13 office locations. help you connect with that work with Microsoft to patient more seamlessly for expand the bandwidth of their system, so that was one big their appointment, and you won’t have to waste time trying snag that we had to overcome. Then we saw a considerable to troubleshoot. improvement as we were heading into week three. The second and third things we did were create virtual

The other hurdle is that each patient’s ability to engage with check-in and check-out processes. After a patient is schedtechnology is going to be different. We have had problems uled, there’s some information that needs to be collected and where people can’t get their video to work, or they can’t get populated so that the doctor has it for their visit. If you’re in the their audio to turn on, or the technology is just not working office, this is done by the medical assistant. Now, we can comin general. Fortunately, because the Centers for Medicare plete that process in a virtual environment so that when the doc& Medicaid Services regulations have been so dramatically tor logs into that patient’s visit, the information has already been relaxed, our doctors have been able to fall back on a regular populated in advance. Similarly, the virtual check-out process phone call, or even a FaceTime call, in order to complete that is where the physician is going to have some recommendations appointment. We always try to use our telehealth platform for the patient as a result of the visit, and all of that information first, but if it’s not working, we still have a backup so that we needs to be transitioned after the appointment is complete. can always complete the visit. It has its hiccups, for sure, but Again, our team will do this in the virtual environment. For examI think everybody has done a phenomenal job of being ple, if they need to send a prescription to the pharmacy for them, adaptable, including the doctors and the staff. they do that virtually after the appointment is complete.

MJ: What are some key tips or steps companies MJ: What has patient feedback looked like so far? switching to digital healthcare should know? CR: It’s been pretty amazing. We’re seeing about 220 patients CR: First and foremost, they should understand all of a day via telehealth, and I think patients are embracing that the changes in the regulations that have come out due to technology. I think everybody has been pleasantly surprised by COVID-19; that will help them understand what technology how comprehensive the visit can be, even though you’re doing platforms are acceptable during the crisis and how to educate patients on accessing the technology. The second thing I would Cara Reymann serves as Senior Vice President it over an electronic device. We’ve seen a lot of very seamless activity, and a lot of adoption of technology. We plan to conduct a survey in recommend is to be aware of the changes to of Practice the very near future to identify areas that we the coding that have been released. It allows Operations can improve upon. a physician to understand what type of visit they can conduct using telehealth and what documentation is required to support their coding. For the most part, a telehealth and Marketing for PE Practice Solutions and oversees Capital Digestive Care, the largest independent GI MJ: Do you think this will be a longterm transition to digital healthcare, or will patients want to be seen in person visit is reimbursed at the same level as an practice in the mid-Atlantic states. again moving forward? in-office visit, which is a huge advantage for practices that are struggling right now. Finally, they need to think about what needs She is a member of the Board of Directors of the Maryland Medical Group Management Association. CR: I think when we get back to work after COVID-19, we will need to be prepared to to be completed before and after the visit. Our group did three things to improve Meredith Jayne is the deliver medicine differently. I believe that we will need the regulatory bodies to workflow as we introduced telehealth. Marketing embrace telehealth and keep some of these First, we created a process for our scheduling team so that they are coaching patients on the technology as part of the scheduling process. They let them know what Manager at Physicians Endoscopy (PE). She can be reached at waivers of the rules in place to encourage people to continue using the technology. Hopefully, this experience will help prove how telehealth is a benefit to patients, browser works best, whether to use mjayne@endocenters.com. doctors, and the system as well.

WHAT WE DO

We partner with gastroenterologists in private practice, providing resources to improve operations, drive growth, and enhance patient, physician, and staff experiences—all while maintaining their independence.

Our strategy is aligned with your interests in tackling the following challenges: • Career security and stability • Succession and recruitment strategies • Growing administrative costs and burdens • Shifting regulatory and reporting requirements • Preparation to move from fee-for-service to value-based care • Competition from hospital and other physician practice models • Declining reimbursements paired with a need to invest in technology, security, marketing, and patient engagement

GET IN TOUCH We’d love to share more details about how we can help you stay independent and thrive in the changing healthcare environment.

Kevin Harlen, President kevin.harlen@capitaldigestivecare.com 240-485-5201