ver the last month we’ve used virtual visits to provide over 15,000 homes with access to health care every week. Our new virtual platforms have eliminated about 300,000 to 400,000 direct contacts between patients and providers. These online visits actively promote safety, social distancing and easy access to care.
Beyond the basic logistics of telehealth, we’re also finding that we can connect with our patients in a new and more intimate way. We get to see people in their own environment. We get to meet their pets, see pictures of their grandchildren, and even see wedding pictures on the walls. We’re able to maintain self-isolation measures and preserve a close relationship with our patients.
It’s virtual, but it’s personal
As health care professionals, just because we are also physically distancing doesn’t mean we should neglect our personal wellbeing. I (Maia) got to experience things from a patient’s perspective when I had a virtual visit with my own doctor to have my shoulder checked out. While it may seem easier to put our mental and physical needs on hold during this pandemic, remaining in contact with your providers doesn’t have to put you at risk. It’s as easy as flipping open your laptop or turning on your phone.
I was also surprised to see that my parents took virtual care in stride, too. My mom downloaded the online app for my dad, and he was able to enjoy a visit with his doctor from the comfort of his own home. They’re even looking forward to a virtual dermatology appointment in a couple of weeks!
As our team works together to implement our virtual platforms, we’re continuously discovering new ways to connect with our patients. Every day we are working to smooth the transition from in-person interactions to virtual face-to-face visits. We’re learning that telemedicine can help us come together not just as a community, but also as a nation and a global force in the face of COVID-19.
The importance of human connection
We’ve found that an ounce of preparation goes a long way in easing our patients into virtual visits. We utilize the most fundamental element—human connection—as a springboard into telemedicine. My colleagues Christin Van Dine and her medical assistant Eileen Prats have been very successful in launching our telehealth system.
Team connection—joint replacement’s story
By Christin Van Dine and Eileen Prats
Prior to the virus, our joint replacement team at the University Orthopaedic Center didn’t conduct many virtual visits. While we had been working on getting our virtual visit system up and running over the last few months, COVID-19 definitely sped things along. It took a concerted effort by our team to restructure how we conducted appointments. Simplifying the process to help our patients feel comfortable with our interfaces—Zoom, Doxy.me and MyChart—was our top priority.
Our patient population is older, which we initially thought would be a major barrier, but we’ve had amazing success assisting them as they familiarize themselves with the technology. Working and coordinating closely as a care team has played a vital role in helping our patients with the transition.
Stay with what works, connect the patient and connect the team
We began by implementing the same basic structure of our in-person visits.
First, Eileen reaches out to the patients about 30 minutes before their appointment just to check in and answer any technical questions, and to help them feel more comfortable.
She also makes sure they have the app downloaded and helps them get everything set up, whether it’s on their phone, laptop or home computer.
Finally, she asks them the usual pre-chart questions that would be asked during a normal appointment. By getting this information before the visit, the providers (Christin, in this case) have more time to focus on patient care. Once the patients are settled, Eileen notifies Christin via text message that they’re ready.
Joining together in new ways
I (Eileen) actually spoke with a patient who said, "I have no idea how I got this number (he was looking for a different department), but I can't get on to MyChart and I have a virtual visit in about 20 minutes." I told him, “Okay, let’s start with what you’re seeing,” and helped him figure out how to enter the visit. At the end of the call he said, “Thank you for being a human.”
It was great to realize that, even though we’re all in different places right now, these virtual opportunities are helping us join together in a completely new way.
The 5 Elements of Virtual Visits
An exceptional patient experience reflects 5 Elements—caring, listening, explaining, teamwork, and efficiency. Patients want to be known, heard, and provided a plan that reflects and includes their values. Patients want the team to coordinate for them and be on the same page with each other. Patients want the team to be organized to meet their needs. When all 5 elements are present, patients describe their confidence, trust, and loyalty to the care team.
| CARING | Eileen addresses safety concerns, and helps resolve technical challenges before they become a problem. |
| LISTENING | Both Eileen and Christin prioritize listening to the patients concerns and acknowledge their worries. |
| EXPLAINING | Both Eileen and Christin invest time in explaining the visit process and care plan. |
| TEAMWORK | Teamwork reflects the in-person team. The care team stays in constant contact, from set-up to close-out, coordinating at each step of the care process. |
| EFFICIENCY | Patients value the convenience of not having to leave their home. |
If you are just getting started with virtual visits, you may want to read “Designing a Virtual Clinic Workflow that Actually Works for Your Team.”
Maia Hightower
Christin Van Dine
Eileen Prats
Rural and frontier communities have a harder time accessing care due to long distances and a shortage of medical resources in their own communities. The leaders of the Rural & Underserved Utah Training Experience (RUUTE) program, Kylie Christensen (medical school) and Sri Koduri (residency programs/GME), share what they’ve learned about improving access for rural communities now and into the future.
Microaggressions commonly occur in medical settings creating psychologically unsafe environments of learning, working, and healing. Pediatricians Reena Tam and Margie Diaz-Ochu share how clinician-educators can cultivate awareness and practical tools to create safer, braver spaces in the moment.
Meetings often default to logistics, platitudes, or maintaining norms, the Resiliency Center’s Megan Whitlock explains. By thinking of meetings as gatherings we can turn them into a powerful tool to bring about something every workplace needs more of: belonging.
