Safety-net clinics reduce unnecessary visits to overwhelmed hospital emergency roomsWith coronavirus forcing many safety-net medical clinics across the country to curtail operations, North Carolina's free and charitable clinics have found new ways to continue treating the uninsured while keeping staff and patients safe – ultimately keeping thousands of patients out of hospital emergency departments.
In a state with 1.3 million people who lack health insurance, 60 of North Carolina's 67 free and charitable medical clinics remain open, thanks largely to a new telemedicine program and the tenacity to bring it online in just two weeks.
Now, North Carolina's safety-net clinics are gaining attention from other states and national leaders searching for ways to "flatten the curve" of the COVID-19 pandemic.
"We feel a responsibility to keep our patients out of the state's hospital emergency rooms during this pandemic, and it was through sheer determination – and bravery – that our member clinics have managed to keep their doors open," said April Cook, board chair of the North Carolina Association of Free & Charitable Clinics (NCAFCC). "Our challenge was to find a way to keep clinic staff and patients safe from those who might be infected – otherwise we'd have to close our doors."
Over two weeks in March, at no cost to the clinics, the NCAFCC secured and onboarded clinic staff to use a specially designed telemedicine program. Telemedicine allows medical personnel to engage in secure communications with patients outside the clinic through texting and video chats over phones and other devices.
North Carolina clinics are using the technology to triage patients at home and in clinic parking lots to determine whether patients need to be seen at the clinic or another facility. Since March 16, the clinics have counted more than 3,500 patient encounters through telemedicine, including 2,300 medically related video chats with patients.
North Carolina's free and charitable clinics treat more than 80,000 patients annually, providing primary and specialty care, pharmacy services, behavioral healthcare, dentistry and optometry – as well as social services such as food banks. Since the pandemic struck, patient visits are expected to climb as more workers lose their jobs and health insurance.
"Telemedicine is like a silver bullet that not only has helped our member clinics stay on course delivering care but undoubtedly will also transform how our clinics – and medical providers everywhere – engage with patients going forward," said Randy Jordan, CEO of the NCAFCC.
Jordan is getting phone calls from other states and recently heard from the Federal Emergency Management Agency (FEMA). They're asking: How did North Carolina's clinics leap so quickly into telemedicine? His answer starts with a moment on March 12 when the first known COVID-19 patient walked into the Lake Norman Community Health Clinic in Huntersville, where NCAFCC chair April Cook serves as director.
"We were on a video conference call with April and a dozen other North Carolina clinic leaders when she got word this possible COVID-19 patient was in the waiting room – and it was like the light bulb went off," Jordan said. "We knew we had to act fast to protect our people and our patients – and also provide the care people need."
NCAFCC brought together a range of partners to launch the telemedicine program from design, to training, to securing protective masks for staff in the clinics. Financial and in-kind contributions from partners total more than $300,000 in annual support. Partners include: Dr. Andrew Barbash of The Apractis Clinic, Biogen Foundation, FaithHealthNC, Kate B. Reynolds Charitable Trust, North Carolina Baptist Assembly, and Updox, the telemedicine platform provider.
About North Carolina Association of Free & Charitable Clinics
The North Carolina Association of Free & Charitable Clinics is a private, nonprofit organization that provides advocacy, research, communications, resource development, training and technical assistance on behalf of its 67 clinic organizations and the people they serve. Our clinics provide life-changing access to quality healthcare and a voice for more than 80,000 uninsured patients in North Carolina. For information, please visit https://ncafcc.org/