"My hope is that healthcare providers embrace telehealth and offer those services on a continuing basis. It’s a way for us to be with our patients where they need us, patients."
When COVID-19 struck, Phil Boucher, MD, and his colleagues with Lincoln Pediatric Group sprung quickly into action. The practice, located in Lincoln, Nebraska, has 10 pediatricians and seven physician assistants and nurse practitioners.
“Prior to COVID-19, we had an idea of what telehealth might look like in our practice. We knew we wanted to offer it at some point in the future but there was never any push to start. That changed quickly,” said Dr. Boucher.
In the early days of the pandemic, healthcare’s thoughts turned to how to care for patients while also protecting providers and staff. The push for telehealth had begun.
“We needed to see patients but didn’t want them to come and sit in waiting areas or exam rooms. We knew patients needed us. We had to figure it out quickly. How do we structure visits? How will our workflows change for staff? What technology do we need? How do we collect histories, notes and charges? We already had a partnership with Updox and knew of their telehealth solution so it was a great fit for our practice. With Updox, we were able to get started with telehealth in just days,” he said.
As the practice moved into telehealth, they had to think about the best way to serve patients. “We needed to do some things differently in terms of patient expectations. Through Updox, we’re able to text patients and ask if they’d like to hold a telemedicine visit, instead of coming to the office. Most of them say yes. Some do need to come in so we can do an exam or test but a vast majority, a lot more than we expected, were able to get by via telemedicine. We can text patients consent forms that they complete on their phone and send back via secure text. Then, we text them the link to click to join the chat,” says Dr. Boucher.
Patients definitely appreciate the convenience. “It's been so well received by our staff, physicians and patients. They love being able to connect, get questions answered and talk through any issues without coming into the office,” says Dr. Boucher. “Telehealth works well for us and it’s something I feel really proud to be a part of.”
Adapting telehealth to the practice
Once the practice figured out how to make telehealth work, any necessary adaptions for care delivery came easily. “The nice thing about the phone is you can hold it right up to the child and easily capture the rash or whatever it is. I can see what they're seeing and step back and say ‘Okay, there is no breathing difficulty. The child looks well hydrated. I can't look in their ears right now. I can't swab them for strep but I think we're safe watching them and seeing how things go over the next 24 hours, rather than bringing you into the office and exposing you unnecessarily or potentially exposing our staff or our providers. Let's just check in again tomorrow over telemedicine and make sure things are okay. Here are the things to watch for. If something changes, let us know and we’ll make a new plan.’ Patients have been grateful that we're able to be with them in their home,” he says.
The practice was also able to personalize their use of telehealth to make it work for each provider. “We have different workflows that different physicians use. Some have half the screen with the telemedicine platform video and half with their EHR, typing as they go or doing their notes after the visit. Some physicians have two computers - one for telemedicine and the other for accessing the chart. I have my nurse get on the computer first with them, get the history, make sure that all that information is correct and then literally, hand me the computer and I can do the visit from there.”
A unique feature that sets Updox apart is the opportunity for patients to use telehealth with their trusted physician. “As physicians, we need to understand that our patients want to get that care from their own doctor. We’re providing a service to our patients and they understand and appreciate that,” says Dr. Boucher.
When it comes to reimbursement, an area of telehealth that is rapidly changing across the country, Dr. Boucher says “We've seen massive growth. For practices across the country, telehealth has gone from zero percent to 30-50-70-100% of a practice’s patient encounters – almost overnight. We've been offering telehealth for enough weeks now that we’ve started to get payments back for the visits and have seen really good consistency across payors. I think everyone is just crossing their fingers, for the most part, and hoping that these visits get covered. Some of it will probably be essentially charity care that we're doing, and we accept that knowing it's building patient loyalty.”
Dr. Boucher has a great perspective about what healthcare will look like post-pandemic. “COVID-19 required us to really take the next level with our patients in terms of technology where everybody has just been waiting for a reason to do this. Patients don't want to call our office to make an appointment. They want to book their appointment on their phone. They want to text us when they arrive and then get a text when their room is ready so they can sit in their car and not our waiting room. They want to get a text that says, ‘Come back to room 29’ and they enter the office and walk down the hall to that room. It’s all about improving patient care and the patient experience.”
As he says, telehealth is here to stay. “Telehealth isn’t just useful – it’s vital. We're doing all of our ADHD, anxiety, depression visits over telemedicine. It saves patients so much time instead of driving across town, waiting in the lobby, sitting in our exam room, talking during the appointment and then heading back to school. Then the parent says ‘But wait, it's almost lunchtime. We have to stop somewhere since you’ll miss lunch period.’ That's like three hours out of a family's day, just for a 20-minute appointment. With telehealth, they can go to the school, get the child, sit in the car, put them on the phone and we can complete a telemedicine visit. Then, back to class, enjoy lunch period and get back to work. Patients are going to want that. My hope is that healthcare providers embrace this and offer those services on a continuing basis. It’s a way for us to be with our patients where they need us, acquire more patients and build customer loyalty, because we are going the extra mile to make care convenient.”
Finally, as pediatrician, Dr. Boucher has a unique take on additional benefits of telehealth. “In the midst of all uncertainty, I will say that my patients, the kids, love that I get to see their dog, their home, their pictures. Little things you can do that really make the experience just as good as being an office. You don't get stickers at the end, but you don't get shots, either, so it's a win-win for the kids.”
Learn more about Updox Telehealth: