"I can’t believe we were able to pivot to telehealth so quickly."
Danny Butler, MD, is a solo internal medicine practitioner who runs his practice from two locations. His main office is located in Paducah, Ky., with a nurse practitioner, physician assistant and 12 office staff. He also has a satellite clinic 30 minutes away with a physician assistant and three staff members. In total, Dr. Butler employs 20 staff members and serves 5,000 patients. He’d never considered using telehealth before – due to concerns about reimbursement – but, when COVID struck, he knew it was his only option.
Aledade and Updox partnership
A cancer survivor himself, Dr. Butler is immuno-compromised and, as an employer, he needed a way to keep his doors open to care for patients in a way that was safe for staff and himself. He had joined the Aledade Accountable Care Organization (ACO) and learned of Updox through the recent partnership between the two organizations.
“Working with Aledade has been great for our practice. They had reviewed 20 or more telehealth vendors and selected Updox so I didn’t hesitate. They were right on point with recommending Updox. It is easy to use. For the sake of my patients and staff, I needed to move fast. We were trained at 8 a.m. and testing it with patients by 10:30 that same morning. We’ve used it ever since,” says Dr. Butler.
“Once I used it, I was blindsided by telehealth. Updox gives us a great way to care for patients. I can see them, monitor how they are breathing, tell if they are comfortable. I know my patients and have a great, long-term relationship with them. I’m grateful that telehealth lets that continue, even during a pandemic.”
Updox ease of use was key for Dr. Butler. He’s done 600+ visits via Updox telehealth in the past two months. Approximately 98 percent of his caseload has been via telehealth. “I have a few patients who aren’t able to or aren’t comfortable with it but the vast majority really appreciate the option of being able to consult with me but do so from their home,” he says.
Even reimbursement is going well. “Honestly, it’s better than we thought. Both private insurance and Medicare are fine. We’ve had no problems with billing,” he reports. He also appreciates the advocacy Aledade is doing in this area.
“Telehealth works for us because we still need to take care of our patients in ways that don’t compromise their health or our staff. We still have to deliver care. Updox enabled us to balance COVID fear with the need to care for and monitor patients.”
Dr. Butler and his staff developed a workflow to maximize efficiency within the practice. A week prior to a new telehealth encounter, an assistant contacts the patient, gets consent for telehealth and does a run through, making sure a family member can be present if necessary. Then, on the appointment day, a staff member calls the patient to tee up the visit, enter it into their system and passes it off to Dr. Butler. He uses a split screen so he can take notes during the call and replies to messages or does additional documentation between video chats.
“Our staff picked up on telehealth quickly and they are instrumental in helping patients get comfortable with the process. Patient satisfaction is strong with telehealth. We both appreciate being able to see and talk to each other. It helps maintain the great relationships I’ve worked to build in my practice,” he says.
Telehealth in a post-COVID practice
Dr. Butler says he’ll definitely continue to use telehealth post-COVID. “Now that I’ve had the chance to use it, I can see how it will benefit the practice long-term. I can treat college students who need medication check-ups, elderly patients who have trouble getting to the office, nursing home or hospital follow-ups, disease management, patients who are at work and need a quick consult or snowbirds who travel south for the winter but want to continue to see me for medication management. It works well in those situations and offers great convenience to patients. I’m surprised by how easily I can assess patients through a video chat.”
In one session, Dr. Butler was scheduled for a routine follow-up via telehealth with a patient. “I recognized immediately that she was short of breath and in pain. She had been sick for two days but didn’t reach out as she was scared to go to the hospital during the pandemic. I was able to assess her by video and convince her she needed to go to the emergency room. She was admitted to the hospital and treated and home in two days. I don’t know what would have happened if I hadn’t observed her.”
“I can’t believe we were able to pivot to telehealth so quickly but I definitely wasn’t considering it before COVID. My preference is to be in the room with patients but now, I see that the technology is easy and it offers a service to patients. I can practice as well with telehealth as I can with in-office visits. As long as telehealth is an option, we’ll be behind the screen if that works best for patients.”
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