If you’ve ever had the flu or some other illness that needed a medical professional’s attention, you know how difficult it is to make a doctor’s appointment in the first place. Then there is getting up on the day of the appointment, making yourself presentable enough to go out in public, driving yourself to the office or finding someone else who can get time off from work to take you, sitting in the waiting room, seeing the doctor, getting a prescription, visiting the pharmacy to pick up the prescription, then finally being able to go home to take your medicine and go back to bed. When you’re sick, that’s one of the worst possible scenarios you could ever face.
The healthcare industry understands your plight. After all, many medical professionals have probably been through the scenario above themselves at one point or another. So, the industry as a whole has been looking at different ways to provide greater convenience to patients, to reduce wait time frustrations and to be able to provide prescriptions and refills for symptoms that are easy to diagnose.
The answer is virtual care. Virtual care, by definition, means any kind of care delivery that can be patient-to-provider or provider-to-provider, delivered via an electronic means. That can be achieved by real-time audio/visual, audio only, text message or other types of electronic interaction.
“It’s kind of an umbrella statement that we refer to as telehealth, specifically auto/video interactions between patients and care providers,” says Tyler Okoren, director of operations for Sentara Medical Group. “We provide telemedicine services out of a centralized clinic, and we have dedicated nurse practitioners who are available pretty much on demand.”
The types of services that Sentara generally provides through telemedicine address common ailments that affect people such as colds, sinus infections, urinary tract infections, rashes and other things that do not require diagnostics, lab results or a physical procedure such as getting stitches (although it can be used to tell you if stitches are necessary).
Here’s how it works: The patient schedules an appointment for an online visit. Sentara then sends them an email to let them know what needs to be downloaded ahead of time and provides some information on what they can expect from the visit. At the appointed time, a staff member and the nurse practitioner will reach out to the patient via their cell phone, tablet, laptop, etc., then engage with the patient. After the patient has had an opportunity to present the symptoms and interact with the nurse practitioner, a diagnosis is made, and an action plan is presented, including the need for any prescriptions that the nurse practitioner can order to be directly filled by the patient’s normal pharmacy.
“I think one of my favorite stories about our telemedicine program involved a working dad, who had just moved to the area, who needed to establish care with a primary care provider, but no immediate appointments were available at the time, and he needed a refill on his blood pressure medication,” says Aida Vicente, team coordinator for Sentara telehealth services. “He was at his son’s hockey game, which he didn’t want to miss, so he connected with us, went off to a quiet area for a few moments, and we were able to get his prescription refilled and actually get him set up with a primary care provider sooner. He was in and out in less than 15 minutes.”
For more rural areas where internet or cell service isn’t great, or for people who don’t have access to a smartphone or tablet, Sentara is also creating a series of virtual walk-in clinics, where a patient can go into a room at the facility, be provided with an iPad and engage in a virtual care visit that way. “We had a patient schedule an appointment at our office, but she was leaving for a trip before we could get her in,” says Vicente. “She only had one pill left in her blood pressure prescription, so we provided her with a virtual care pamphlet. She told me she couldn’t remember her iPhone password, so she wouldn’t be able to download the app. We directed her to come into our office, sat her down at a computer and got her connected to the nurse practitioner for virtual care. We were then able to get her prescription refilled so she could go on her trip without any worries.”
To schedule a video visit, call your Sentara Medical Group primary care provider’s office or the Care Connect team at 844-693-0270. You can also schedule an appointment online.
Bon Secours St. Mary’s Hospital is also using technology to reach patients in rural areas by giving them access to pediatric specialists without having to make long commutes to get to an appointment. In addition to Bon Secours 24/7—downloadable from the App Store, Google Play Store or at BonSecours247.com—an app that allows you to do virtual visits for a set fee of $49 (which may be covered by insurance), they have also added something unique so doctors can come to more rural patients virtually.
“We’ve been working with a company to launch a telehealth platform, which is basically a way of saying that we have a robot now in our Kilmarnock location where kids can go to that pediatric office and see me or one of our other specialists virtually without needing to drive two hours, says Dr. Carl Rountree, Jr., a pediatrician specializing in pediatric gastroenterology with Bon Secours Health System. “The types of services we provide tend to be specialty driven and very common, so the options our patients have are generally not conveniently located for them.”
The centrally located robot, on the other hand, provides a secure video link that is encrypted so there is no risk of patient information being lost or hacked. Dr. Rountree can use controls on his end to zoom in and out with the camera, turn up the volume so he can listen better and get visuals on a variety of things. A nurse in the room on the Kilmarnock side can provide all of the other diagnostic information he would need.
For rural patients who need specialty pediatric services, they can contact Bon Secours Kilmarnock Pediatrics or use the direct line to the Bon Secours Pediatric Specialty Group at 804-281-8303 to schedule a virtual appointment.
Riverside Health System is also using robots to help manage patient care. To aid in critical care for patients in the evenings, they contracted with a company that can virtually provide a core pod of critical care physicians that actually feels like part of the Riverside team. If any patients need to be seen, the nurse in the intensive care unit (ICU) can trigger the telemed system and a physician can call in 24/7.
“We expanded that program last November, so telemedicine physicians can do rounds on patients without the staff even being there,” says Christy Helsel, registered nurse and telehealth program director at Riverside Health System. “With that, we wanted to look at different equipment available out there to see how we can get doctors in the room quicker and make things easier for the nurses.”
One piece of equipment tested with positive results was the EnTouch La Vida Robot. “It functions a little like a robotic vacuum system you might have at home,” says Helsel. “The robot is docked and mapped to every patient room on the unit, and it is also mapped to both nurses’ stations. If a nurse has a patient that isn’t doing well, they can walk up to the robot, press the screen that tells it which room it needs to visit and the robot will undock and go to the door of that room. In the same respect, the physicians on their end can log in to the EnTouch system and drive the robot manually.”
Helsel states that the reason they like the La Vida Robot so much is because EnTouch put a lot of thought into providing quality care to their patients. “On a traditional telemed cart, only the camera moves,” she says. “On the La Vida Robot, the screen moves, too. So, it’s like you’re talking with a real person because you can follow them as they move. They also made the robot white because they wanted to mimic a physician’s lab coat. It has a stethoscope. The zoom capability is amazing. It’s one of those things you really need to see in action to truly believe it. But the most important outcome we’ve seen from this is from the time the nurse triggers the physician—whether they need to see a current patient or admit a new one—to the time the physician is in the room via the robot, a typical response time is under two minutes. That’s very impressive, especially at night.”
For additional information on all of Riverside’s telemedicine services and how to connect to them, visit RiversideOnline.com/Services/TeleMedicine.
For critical care patients who are in a home setting, a company called Trapollo—a venture company owned by Cox Communications—can provide remote solutions.
“Trapollo is an organization that started out about nine years ago that is focused on telemedicine and what is called remote patient monitoring (RPM),” says Trapollo CEO Mike Braham. “We concentrate on patients with chronic illnesses and help assist providers (like hospitals) and payers (like insurance companies) with the ability to connect—essentially through technology—with patients in their homes, to deliver essential data or information on key vital signs. These measurements can be used to determine if someone is having trouble on a certain day or declining over a period of time.”
Trapollo not only helps with the monitoring, it helps with the design of how a remote patient monitoring solution will work in a clinical setting. They then work with the provider to help design the appliances (hardware) and help connect that to a software program that can read and report all of the data collected. Once a system is operational, they deliver it to each patient’s home, work with the patient to make sure they understand what it’s for and then set it up for daily use.
“We’ve helped to enable the environment,” says Braham. “It’s usually prescribed in the hospitals but delivered in the homes. We like to use the phrase ‘connected health.’ The idea is to keep the doctor/patient relationship more connected, using technology, and enabling for care delivery outside a hospital or clinic. This is essential for individuals who choose to ‘age in place,’ which means remaining in their homes versus downsizing or moving to an assisted living community.”
With more than 10,000 Americans turning 65 each day, the need for this kind of technology is an important new piece to the healthcare puzzle. “Virginia is a place that we’re excited about in regard to the potential of TeleHealth moving forward,” says Braham. “Some of the key founders of the American TeleHealth Association were from Virginia, so I think the residents here are very blessed with the quality of services that are delivered throughout the hospital systems here. As for Coastal Virginia, telemedicine provides a tremendous option for anyone moving into the area, knowing that the hospital systems in this region are focused on these types of care options.”
To learn more about Trapollo, visit their website at Trapollo.com.
We’re just now scratching the surface. It’s important to note that the hospital systems included in this article are also currently working on a variety of telehealth programs that include more specialized programs such as telestroke—where a neurologist can interact with a patient suspected of having ischemic events and can speed diagnosis and clot-busting drugs to facilitate faster recoveries—and telepsychiatry—where psychiatrists can view and diagnose psychiatric patients in an ER setting to prescribe medications or have the patient admitted, as well as many other groundbreaking ideas. We encourage you to visit each hospital systems’ website to read more about the seemingly endless applications that virtual medicine can provide.