In the midst of the COVID-19 pandemic in mid-March, Dr. Mamdouh Riad, a solo practitioner in Hyannis, Massachusetts, began to take notice that he would not be able to see patients in the office as usual and had many patients start to cancel appointments as they were nervous about coming in.
THE PROBLEM
This became a growing concern, especially for patients with chronic illnesses such as hypertension and non-insulin-dependent diabetes mellitus. It also posed a new challenge for Riad, as he needed an efficient and safe way to continue patient appointments and treatment as needed. Thanks to insurance companies’ and the governor’s direction, telehealth visits were allowed, which prompted Riad to explore options using the athenaOne Mobile EHR app. Athenahealth had created an integration between it and Apple’s Facetime, a video chat app for iOS devices many are familiar with, and this was a very timely solution to address the issues Riad’s practice was facing.
PROPOSAL
To provide patients with quality care in the comfort and safety of their own home, the team at athenahealth quickly launched an Apple FaceTime integration within the athenaOne mobile app. As a result of recent HHS guidance with adapted HIPAA guidelines, the integration enables providers to initiate a video call with a patient from directly within the app. “This was a seamless solution that I could start using right away without any extra work to alleviate the burden many healthcare providers like myself have been facing to treat patients afraid of leaving their homes,” Riad said. “The athenaOne integration gives providers the ability to communicate face-to-face with patients while safeguarding both parties from unnecessary in-person contact.”
Additionally, since athenahealth offers a cloud-based system, it also very quickly updated product structures (with COVID-19 order sets, screening questions and more) within athenaOne for providers with no disruptions. Athenahealth also implemented several patient communication options to help providers connect with patients about everything from what to expect upon arrival in the office to canceling routine well visits.
MARKETPLACE
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MEETING THE CHALLENGE
After athenahealth announced the FaceTime integration, Riad began to transition in-person visits in March to telehealth visits. In April, the practice strictly did telehealth visits with patients. “In order to alert our patient community about the new method of communication, we started an email campaign using a feature called athenaCommunicator, a patient interaction and engagement service,” he explained. “The platform allows automated messaging, live operators and a patient portal, to help me and my staff engage patients in their care and reduce our administrative work.”
The EHR has a feature that connects FaceTime through the patient’s chart. Riad clicks the camera icon in the chart and it automatically connects the call. It’s a practical feature so Riad does not have to dial every patient.
RESULTS
Riad has been able to see an average of 30 patients per day via the mobile FaceTime integration and has converted 85-90% of patients to telehealth since March. Since many consumers already have and are familiar with using FaceTime, it was a relatively easy transition, Riad noted. “We live in a retirement area on Cape Cod with a lot of Medicare patients, and are seeing a large number of these patients use the new FaceTime feature,” he said. “A lot of the elderly patients have been able to successfully use the feature without any issues and feel confident with the video capabilities. Additionally, some patients can show me certain symptoms on camera, and they find it reassuring to have the video access.”
For example, Riad connected with an acute care patient via FaceTime who was complaining of neck pain. As part of the examination, he asked her to perform a range of motions with her shoulders, so he was able to examine the source of the pain. The patient was assured more by doing the telemedicine visit than just doing it over the phone, he said.
“Additional examples of ailments we are able to diagnose and treat through the FaceTime integration include acute illnesses like sinusitis, urinary tract infections and back pain,” he noted. “We also have the ability to adjust blood pressure medication for treatment of hypertension as patients report high blood pressure readings at home, and we can adjust diabetic medication for patients reporting high fingerstick blood pressure readings.”
ADVICE FOR OTHERS
Telehealth has tremendous value for both providers and patients, Riad said. “I hope insurance companies will continue to reimburse for telehealth visits in addition to HHS and HIPAA accommodating telehealth visits in the future,” he added. “Telehealth has proven to offer easy and personalized care visits without compromising quality. If it continues, it’s a huge benefit.”
An example of the value of telehealth is post-hospitalization visits. Studies have shown that if hospitalized patients saw their primary care physician within one week of discharge from the hospital, the likelihood of readmission to the hospital for the same illness is greatly reduced, which saves Medicare and hospitals a lot of money, Riad said.
“With our local physician network requiring post-hospital visits within 72 hours of discharge, we often find it difficult to bring post-discharge patients to the office because they are often too tired to come or feel they had enough blood tests, exams, etc.,” he said. “If telehealth continues to be an option, it can be extremely helpful to patients, hospitals and insurance companies, as we can do a telemedicine visit post-discharge. This visit will ensure patients are getting follow-up care that is necessary to keep them healthy, which will reduce the likelihood and cost of unnecessary readmission.”
Apart from post-discharge patients, Riad also would be able to better treat patients who are elderly, immobile or too sick to come to the office, he said. With telemedicine, Riad has the ability to help patients get the care they need and help insurance companies avoid ER visit costs and hospitalization if the patient’s condition worsens from lack of early intervention, he concluded.
