During the COVID-19 pandemic, business at Gastro Health in Miami came to a halt. In order to uphold social-distancing practices, patients stayed at home and thus physicians at the practice did not have access to them.
THE PROBLEM
Additionally, all elective endoscopic procedures were cancelled. Only urgent procedures were performed. There was a dramatic drop in business.
The question became: How was Gastro Health going to continue to contact and care for patients? Further, how could the practice create a virtual front door for patients while the real front door was closed? At that point, the practice explored telemedicine.
PROPOSAL
Gastro Health staff decided on the Healow telehealth system from eClinicalWorks, which, according to the vendor, is used by 40,000 physicians servicing nearly 25,000 visits a day.
“First and foremost, with the Healow technology, we would be able to connect with and continue to care for our patients,” said Dr. James Leavitt, a gastroenterologist and the president and chief clinical officer at Gastro Health. “The app would allow us to conduct a tele-visit and our patients would be able to directly message our physicians.”
Staff still could conduct tests and return results in a timely manner with no office visit required. And physicians could provide personal and immediate answers, which allows them to keep open that virtual front door in a meaningful way, he said.
MARKETPLACE
There are many vendors of telemedicine technology on the health IT marketplace today. Healthcare IT News recently published a long list of these vendors (a list that continues to be updated). Click here for the feature story on telemedicine vendors in the age of COVID-19.
MEETING THE CHALLENGE
Gastro Health is a very large medical group – it has more than 250 providers in four states and is growing. While rolling out Healow tele-visits, staff had several factors to consider. Recently, Gastro Health acquired several practices that normally would have been switched over to its eClinicalWorks platform. However, under the current circumstances, staff have not been able to switch over every practice yet.
“We also had to consider our patients’ needs,” Leavitt noted. “We wanted more than just one technology available to us in order to adjust to the patient’s preferences. Our preferred platform is eClinicalWorks’ tele-visits; however, our physicians also are trained to use FaceTime, WhatsApp, Zoom, Doximicy and Doxy.me.”
In order to train staff, Gastro Health conducted massive GoToMeetings four to five times a day where instructors went through each technology platform and taught everyone how to effectively use them. After that, the practice had an open house call for any questions, wrote up the processes and published everything once it was reviewed to establish a user manual.
Then, for a week, the practice held additional open house meetings regarding billing, coding and/or safety questions.
“With the updates to Healow tele-visits, the platform is getting easier to use,” said Leavitt. “Now, if we have their email and phone number, they receive an automated text message. They can click on the link and we can start the tele-visit. I prefer this platform because it is user-friendly and everything is automated once we initiate the visit.”
Additionally, if the patient gets used to optimizing the Healow app as opposed to some of the other communications options, they know they can rely on one app for all their needs. Everything from messaging to test results is centrally located, he added. The process is easier for both the physician and the patient, he said.
RESULTS
Gastro Health has built a business-intelligence platform. With that, it can create comprehensive weekly reports that show the ramp-up with the eClinicalWorks platform and tele-visits in general.
“Specifically, we can look at volumes by location, care center, doctor and state,” Leavitt explained. “By doing so, we can look at the rate of growth, identify any roadblocks and remedy any issues to generate more use of tele-visits. In just our Florida locations alone, we are doing more than 5,000 tele-visits a week.”
The other metric the practice has looked at regards growth and revenue amid the current pandemic crisis.
“We have created a tool that allows us to identify how many visits we would have to conduct per doctor or care center to break even at that specific location,” Leavitt said. “Therefore, we set our goals appropriately and doctors can set their individual goals.”
ADVICE FOR OTHERS
“You need to connect to your patients, as a business you need to continue to generate some revenue and you need to take care of people. It is very clear that telemedicine is the right solution,” Leavitt advised. “This would have been adopted in greater magnitude in the past; however, payers were not paying for it. Now that payment has opened up and telemedicine technology is allowed to operate on a broader scale, this is a natural shift in medical practice.”
Practices also must go through a robust implementation process. They must teach, document and measure so they can see the telemedicine volumes increase, he added.
“You also must identify any roadblocks or issues that arise and use rapid-cycle improvement techniques to remedy these issues,” he suggested. “Doctors want to see patients, and patients want to see doctors. Another aspect is marketing this to the patients. One capability that was greatly beneficial to us was producing a large market blast to our existing patients.”
More than 250,000 patients received notice that Gastro Health was shifting to telemedicine. And the practice continues to look for new ways to effectively market to patients.
“When this pandemic subsides, telemedicine will become a predominant way to see patients,” Leavitt concluded. “There generally will be a fundamental shift to how we deliver our care even when social distancing is not an imperative. Especially for routine follow-ups, this will become increasingly common and preferred. I have found this to be an incredibly satisfying interaction with my patients with whom I already have an established relationship.”
