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Telehealth Demand Surges

Commentary by Donald Reuther, CEO Community Health

Telehealth and telemedicine have been on my radar for years. The concept seemed perfect for patients allowing them the highest quality care from the convenience of their home.

As the coronavirus outbreak escalated in Vermont, I realized that virtual health care could be a lifesaving alternative, one that clearly could make a huge impact on Community Health’s ability to reach the widespread community that we serve in Rutland and Addison counties while allowing our most vulnerable and senior population to maintain the needed separation.

When COVID-19 reached us in Rutland a few weeks ago, I knew that Community Health’s Telehealth program that we had begun last year in the Fair Haven school district needed to be prioritized, expanded and rapidly integrated into all of our practices. We needed telemedicine at Community Health’s five locations, quickly.

Whether it was good fortune, or incredible foresight on behalf of our board of directors, a telemedicine consultant had joined our organization in January and was fully involved in planning our new service line. “How fast can we launch telemedicine in our clinical practices?” I asked our medical team and the answer was startling. Community Health’s Associate Medical Director of Express Care Jennifer Hanson assured me all five practices would be using telemedicine in two days. And in 48 hours, the telemedicine infrastructure was launched to all five Community Health locations.

Starting with a few providers at each location, training sessions were scheduled to introduce the new process, technology, policies, video and audio rapport, quality monitoring and administrative services such as billing. By the first day of operation, a Friday, a dozen telemedicine visits were accomplished. On Monday, another 20 took place, and a week later 200 patients and provider meetings were to occur by video connection in a single day. More recently, over 400 virtual visits were completed in one day, representing about two-thirds of the number of patients we typically see in a day.

As a team we coordinated the staff training, installation of technology and adjusted our usual workflow to accommodate this new delivery service and made sure that the service was up and running properly.

While it may seem like a simple transition, telemedicine is a lot different from having a Facetime conversation with your family member. Since only a few of the providers had ever delivered care by video it was important to provide them with an organized process, a workflow that was detailed, the ability to capture the necessary visuals and a professional and private setting for the consultation. Considering that we were fully engaged in a health crisis, the pressure on providers was massive and their workloads exhausting. However, working collaboratively as we do at Community Health, the group training sessions provided staff with the support and backup needed to move quickly into this new workflow. Everyone was on the same page and appreciated the value remote consultation could bring especially to those worried about contracting the coronavirus.

Remotely, we can check in on patients who have chronic conditions, do preventative health screenings or determine if an office visit is needed. We also conduct mental health counseling, a service that Community Health Behavioral Health has been offering for several years. Chris Chadwick, Community Health Behavioral Health team leader, told me Telehealth offers an opportunity for Community Health’s providers to have individual sessions with patients from the safety of their homes.

“The best behavioral health treatment outcomes are when patients have consistent and consecutive sessions with their providers. Telehealth is a very effective tool in making those sessions happen,” Chadwick said. With the onset of the COVID-19 health crisis, we switched over to the Telehealth model for most behavioral health appointments to implement the mandated social distancing. “With this change, many patients did not miss a single visit with their providers,” Chadwick said. “Telehealth has been a pivotal tool allowing Community Health to provide consistent appointments with our patients and offered opportunities for the providers to engage with the patients in their home environment.”

Telemedicine has been around for years, but is just now being recognized as a safe and beneficial option for health care services delivery. The Centers for Medicare and Medicaid Services just last week approved Medicare telehealth coverage during the COVID-19 outbreak, recognizing the value of remote health care.

CMS Administrator Seema Verma said in a news release, “These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus.”

At Community Health we are stretching our innovation and creativity to provide the highest quality health care to everyone in the most cost-efficient way. The COVID-19 crisis is critical and dangerous, but we are using this opportunity to deploy our best and brightest minds and create safe and appropriate services to everyone in our communities.

It took us less than a week to successfully launch telemedicine to all five practices in the Community Health network of practices, and we will continue to diversify the clinical offerings and remote capabilities of this service. Telemedicine is just a logical extension of what we do.

I fully expect that all our primary care providers, including behavioral health and dental, will implement the telemedicine and telehealth offerings in the near future as we lead the way providing quality, affordable care to everyone who needs us.

Don Reuther is the CEO of Community Health in Rutland.

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Donald Reuther, CEO

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