With the arrival of the COVID-19 pandemic, businesses nationwide have been forced to restructure their typical workday. Currently, around 316 million Americans1 are being advised to stay home. In this unique situation entire industries are making changes to facilitate this new way to work. Whitehat Virtual is one such business helping companies make this shift. Many working Americans are waking up to the idea that work is something you do, not necessarily a place you go.
“We aren’t working from home. We’re at home doing our best to work.”
- Erin, Nurse Practitioner
Ensuring a similar experience in productivity, safety, and success, is crucial among many industries. This is especially true within healthcare. Among industries, healthcare makes up about four percent of the total work-from-home workforce according to a Global Workplace Analytics 2016 analysis of U.S. Census Bureau data2. Erin Wert, a nurse practitioner at Southern California Medical Gastroenterology Group, discussed the attempt to provide a high level of patient care within a rapidly restructured system.
“Patients still need to desperately see their doctors right now for things unrelated to COVID-19 or exacerbated by it,” Wert said. “We’ve cancelled hundreds of our routine procedures. Although those procedures are technically elective, the patients need them. It’s their colon cancer screenings, surveillance for inflammatory bowel disease and other important diagnostic testing.”
She said that many of their patients are already late to schedule these essential colonoscopy and endoscopy cancer screening appointments. She expects patients will experience a backlog and hefty waiting list when offices open once again.
The current demand for patient visits also remains high. Healthcare providers have rushed to meet the need by utilizing technology that offers patients virtual visits. Through telehealth, various healthcare services are provided to patients online. Telehealth offers everything from virtual visits and education to proper handling of sensitive patient information.
These platforms have existed for several years but surged in recent months. Southern California Medical Gastroenterology Group uses MyChart, a feature of Epic electronic medical records, to securely send links to their patients. Their patients then use those links to join Zoom video calls with their providers.
“Being able to have these virtual visits has been a lifesaver,” Wert said. “Most healthcare plans are fully covering telehealth visits no matter what doctor you are seeing.”
However, the system has its fair share of issues, with disjointed communication, technology proficiency of healthcare providers and their patients and privacy concerns.
Disjointed communication
A difficult element to replicate virtually is the medical assistant and front desk. Medical assistants go over a patient’s medications list, their preexisting conditions and their pharmacy location, in addition to other roles. Currently, medical assistants are still working, albeit in a different way — said gastroenterologist Dr. Adam Tzagournis of Digestive Associates of Ohio.
“Our medical assistants are taking patient calls and setting up the clinics through the electronic medical record,” Tzagournis said. “They help us fill prescriptions, answer patient questions and put in lab orders for scopes and endoscopies down the road.”
Although the medical assistants are not as busy as usual, they are still an essential part of the patient care process. If the provider wants another visit with the patient the medical assistant can access that information in the doctor’s notes to set up those appointments. Medical assistants may still call to follow up with a patient the same day, said Tzagournis. However, the process is not as seamless as usual and there is a disjoint in communication, according to both Tzagournis and Wert.
“We don't have a good solution for integrating the things our medical assistants usually do for us,” Wert said. “Now, we have to send a message to call the patients back later and when will that later be? We can't tell them because we don't know. In the office they would just go check out and [get rescheduled] there. [Virtually] there isn't a place to send them or transfer them.”
An integrated system or application could effectively link the remote providers to their medical assistants and staff, Wert said. Wert suggested setting up home offices with a connection to the office phone line so patients could be transferred, put on hold or connected with their providers. Connecting doctors to their medical assistants and staff offers seamless communication and higher quality customer care. Companies like Whitehat offer optimal connectivity for small and large companies.
“In healthcare it can take a village to care of the patients. Telemedicine continues to be a successful strategy delivering quality care between providers and their patients,” Whitehat CEO, Val King said. “Some leading-edge clinics are integrating telemedicine sessions into smooth workflows where patients can see their provider, get a prescription, handle payment, and schedule follow-up visits in one setting.”
Technology proficiency in patients and providers
It’s important to consider both ends of the patient and provider interaction regarding technology proficiency. Whether the provider or patient has a high or low degree of technological literacy has a serious impact on the patient’s quality of care. Wert took it upon herself to educate the doctors in her practice on how to use video chat tool Zoom.
However, she said an important component of a successful work-from-home strategy is education for both the providers and the patients. One way to achieve this is setting up resources to teach providers and patients how to use the technology appropriately.
“Some clinics have borrowed a page from the IT department playbook by using more traditional IT tools to remotely connect to a provider or patient computer and teach them how to use the tools or step in, where appropriate, and complete the work for them,” King said.
It is difficult when both provider and patient struggle to use or understand the technology. To further complicate matters, Wert said that typically the most vulnerable patients have the lowest technology literacy.
“Certain patients cannot seamlessly move into online health and those are the patients who are most at risk and should not be leaving the house,” she said. “They are both [the] highest risk to get COVID-19 and also are in frailer health to begin with.”
Older Americans are at greater risk for many health issues including late-onset diseases and specifically COVID-19, according to the Centers for Disease Control and Convention3.
“We have patients in their eighties and nineties,” Wert said. “Patients who are not computer literate are potentially cut off from being able to reach us anymore.”
Wert also suggested offering updates on how they are handling the COVID-19 situation to keep patients better informed. Whether patients can access a virtual visit via Zoom, Facetime or another digital tool is not the only issue. At times, older and at-risk patients are unable to access their online accounts or any of their digital health information due to lack of technology proficiency as well as privacy concerns.
Whether care is in-person or virtual, sensitive patient information must be protected to the same government-mandated HIPAA standards. These standards ensure patient information is protected. Whitehat is one such company that actively monitors network security to prevent data breaches or network vulnerabilities.
“On one hand we have the administration saying you shouldn’t be calling [patients] directly and to call them using your Zoom code,” Wert explained. “This person’s caregiver is with them, who has Zoom on their phone, and we need a visit, so we are going to Zoom in to talk to this patient because [they] still need care.”
When working remotely with patients there is an added complexity since healthcare falls in the reimbursement business. Typically, hospitals and clinics perform services they later bill to government programs such as Medicaid or private insurance providers. This means the best remote work strategies are shelved due to the lack of a clear path for reimbursement of services.
The work-from-home idea is not a new one but rather a new way to do business for many companies. However, in the current climate, companies don’t have a choice whether to implement the work-from-home model. Although it’s fairly simple to send employees home to work for a few days, anything more than a couple weeks requires a high level of consideration.
“Healthcare presents its own unique challenges but that just makes it more fun and rewarding when it’s done right,” King said. “This is something we do as a company. The work-from-anywhere model is one we have used to build our own company and its locations around the world.”
Currently, King and his staff at Whitehat are spending their time talking and teaching businesses of all sizes how to achieve the work-from-home model successfully.
“Sometimes we talk about how Whitehat can help. Other times we are not the best fit but can offer guidance on where to get that specialized help,” King said. “The point is helping companies figure out how to make the shift and be successful going forward. It’s a great thing to contribute in the current crisis.”
Final thoughts
Shelter-in-place orders currently affect around 96.5 percent of Americans4. Different industries are responding however they can to keep up with demand or survive where there is none. The healthcare industry remains essential in both fighting COVID-19 and offering routine quality patient care.
“We’re all struggling as we work from home to stay focused and keep up our energy. ‘We aren’t working from home. We’re at home doing our best to work,’” Wert quoted. “We have to give ourselves a lot of grace because, like our patients, we are under a lot of stress doing the best we can right now.”
If you are struggling to figure out how to keep your organization productive with a partial or fully remote workforce, need some guidance or a better plan of action, contact Whitehat Virtual Technologies at 888.406.8719.
1 Mervosh, Sarah, et al. “See Which States and Cities Have Told Residents to Stay at Home.” The New York Times, The New York Times, 7 Apr. 2020, www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html.
2 Global Workplace Analytics. “Latest Work-at-Home/Telecommuting/Mobile Work/Remote Work Statistics.” Global Workplace Analytics, globalworkplaceanalytics.com/telecommuting-statistics.
3 “Older Adults.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 21 Mar. 2020, www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html.
4 Mervosh, Sarah, et al. “See Which States and Cities Have Told Residents to Stay at Home.” The New York Times, The New York Times, 7 Apr. 2020, www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html.
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