Washington was one of the first states to report a death from COVID-19, and rheumatologists in the state were among the first in the U.S. to adapt their practices to mostly telemedicine appointments.
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“In order to do telemedicine correctly, we understood that workflow and telemedicine had to fit together, and we had to make this transformation within a week’s time—not without its many challenges,” says Karen Ferguson, practice administrator at Arthritis Northwest, PLLC, Spokane, Wash. She spoke with The Rheumatologist about how her practice has adapted during the COVID-19 pandemic.
Q: How are you and your staff adapting to the sudden changes brought about by the pandemic?
From the onset, a major focus of our effort has been to integrate the telemedicine program within the standard workflow and electronic health records [EHR]. This work has included syncing our schedules, templates, encounters, billing and documentation requirements to satisfy our coding requirements. Now, our physicians can jump onto a telemedicine visit and document right into the EHR. Other workflow solutions involved establishing a virtual rooming process in which our medical assistant rooms the patient by calling 15 minutes prior to the patient’s appointment to review and record the patient’s history, pain, complaint, medications and other details to be discussed during the visit.
Many challenges still exist as our practice adapts to this relatively new telemedicine technology. To make it work well, it’s going to evolve over time. Creating an efficient user experience is also really important. Ultimately, we need to understand the full cost implications of a telemedicine program, the long-term challenges and benefits to the practice, and how telemedicine may fit into a value-based contract with our payers.
Q: What type of appointments are you conducting, and what are patient’s chief concerns regarding COVID-19’s potential risks and symptoms?
We are currently seeing 100% both new and established patients via telemedicine. Both physicians and staff are sharing responsibilities with these visits by either working from home or at the office. We continue to be open for infusions and have been fortunate to use our exam rooms for our infusion patients. Because Washington was the first state to declare a state of emergency, there was an immediate response from our patients, and the volume of calls [was] tremendous.
The main concerns from autoimmune-suppressed patients were if they should continue taking their medications and if they should continue to go to work and be around other people who [could potentially] expose them. Additionally, some of our payers and pharmacies have limited the [availability] of hydroxychloroquine, and this has caused concern for our patients [who] are currently on this treatment.