Kirk Campbell, MD, an assistant professor of orthopedic surgery at NYU Langone Health in New York City, saw all of his patients via telemedicine for about six weeks during the COVID-19 pandemic.
Dr. Campbell, who has been using telehealth for about a year and a half, spoke to Becker's Spine Review about his experience conducting HIPAA-compliant virtual visits through NYU Langone's Epic medical record system. The technology has taken on new importance amid shelter-in-place mandates and elective surgery restrictions.
Polishing the virtual experience
NYU Langone was prepared for the sudden need for telemedicine visits because it has been fine-tuning its platform for years, troubleshooting existing and potential issues, Dr. Campbell said. Patients can schedule — and complete — virtual visits through their MyChart app, which also houses information such as lab results for a seamless experience.
Ahead of a virtual visit, patients are contacted by office staff. They're given detailed information about how the visit will work, as well as instructions on how to troubleshoot issues that may arise and who they can call for help.
Establishing this proactive outreach and guidance was time-intensive, but it now makes for a "smooth-sailing" process, Dr. Campbell said. "We're prepared even before starting the visit."
Dr. Campbell isn't just saying that — he has personally tested the platform, putting himself in patients' shoes.
"Every now and again, I'll go in and schedule a visit myself," he said. "I'll call my office and try to schedule myself to see how efficient scheduling is and how available I am. The quality control is important."
Another way physicians can evaluate patients' experience using telemedicine is simple: Just ask them. Dr. Campbell has found patients are upfront when it comes to discussing how scheduling and the visit itself went.
He's also found that patients are largely satisfied with telehealth visits. Before the pandemic, he conducted a study in which postoperative patients were randomly assigned to in-office or virtual visits. Both groups scored the same on the Hospital Consumer Assessment of Healthcare Providers and Systems — but the virtual visitors "saved a significant amount of time," Dr. Campbell said.
'Use the technology you have'
Not all orthopedic specialists will have access to the kind of technology and resources available at NYU Langone, but they can still successfully conduct virtual visits, according to Dr. Campbell.
"Right now, at least during the pandemic, [physicians] can use multiple different video softwares to do virtual visits — you don't need a big, expensive or integrated health record system. Use the technology you have available," he said.
Dr. Campbell also advised new telehealth adopters to ensure staff is "well-versed in walking the patient through any potential hiccups."
With these quality assurance measures, Dr. Campbell has had successful video visits with patients ages 18 through 80. He can guide patients through self-examination and recreate what he does in the office before actually having the patient come in for treatment.
Augmenting the office — not replacing
Beyond the pandemic, in-office visits will remain the "dominant way to see patients," Dr. Campbell said, explaining that orthopedics is a hands-on specialty. Telemedicine, however, is useful for follow-up visits, new patient appointments and patients who don't live nearby.
Dr. Campbell doesn't believe telemedicine damages the patient relationship, especially since it should only augment face-to-face orthopedic care. In fact, he said, it could put patients at ease in light of the pandemic and concerns about the spread of the new coronavirus.
Telehealth platforms can also help facilities maintain social distancing by giving providers scheduling flexibility. For instance, a surgeon could alternate in-office visits and telemedicine visits throughout the day to control patient flow.
While "telemedicine is here to stay," Dr. Campbell said, it's hard to pin down what insurance coverage will look like in the long run. He thinks patients will have some influence.
"Over the last six weeks, patients have been able to have the care that they need at their fingertips, within the comforts of their homes, offices or wherever they may be," he said. "I think patients will demand continued access to telemedicine."
Want to weigh in on orthopedic trends and news? Email Angie Stewart: email@example.com.