AMGA CMO Council: Managing Telehealth Workflows

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Discussion Summary
May 26, 2020

This summary is based on a discussion via AMGA’s Chief Medical Officer/Medical Director Council listserv as of May 26, 2020. For more information about the CMO Council, please click here.
 
Question: When technical problems lead to delays in the middle of a busy schedule, how do you avoid snowballing and minimize frustration for/communicate with subsequent patients?

  • Support staff prep the patient before the call. As part of this, there are two common approaches:
    • As part of the prep, support staff tell patients they can expect to hear from the physician between two times of day (same basic idea of when you have the cable guy or a handyman show up). This way, there isn’t any pressure to make the call at a specific time and since patients are usually home anyway, it has been well received.
    • Alternatively, some are doing video visits in the same slots folks typically have on their usual schedules.
  • During the visit itself, medical assistants "room" the patients and walk them through the technical steps to ensure a successful visit. (In a worst-case scenario, folks know to carry the visit via phone.) Try to allow the clinicians to do the usual “rooming” steps (health history, mediation reconciliation, help patient take their own vitals, etc.) and let staff do the other work (load the template, call patients after the visit to schedule follow-up, orders, etc.). Some of the usual steps for the clinicians are taking longer than when done in-person.
  • The biggest issue is patients trying to do a virtual visit while driving. The workaround to this is telling patients they must be in a safe environment for this visit to take place and we will not continue with a call if it appears that a patient is driving.
  • There has been a definite learning curve for medical assistants, staff, and clinicians to get comfortable with all the steps. Many assume it takes a couple of visits before most patients are comfortable with the tech. As telehealth visits have become more widespread, the number of problems, technical or other, have diminished.
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