Anywhere Call

By SUZANNE BOYD


Anywhere Call

With the Jackson Clinic's VideoVisit, house calls are making a comeback as access to a primary care physician is as close as your smart phone, tablet or computer.

Jackson Clinic rolls out telehealth for wider, quicker reach

For patients of one West Tennessee Clinic, access to medical care can be as close as their phone, tablet or computer. At the end of May, the Jackson Clinic, launched its telehealth video visit program for its patients that, unlike some other programs, utilizes only local clinic physicians leading to better continuity of care for patients.

For Jackson Clinic patient, Amanda, the program could not have launched at a better time. She had injured her leg jet skiing and while there was no bruise it was sore. A few days later she noticed some swelling and redness in the area that was injured but thought it was just cellulitis. By the next weekend, the pain had worsened but she was at the river and nowhere near a clinic. On Sunday morning, she decided to cut her weekend short and head back to Jackson to go to Convenient Care when she remembered an ad on Facebook about the clinic's video visit program. At the very least, Amanda thought the online medical visit may prevent a trip to the clinic as well as the wait to be seen.

"Once I logged into my Follow My Health Account on my smartphone, I requested a video visit. The system notified me when the doctor was available, so I could do other things in the meantime rather than just sitting and waiting," said Amanda. "It was very professional. I could hear and see the doctor well despite fact that I don't always have the best cell reception at the river. I told her about my injury and issues from it, showed her the injured leg as well as the other one for comparison and even my assessment that it may be cellulitis which she confirmed. She gave me the option of having my prescription called into a pharmacy at the river or at home. I went with home and by the time I got back into town, it was ready. The whole experience took maybe 15 minutes out of my day and I never had to leave the house."

While having telemedicine as an option for care was something the Jackson Clinic had been investigating for some time, there were two main issues to offering the service to its patient base: cost and providers. "When we first started looking at vendors, not only could the cost of the technology required be hefty, most of the programs utilized a pool of providers that may or may not include our own so our patients may be seeing a physician outside the clinic for care. We knew this type of program could increase access to care while also decreasing costs, but it was important that we utilize our physician base so that quality and continuity of care would be maintained," said Amy Smith, Director of Business Operations for the Jackson Clinic. "When our patient portal Follow My Health added a telehealth component to its platform, it was the answer we were looking for. Not only was it cost-effective and did not require additional technology, but it also allowed us to use our own physicians.

Since there were no major changes or updates required in terms of technology or vendors, the project had a relatively short timeline for implementation. "The biggest elements that needed to be addressed were workflow and staffing. The staffing was simple since it only requires a doctor. It is primarily staffed by our convenient care providers. One exam room in our convenient care office is outfitted with a web camera for the program, but it is somewhat underutilized since many physicians can access this program from their home office," said Smith. "We piloted the program internally, first to streamline it for our needs, and discussed how best to market it in terms of what ways patients would utilize it."

Not all medical issues are suited for a video visit and it still does not ensure you will avoid a trip to the clinic. Telehealth is available to treat nonemergency situations such as sinus infections, colds, flu, pink eye, sore throat, mild allergic reactions, bladder or urinary tract infections, arthritis, minor cuts and burns. If a prescription is needed, it can be sent directly to the pharmacy of your choice. Video visits are held to the same privacy standards of a regular office visit. Telehealth Video Visits are not currently covered under many health insurance plans and the cost of $49 is payable online. If the provider is unable to treat the symptoms through Telehealth, the patient is asked to come into the clinic and the cost of the video visit is applied to their account.

"The Jackson Clinic has been the healthcare innovator in West Tennessee for decades: first Convenient Care walk-in clinic, first hospitalist program, first comprehensive electronic medical record. We have been studying telehealth for the past 5 years, and we know our patients want the service for its convenience. But we held back until we could get it right," said Mark Allen, Jackson Clinic CEO. "Users won't get a strange doctor in some distant state who doesn't know anything about the patient. Our telehealth service will be for Jackson Clinic patients, using a Jackson Clinic provider and supported with the patient's Jackson Clinic medical record. This provides the structure for a trusted, high-quality telehealth service."

"With the program staffed by clinic physicians and only available to established clinic patients, continuity in care can be improved because the doctor can access the patient's medical record and get a complete picture," said Smith. "While the advent of the internet has made patients more in touch with their own health and better educated as to how to speak with their doctor, the physician still has to be well-trained in asking right questions but not leading the patient. It is high touch medicine in a high-tech environment because the physician has to really listen to the patient to best ascertain what is going on."

The response to the program has been outstanding so far and Smith thinks they have only begun to scratch the surface of how it can be utilized. "We definitely want to expand access to the program," she said. "We are just starting to unlock the program's potential. Right now, we are only using it as an on-demand service, but we do plan to open it to clinical pharmacists, care coordinators, social workers, etc. as a way to help intervene in the lives of chronically sick or elderly patients to make sure they are being followed up on. We are really excited as to what this module can open up for us and what we can offer our patients."