Memorial increases telehealth during pandemic


JASPER — He can’t use a stethoscope to listen to their hearts.

But when Dr. Adam Dawkins turns on his webcam and loads into telehealth appointments with his patients, he uses conversation and his observation skills to help people from afar.

“I’m trying to recreate a traditional visit in the office via this platform,” said Dawkins, a Memorial Hospital and Health Care Center cardiologist. “So, I do everything the same. I talk to them, I go over their problems, I go over their symptoms. We go over their meds, we go over their labs. We refer to all the old history that they’ve had, and then I try to do the best exam I can.”

Since launching the new, online programs about a month ago, 84% of Memorial’s medical practice management providers have been granted access to online appointments. Patients are still being seen in person, too, but provider offices have surpassed 1,000 online visits since remote operations began.

Amy McConnell, Memorial’s director of medical practice management, explained her role in leading the implementation of local telehealth. She recalled how once pandemic concerns began to rise in March, the administration knew they needed to offer a remote medicine service.

Six pilot providers were part of the initial launch on April 6. Fourteen more were added a week later, and the number of medical professionals who have access to the online software has since grown to nearly 60.

“It’s available in nearly all offices,” McConnell said in a Wednesday Zoom interview. “But some providers, for various reasons, are not up and running yet. But they will have access to do so.”

Memorial Counseling Center had used telehealth before the rollout, as did the hospital’s stroke program, in collaboration with the University of Louisville.

So, how do the virtual appointments work?

Patients first launch software that is compliant with privacy laws on their smartphones, tablets and computers. Behind cameras, they sit in virtual waiting rooms before their providers bring them into their online meetings.

Of course, physical touch is not an option in this environment. But Memorial’s medical professionals try to keep the visits as similar as possible to in-person appointments.

“Sometimes you can just sense something is wrong when you look at somebody you’ve known or taken care of for 10 or 15 years,” Dawkins said.

He explained that he has some patients who have urgent or acute needs that “are very difficult to assess over the phone or via telehealth,” such as an irregular heart rhythm, or symptoms that may need an EKG or hands-on evaluations, still come to see him in person in his office.

“But the majority of [the] time, we’re really trying to keep ... the impetus is to try to keep people safe and out of the potential fray of getting an infection,” he said. “So, the majority of the time, we’re doing telehealth visits, which is something like this [Zoom video call].”

While some of his patients have also communicated to him via old-school telephone calls, Dawkins said that the visual capabilities of telemedicine offer advantages, including being able to give partial exams, as well as being able to read his patients’ faces and bodies.

“I think, No. 1, our understanding of what the patient is meaning and trying to convey to us is easier,” he explained. “And it’s easier for me to understand what the patient is saying.”

Dr. Dean Beckman, a Memorial-affiliated internal medicine and pediatrics physician, told how his office, too, has begun utilizing telehealth.

Like Dawkins, he is also continuing to see patients in person who have acute needs — while directing those who have symptoms consistent with COVID-19 away from his office and to other facilities.

His staff is working to keep the space as safe as possible. Still, many patients who don’t have symptoms of the coronavirus have been scared to come into the office. That’s where telehealth has helped.

“Whether it’s just a checkup, they need medication, they’ve got questions,” Beckman said, listing off what can be addressed through telehealth. “Maybe even a lab result or a test result that we wanted to [discuss] face-to-face with them, we’ve been using that.”

Connectivity issues and technology apprehensiveness do present challenges for the online visits. But once the patients figure out how to work the software and embrace it, they enjoy the interaction, Dawkins said. Beckman agreed.

Melanie Powell, Memorial’s director of business development and marketing, said that she thinks providers will continue to offer telehealth services even after the coronavirus has dissipated. Telemedicine services had been part of Memorial’s strategic plan prior to the global virus outbreak, and their implementation was fast-tracked during the pandemic.

She stressed that Memorial is a safe place. But she also said that currently, some people feel very confident walking into a hospital or physician’s office, while others do not.

“I think life as we know it, after COVID, will be different,” Powell said. “And so this is a way where we can meet patients where they are.”

She continued: “And I think that the hospital has really done a good job of providing the flexibility to meet people where they are.”

Beckman and Dawkins also believe there is a future in local telehealth — especially for patients with who they are familiar with and have been examined previously. Beckman said the platform appeals to those who are tech-literate as well.

“I think there’s a niche for access for people that prefer this type of technology,” Beckman said. “And I think that will grant them access, and that’ll help us service people who ... are maybe a little intimidated coming in face-to-face. So, this might be a good way to break the ice or increase our access to patients who sometimes might be reluctant to come in to see us.”

According to McConnell, many in-person appointments were postponed due to the COVID-19 crisis, and now that Gov. Eric Holcomb has issued a reopening plan, some patients may be more willing to make those kinds of visits.

Telemedicine numbers have remained strong, however, and leadership believes requests for telemedicine will increase as patients learn of the option.

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