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HEALTHCARE JOURNAL OF BATON ROUGE  I  JUL / AUG 2020 35 was the variability in insurance coverage for the services. However, once the need to keep people at home as much as pos- sible took effect, the insurers got on board and covered the services offered. Patient demand for these services has obviously increased dramatically to avoid unneeded trips out of the house,” he explained. The story is much the same at Southeast Community Health Systems, according to Dr. Carol Patin, Chief Medical Officer. “Although we had been talking about starting telemedicine visits for over a year, the COVID-19 pandemic was the impetus to expedite the plan and implement the program. We quickly recognized that our patients still needed us, despite the gov- ernment-recommended restrictions,” said Dr. Patin. Preparing for Adoption In the pre-COVID-19 AMA study, physi- cians cited a number of reasons for being hesitant about adopting and implement- ing telehealth services in their practices: fraud, policy, cost, and continuity of care, to name a few. But perhaps the biggest concern among physicians was the need to ensure the delivery of quality care, and in the midst of the pandemic, this concern remained the most pressing at Red Stick Pediatrics. “As we first rolled it out, I think every- one’s main concerns were around making sure we could deliver a high level of care without the in-person visit,” explained Dr. Sanches. “The only reservation I had was wheth- er this type of care would be accepted by patients, and whether we would be able to adequately diagnose patients’ medical conditions,” agreed Dr. Patin. To ensure the quality of care remained high, Dr. Patin explained that Southeast Community Health Systems planned the adoption and implementation process very carefully. “We followed several steps, beginning with researching the telemedicine plat- forms that would be suitable for our pa- tients’ needs, and implementing rules that would distinguish what conditions could be handled via telehealth, and which ones required in-person visits,” said Dr. Patin. “Then we developed policies, procedures, and protocols for notifying, educating, and training both the staff and the patients on how to use telemedicine.” With those steps in place, said Dr. Pa- tin, ancillary programs like Elevate were enlisted to aid in communication efforts, compliance consents were developed, and the process for performing the telehealth visits was mapped out. “With that done, we tested the system and corrected any issues, and then we scheduled our first patients,” she said. The Patient Response Patient response to telehealth has been largely positive, according to both Dr. Sanches and Dr. Patin, although use of the technology has revealed some challenges. Explained Dr. Sanches, “At first, during all of the initial unknowns and fears, I think our patients were just happy to have the access without coming in. However, some of the early visits also showed us some of the limitations of telehealth, and reminded us why sometimes you need an in-office visit. For certain visit types, it has contin- ued to be a convenient and useful tool.” Dr. Patin noted that at Southeast Com- munity Health Systems, approximately 75 percent of current visits are conducted via telehealth, including tele-dentistry and tele-behavioral health. “From all accounts, patients love the system,” she said. “They cite reasons that include not having to wait weeks or months for appointments, not having to spend time in traffic getting to appoint- ments, and being able to have appoint- ments while dressed in pajamas. I have also been told that the encounters between providers and patients feel more personal, and they feel like we really care.” She added, “The rare patients who pre- fer in-person appointments are ones who have difficulty understanding how to con- nect to the system or who do not have in- ternet/proper equipment to connect.” Dr. Sanches agreed, “The biggest chal- lenges we faced were on the patient tech- nology side. Not all families had access to devices that worked well with the Elec- tronic Medical Record (EMR) platform.” The Future of Telehealth Due in large part to the COVID-19 pan- demic, telehealth has become an essential part of the modern healthcare landscape, and both Dr. Sanches and Dr. Patin have advice for their fellow physicians who may be considering telehealth adoption. “Overall, I would encourage them to pursue it,”said Dr. Sanches, adding, “Make sure you understand the technology needs for your EMR and for your patients. Make sure to think about what types of visits would work best for telehealth and how it might work best to schedule these visits during your workday, and make sure you know how to properly docu- ment and bill for the services.” “My advice would be to do your home- work, get a head start, and continue to modify your program as patients’ needs change,” said Dr. Patin. “To those who plan on practicing for the foreseeable future, telemedicine is here to stay. Start planning now for your patients’ future.” n Stewart T. Gordon, MD, FAAP Chief Medical Officer, Medical Affairs Louisiana Healthcare Connections “To those who plan on practicing for the foreseeable future, telemedicine is here to stay. Start planning now for your patients’ future.” – Carol Patin, MD