Using Telemedicine to Maintain Patient Care

Integrating telemedicine was already underway for the medical team at Samaritan. Then the arrival of the novel coronavirus known as COVID-19 early in 2020 accelerated the urgent need for a working telehealth system.

In March 2020, Samaritan rolled out MedPod, a live, cloud-based, two-way tele-video communications “ecosystem” that uses cutting-edge infrastructure to connect physicians and patients. MedPod integrates live-streaming of HD audio/video over a 265-bit encrypted network and offers the functions of e-prescriptions, real-time collaboration with patient care team and more.

“It’s a computer-based software that allows us to contact patients securely and gives us privacy,” says Stephen Goldfine, MD, DABFP, CAQGM, DABHP, Chief Medical Officer, Samaritan. Patients receives a URL link that routs their call and queues them in a virtual “waiting room” before they connect with their physician via a highly secure and HIPAA-compliant video call.

MedPod’s software and network can be utilized on both broadband and mobile networks, meaning patients can connect on a computer, smart phone or tablet. And it allows for easy benefit eligibility verification and payment processing. “We are making sure our teams are reimbursed fairly for the hard work they are doing for patients, and we’ve been open and honest with patients as well – they deserve that clarity,” says Dr. Goldfine.

In fact, the adaptability of patients to MedPod and the idea of telemedicine in general has been pleasantly surprising for Dr. Goldfine. “It’s been eye-opening to see how adaptable our patients and their families are,” he says. And while nothing compares to embracing a patient or speaking with them in person, the benefits of telemedicine have been striking.

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How to Help Patients Prepare for a Telemedicine Consultation

Dr. Goldfine offers a few tips to help patients make the most of their virtual appointment:

• Make sure patients know the tools they need for their remote consultation – they’ll need a strong internet connection, and decide whether they are going to use a tablet, smartphone or personal computer with a web camera.
• While the “new normal” has made video call interruptions by dogs, cats and children common occurrences, patients should sit in a quiet room free of interruptions or distractions.
• Patients should prepare for a telemedicine visit as they would for an office visit – ready any insurance information, identify questions beforehand and be prepared to talk about goals. telemedicine visits are as important as patients want them to be, Dr. Goldfine says.

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“A lot of what we do in palliative care is communication – we’re discussing goals and prognoses. The physical component is important too, but the conversations we have are key. Telemedicine keeps us working on those relationships with patients,” Dr. Goldfine says. “We’ve been keeping appointments and seeing less cancellations. In our palliative medicine clinic, we see very sick cancer patients usually. On the morning of their appointment, they might be vomiting or just can’t get out of bed that day and have to cancel. But with a telehealth appointment, we’re seeing them in their home environment, in their most honest and natural state.”

Now, he says, the impetus is on the medical community not to de-value the importance of telemedicine. “I put the same energy and effort into a telemedicine meeting as I would if I were meeting a patient in person,” Dr. Goldfine says. And he urges physicians not to discount patients’ ability to use telemedicine software like MedPod simply because they are older. “I hear this all the time, the medical community worrying that an older person can’t participate in the conversation,” he says. “This older generation can actively participate and do an excellent job. I’ve seen it.”

As the restrictions and safety precautions put in place because of the COVID-19 pandemic change, Dr. Goldfine and the Samaritan team hope to integrate telemedicine appointments as they begin to see patients in person too. “This will all be determined by the crisis as it changes day to day,” Dr. Goldfine cautions. “But we are hoping to manage our appointments in a robust way. I’m guessing we will have a 50-50 split of telemedicine and in-person appointments, and that will be determined by patient preference, the amount of co-morbidities and health concerns facing each patient, and more.”

Dr. Goldfine is also looking to the hardware and devices MedPod produces, which allow patients to test or monitor themselves and upload the data for physicians to review. “Right now, we’re using the software for the visual component, but as the technology develops, we may be able to provide routine physical exams remotely as well,” he says. He’s also thinking how telemedicine can impact Samaritan’s geographic reach. “There are spots in the country where there are no palliative providers and palliative care does not yet have the value or importance it sees in New Jersey. It’s an exciting moment, and Samaritan hopes to be part of that.”