From Zoom seders to online AA meetings and digital dance parties, in the age of COVID-19 we’re relying on technology more than we ever did before (and we relied on it a lot before). Now, patients at Fenway Health can add individual and some group appointments to their digital to-do list, as we’ve implemented telehealth visits to continue providing safe, easy, convenient, and confidential care as the coronavirus quarantine grinds on.
The technology will enable any Fenway Health patient with a smartphone, tablet, or computer with video/audio capabilities and a stable internet connection to schedule an appointment to see their clinician from the safety of their own home. Both patient and healthcare provider will be able to see and hear one another, as with a traditional office visit. The healthcare provider will assess the patient’s condition and make recommendations for ongoing care. Behavioral health patients will be able to access individual therapy, group therapy, and psychiatry services.
We have prepared a complete tutorial for setting up, logging on, and what to expect at a telehealth appointment.
To be clear, telehealth, also referred to as telemedicine, is not a new concept or practice. It has been a boon to rural communities over the past decade and is regularly used by specialists to consult remotely with patients and colleagues. And with encouragement from the White House, including loosening restrictions on Medicare and Medicaid coverage and the use of mobile devices for virtual appointments, the use of telehealth has skyrocketed over the past month.
Prior to the COVID-19 crisis, the technology wasn’t widely used at Fenway Health beyond follow up phone calls in the behavioral health, medical, optometry, and dental departments. But the need to continue seeing patients while also practicing social distancing was too urgent to just do nothing.
“Typically, it takes many months or up to a year for an organization to implement a telemedicine program,” said Chris Grasso, Fenway Health’s Associate Vice President for Informatics and Data Services, who oversaw the implementation of Fenway’s new telehealth program which was completed in just two weeks’ time. “To go from zero to one-hundred pretty quickly is really the most impressive part of this process.”
In fact, Fenway Health had wanted to do telehealth for years. About five years ago, the organization sought grant funding to implement a program but was not funded. Nonetheless, Grasso continued to conceptualize implementing telehealth at the center. In January, the organization revisited the prospect again in an administrative meeting where Grasso and others discussed rolling out video telehealth in one of its public health sites—like AIDS Action, for example.
But COVID-19 forced a quick change of direction and scale, and Grasso was ready.
“When I got the call to action, it was pretty easy for me to move with it quickly, just because I’ve been thinking about it for so long,” said Grasso.
She had plenty of help, too. Grasso credited the collaboration of staff members across the organization for making the speedy implementation of telehealth happen, from grant writers who quickly wrote proposals to secure funding from Liberty Mutual and Biogen, to Grasso’s informatics team, the IT department, patient services, finance, the compliance group, and countless others.
“I’ve been here for 17 years, I’ve implemented a lot of projects here, and I have to say that this is the one that I think Fenway Health should be incredibly proud of because it really has been an inter-departmental collaboration,” said Grasso. “It really brought out the best of the organization in terms of us being collaborative, decisive, and nimble.
“That speaks volumes to me about the organization and the commitment of my colleagues to our patients and our community,” she added. “They saw a need and a gap and wanted to get the service set up as quickly as possible so that we can provide the best possible care.”
Of course, that includes quality control of the new service. Grasso and her team will review documentation from the visits to ensure it complies with Fenway policy, that the correct information is being collected in telehealth visits, and that documentation is completed in a timely manner. Fenway Health will also analyze data around who is using the service, who is keeping appointments and who isn’t in order to identify gaps in their service delivery.
“We’ll really dig into the data and analyze it and ensure that we’re meeting patients’ needs,” Grasso said. “For instance, are we seeing difference in our diabetic population? Are they actually improving in their health outcomes or worsening? We’ll look at all sorts of different areas to assess the outcome of the technology.”
Grasso is hopeful that, absent our current public health crisis, the federal government will maintain the rule changes around insurer reimbursement that have allowed telehealth to flourish at this time, so that it will become a sustainable option for patients to access healthcare. Telehealth, she said, is a potential game changer for people who have challenges getting out to a brick-and-mortar healthcare facility. That’s why she’s been thinking about and working toward this moment for the last five years; telehealth eliminates a big healthcare barrier for people in need.
“We sometimes forget that it could be costly for somebody to get to one of our locations. Maybe their work hours don’t align exactly with the hours that we’re open, but they could potentially do a video visit,” said Grasso. “Think about our younger populations, who like services delivered differently than other generations. We have many patients who travel far to access our services, like our trans and gender-diverse youth, who could potentially benefit from eliminating the barrier to travel to one of our locations of care. There’s really just so many innovative opportunities and we’ve only seen the tip of the iceberg. For me, it was always about using technology to improve care and remove barriers for patients.”
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