By Lisa Cesarano
As seen in the September 2020 Issue of Advancing Care.
When COVID-19 began to spread in the U.S. in early 2020, healthcare organizations nationwide faced a multifaceted challenge: to safely continue routine patient care, address the complex needs of COVID-19 patients and quickly develop infection testing programs on a scale never seen before.
As New York State became an epicenter of COVID-19, WMCHealth responded to protect our community’s health with a strategy to create robust telemedicine options and to open COVID-19 testing programs across the Hudson Valley.
Moving Quickly to Telemedicine Visits for Safety and Convenience
With COVID-19 cases on the increase, by mid-March, New York State determined that medical practices could not see patients in-person for routine care needs until conditions improved. Healthcare organizations across the state — including WMCHealth — faced a daunting challenge: How to safely provide both routine and COVID-related care for patients in an unprecedented environment?
WMCHealth already had substantial experience and knowledge in using telemedicine in emergency settings. So, as COVID-19 spread, the Network was able to leverage that experience to enable physicians and other providers to offer contactless and convenient ‘virtual’ care for patients who had non-urgent healthcare needs – while patients with urgent situations continued to receive care in emergency rooms with no delay.
“We ramped up our telemedicine capabilities immediately,” says Carol Karmen, MD, of WMCHealth Physicians Internal Medicine in Hawthorne. Patients were offered the option of a telephone visit or a video visit using a HIPAA-compliant app with video and messaging capability.
“We remained in constant contact with our patients and were able to follow them virtually, which was especially important for COVID-19 patients who required multiple follow-ups. My colleagues and I were able to remotely monitor people with a range of other conditions, including those who were concerned about leaving their homes at that time. While not everything can be done via phone or video, we were able to monitor conditions like diabetes, anxiety, skin infections and injuries from falls with telemedicine.”
Dr. Karmen credits the hard work and collaboration of clinical and administrative professionals across the WMCHealth Network in launching a practice-based telemedicine program that provided 18,000 telemedicine visits from the start of the pandemic through the re-opening of medical practices for routine inpatient visits. Telemedicine continues to be an option for patients.
“Now, many patients we first ‘met’ when they were diagnosed with coronavirus can come to the practice to be seen in-person. They say, ‘I recognize your voice,’” says Dr. Karmen. Reflecting on the experience, it was an emotional time for Dr. Karmen and her colleagues, as well. “I can still see many of their faces, images of them at home,” says Dr. Karmen. “Many were isolated, as they didn’t want to infect their families. I was so happy to see them get better.”
Forward-Thinking Advancements. Here.
WMCHealth’s ability to ramp up a telemedicine service for patients of the Network’s medical practices has been based upon deep experience in telehealth in different settings. In 2015, the Network launched a leading-edge telemedicine program to improve healthcare outcomes in New York’s 6,200-square-mile Hudson Valley region.
“We had established well-developed, specialized practices in TeleICU, TeleTrauma and TeleStroke care, as well as Mobile ICU in transfer in our ambulances,” says Corey Scurlock, MD, MBA, Director of eHealth at WMCHealth. “So, thanks to the forward-thinking and vision of our leadership, when COVID-19 came, we already had experience within the organization to scale up in a different setting.”
For example, iPad stands for telemedicine were set up in the room of each COVID-19 patient. This HIPAA-compliant, audio-visual platform enabled nurses and doctors to communicate with patients. “If a patient had a request, a nurse could enter the room just once, which reduced both their exposure and use of Personal Protective Equipment,” explains Dr. Scurlock. “Since visits were not permitted due to the risk of infection, our communications team also helped to facilitate family discussions and updates.”
Telemedicine also played a part in urgent care. “We expected to see many sick patients very quickly, so we looked at ways to create redundancies and to strengthen our teams,” says Dr. Scurlock. “To do this, we leveraged our telemedicine platform to link our Emergency Departments in Poughkeepsie, Kingston and Valhalla, so they could cover for each other, as needed.”
Comprehensive Testing Services
Another major component to WMCHealth’s response to the pandemic has been the creation of a large-scale testing program deployed at multiple sites at, or near, its hospital campuses across the Hudson Valley, including the Westchester County Center in White Plains.
Initially, COVID-19 diagnostic testing was offered, followed by the addition of antibody testing options. From March to mid-summer, 58,034 COVID-19 diagnostic tests and 17,891 antibody tests had been completed at sites across the region. Antibody test specimens are processed by Westchester Medical Center’s on-site, board-certified clinical and anatomic laboratory services.
“The big win is that we were able to set up testing very quickly and very early. This enabled us to test people from all over the tri-state area, as testing was not widely available in the earlier days of the pandemic,” says Anthony Costello, Senior Vice President and Chief Operating Officer.
“Many patients who tested positive were sick and did not have a primary care doctor. They were very frightened,” says Dr. Karmen. “Some went straight to the emergency room, while others made appointments with our physicians and were able to see them quickly using telemedicine.”
Dr. Scurlock adds, “COVID has shown us that telemedicine can be done safely and effectively, while reducing potential exposures and offering access and convenience to our patients.”
COVID-19 TESTING TODAY @ WMCHEALTH
WMCHealth continues to offer COVID-19 diagnostic and antibody testing by appointment to the community at large, and its patients, at multiple sites across the region. Community members can request a diagnostic or antibody test online via: wmchealth.org/testing or call the COVID Call Center at 914.202.4530.
Visit us at Westchester Medical Center, a member of Westchester Medical Center Health Network, to learn more. Advancing Care. Here.