HJNO May/Jun 2020

HEALTHCARE JOURNAL OF NEW ORLEANS  I  MAY / JUN 2020 51 Aaron Martin, MD, MPH Telemedicine Medical Director Children’s Hospital New Orleans WITH stay at home orders in place, and state mandates to postpone non-urgent procedures and visits in the healthcare setting, operations at healthcare facilities across the country have been affected, in- cluding here in southeast Louisiana. But that doesn’t mean we can just hit the pause button. Just the opposite, in fact. In the midst of COVID-19, clinicians have had to rethink how we see patients. The challenge… how to allow for a con- tinuum of care while minimizing risk of exposure to COVID-19 for our pediatric patients, families, and teammembers. The solution… a vastly expanded virtual care platform that allows pediatricians and specialists to see their patients without go- ing into the hospital or clinic. In the face of the COVID-19 pandemic, with fear and uncertainty running high among families, virtual care allows families to continue to seek care from their own trusted clinicians. Prior to COVID-19 we saw approxi- mately 250 virtual visits per month, main- ly in specialty care and behavioral/mental health. Throughout the pandemic, we have averaged more than 300 patients per day, with many of these now being primary care visits in addition to all specialties. Virtual care has allowed clinicians to continue to care for the multitude of on- going health needs of children that aren’t coronavirus related, including routine care. For pediatric patients who are expe- riencing COVID-19-like symptoms, virtual care allows for the ability to safely triage patients fromhome, and then if needed, di- rect them to the most appropriate place to be seen in person, with as little communi- ty contact as possible. Pediatric clinicians can also screen over the phone and deter- mine what level of care is needed. Adapting quickly to continue to care for kids In response to the COVID-19 pandemic, clinicians and ambulatory leaders quickly adapted to continue caring for children with a vastly expanded virtual care plat- form. Almost overnight, we trained and en- rolled over 150 new clinicians and support staff to see patients via virtual care, repre- senting more than 20 pediatric specialties and primary care. In the first week follow- ing the COVID-19 outbreak in our com- munity, we saw a 2,000 percent increase in virtual care visits compared to before the pandemic began, and that number contin- ues to rise. Creative applications of virtual care have been developed for multidisciplinary care, including a monthly spina bifida clin- ic which integrates clinicians from PM&R, urology, psychology, orthopedics, and neurosurgery all in one clinic, now done virtually. We now have several of these multidisciplinary virtual clinics to con- tinue to see patients with complex condi- tions who live throughout the state, and otherwise would have had to travel from far reaches of Louisiana or the Mississippi Gulf Coast to receive the ongoing care they need. Converting scheduled in-person clin- ic visits to virtual care has allowed for a continuum of care, while eliminating the risk of exposure for our team members, patients, and families, and conserving precious Personal Protective Equipment (PPE). The same technology has also been adapted for use in the inpatient psychiatric and intensive care setting, bringing care to the patient’s room via video technolo- gy, without unnecessarily exposing clini- cians or patients to the possible spread of COVID-19. It is powerful to hear fromfamilies about their positive experiences connecting with their trusted clinicians throughout this pandemic, and not having to rely on tem- porary solutions for care, such as urgent care centers or commercial virtual care services. Realtime feedback from families has been excellent, with one parent noting, “As a parent of a cardiac patient, I found that the virtual care and telemedicine during these times is an exceptional way to communicate with his cardiologist. The process was very easy and parent friendly. It gave me a sense of relief and made my heart feel at ease.” As we continue to grow virtual care in the midst of COVID-19, this is undoubtedly transforming the way we practice medi- cine now and into the future—meeting our patients and families where they are, and enhancing the quality of care we can pro- vide. n Dr. Aaron Martin is an associate professor of urology, health policy, and systems manage- ment at LSU Health New Orleans, and prac- tices pediatric urology at Children’s Hospital New Orleans, where he also serves as tele- medicine medical director. His research in- terests focus on the intersection of medicine, technology, and healthcare delivery, with sev- eral projects involving telemedicine and sur- gical device innovation.