COVID Pandemic Forces Internal Changes and Fruitful Discoveries
By Danesh Mazloomdoost, MD
Sometimes, a radical change forces internal changes and fruitful discoveries. My team has been scrambling to maintain continuity of care with our patients ever since the Covid-19 closure of electives outpatient services. I commend my team in rallying to organize the infrastructure necessary for remote management of our entire patient population.
In a very short timeframe, my team evaluated and identified a platform to conduct telemedicine visits. They collaborated in developing new workflows that used staff in creative ways to streamline the clinical encounter. We overcame the knowledge and technological barriers many of our patients face by using medical assistance to coach the patients into the virtual visits and created a handoff system by which staff can message each other as patients transition through different components of the visit.
We had to be creative in how we do our physical exams and assessments and develop internal processes to prioritize and manage the pending orders that needed to remain in a holding pattern. Our team developed guidelines and policies to evaluate the need for urgent procedures, when imperative, to help patients maintain their activities of daily living, all while still complying with personal safety measures required for Covid-19.
Historically, healthcare has treated patients by prescribing medications, ordering tests, consulting, or conducting procedures. Behavior change and coaching have remained among the most difficult challenges yet may also be among the most effective in managing chronic conditions and preventing acute problems. Having engaged with patients in their own home, the relationship we have with them has changed, becoming more personal and connected.
This integration has prompted our team to deconstruct the clinical encounter and reevaluate it for the touch points that truly have meaningful value to our patients’ health. So much of what we do in healthcare is mired in convention and tradition, we often overlook the ontology or the “why”of how we do things. Vital signs have tremendous value in the acute setting but are only snapshots that have little meaning in the chronic setting until patterns start to emerge. Thanks to this disruption, the Wellward team is starting to rethink how we can be even more effective by using technology that helps us coach in real time rather than relying on monthly check ins.
As difficult as this time has been for our nation, I believe good can come of it by forcing each of us to introspect as the world seemingly takes a timeout. As much change that has evolved professionally in a very short amount of time, I know that our Wellward team has also rallied and re-prioritized in a very positive evolution. I am hopeful that as we return to a somewhat normal Covid-exposed world, our renewed mindfulness will continue to spur growth and innovation.