S04 E03: Telehealth and Teams

In this teamBIT, Morgan reflects on using telehealth - it is here to stay in primary care.

If you are interested, think about using telehealth for case conferencing.

Ask members of your team if anyone has an interesting in doing a virtual group visit - an educational session - for your practice. This is a good way to engage more peripheral team members who are part of your primary care network and maybe not co-located.

Creators & Guests

Host

Morgan Price

What is Team Up! Team-based primary and community care in action?

A podcast that brings together primary care providers, healthcare planners, patients, innovators and others to talk about the changes that are happening in primary care in British Columbia.

Morgan: Do you use
telehealth in your practice?

Do you use telehealth in your primary
care office, but think it could be

used better across your whole team?

Yeah, me too.

Covid.

I mean, among other things, it was the
dawn of, widespread primary care, te.

Of course, we were doing remote
care and telehealth before covid.

But in March, 2020, so many people
pivoted to a large percentage of

telehealth and that's here to stay.

You may have heard my story about how
I immediately ordered iPads and got

bamboo duct tape bubblegum and ethernet
cabling to MacGyver up a telehealth kiosk

and set them up in all the shelters in
supportive housing units in Victoria.

We still use it now, of
course, in various hybrid

models of practice telehealth.

That is, and I'm still using
that very first MacGyver kiosk

every week in my practice.

So what exactly is telehealth?

Well, for me, simply put, it's the use
of technology to connect with patients

and healthcare providers in real time so
they don't have to be in the same room.

That can be through video conferencing.

A lot of us are using phone calls.

Uh, some people are using some,
some realtime text messaging.

I like to think about it being real time.

So then I put things like portals
and other asynchronous communication

to, its sort of different categories
and telehealth for me being more that

real time synchronous aspects of care.

So that's what I'm gonna
focus on in this episode.

And there's lots of benefits to.

The big one that we talk
about a lot is access.

So first, telehealth can improve
access to the care for patients.

And it's particularly true for
patients who can't come into

the office due to distance.

They may live rural or in an
underserved area, and so by using

telehealth you can connect and the
whole team can connect with that.

for people who are unwell, have
chronic illnesses that can't get in,

or they're too busy for family and work
commitments to get in due to travel,

waiting in the waiting room, et cetera.

That provides a different level
of access through telehealth.

One of the other, , advantages
is kind of the reverse.

As a provider, you get access to a
different view into that person's life

sometimes, and sometimes virtual visits.

You see where they're.

You can see where they live and if
they're on mobile, you can actually get

them to give you a bit of a 360 tour.

They can pan the camera around and you
can get to see their place a little bit,

and that gives you a kind of an insight
into , their life and their family that's

different than what you get at the office.

And so there's, there's a
different kind of access there,

which I think is really interest.

The next benefit is team collaboration.

telehealth can help primary care
teams work more efficiently and

more collaboratively together.

And I know that sounds counterintuitive
because working side by side and

co-located is really important,
and I don't wanna diminish that.

But team members who aren't co-located
can use telehealth to do case reviews,

and care planning with the patient
and just between team members.

to share ideas and coordinate care
more easily when you don't have to

be in the same place for the visit.

You can, zoom in or connect in through
whatever video conferencing tool you have.

and that flexibility of not always
having to be in the same place for,

a case conference is really valuable.

so it's an augmentation in that way.

And I always say, you know, make
sure you've got pretty good audio

no matter where you are, so that
people don't get zoom fatigue.

The simplest thing is to, to
wear headphones, it can be huge.

It can be a, a really big benefit
to quickly bring somebody in.

And the third aspect of telehealth that
we don't often talk about, it can be a

very valuable tool for patient education
engagement is through virtual group visit.

So these can be virtual
classes or support groups.

Providers can help patients stay on top
of their typically chronic conditions.

And this helps with connecting to the
primary care team because while you

might write this off as too much work,
this is actually something that you

can do across the team really well.

And you might have one or two people
in your primary care team who are keen

to give this a try, any team member
can offer any kind of a visit that's

within their scope and interest.

So it's a great way to engage
different team members and even those

who are maybe not quite as closely
connected into the practice who might

have a little bit more capacity.

So pharmacists, nurses, social workers
who are part of a primary care network,

they might be able to host a group visit
and group visits can also be peer led as.

these group visits can be in person, of
course, but they can also be virtual.

I don't recommend doing a
hybrid where there's six people

in the room and two online.

I think if you're gonna do
this, do it one or the other.

But there's a huge advantage
to giving people access through

the virtual, connection.

If you are a nurse working in a primary
care team, group visits might be

things like chronic disease management.

A chronic pain management is another one.

Uh, if you're a pharmacist in
a team, medication management.

Medication education obviously
are, are common ones.

Smoking cessation would be a
natural as well as an office

assistant as part of the team.

Take an area of interest and, explore that
as a possible group visit if you want to.

stress management, uh, is something
that office assistants do really well.

if you have an interest in nutrition,
that might be something that you could do.

If there's no dietician to do that
or work with a dietician and co-lead.

. then patients as peers can definitely
be involved in any of those, as well

as leading a chronic illness support
group or a mental health support group.

And I think there's a lot of
different opportunities from

the mental health perspective.

Social workers, counselors can run a
whole series of virtual visits to engage

people in stress management, mindfulness,
there's just a ton of opportunities.

So with this team bit, you can think
about one concrete idea that might be, uh,

valuable and feasible in your practice.

most of us are doing one-on-one telehealth
right now, even if it's just phone calls.

So, up your virtual game a bit, offer
a bit more video, and then think about

how to share that across the team.

Pull in a team member and have a
virtual case conference with a.

, do that once or twice
and see how that works.

Or start , small with group
visits and plan a short series.

it doesn't have to be ongoing.

You can say, we're gonna run three
sessions on mindfulness, test the

waters and see how that works for you.

Thanks for tuning into
this episode of Team Up.

Join us next time when we explore
the third topic patient portals.

Until then, keep working together
and then keep building a stronger.