It’s midafternoon and Alycia Walty, MD, pediatrician and Chief Medical Officer of Star Wellness, is trying to look up the nose of a four-year-old. Dr. Walty is in her office, and the patient is at home with his mom. How does this work? A flashlight helps. A smartphone is essential. So is plenty of patience with little kids. But the whole encounter is made possible by Microsoft Teams, the digital collaboration service in Microsoft 365. Eventually, Dr. Walty makes her diagnosis: a common cold, not COVID-19. The visit ends with a very thankful and relieved mom.
“Scheduling a virtual visit for a mom who would have taken a day off to bring her four-year-old to the doctor is a whole new paradigm of efficient care. Thanks to Teams, it’s part of the future at St. Luke’s.”
James Balshi, MD, Chief Medical Information Officer, St. Luke’s University Health Network
“None of the several hundred staff and providers at our clinic were trained in virtual visits, and we were hesitant,” says Dr. Walty. “But then COVID-19 arrived. In those first unsettling weeks, Microsoft Teams rapidly became the foundation of our practice. We went from 0 virtual visits to 800 in seven days. So far, we have had more than 11,000 encounters. That’s 11,000 opportunities to care for our patients who couldn’t come to the clinic. As a practitioner, I can’t tell you how much this means.”
Helping clinics recover with a new treatment paradigm
The story of Star Wellness, a group of clinics affiliated with St. Luke’s University Health Network, reflects a common experience for all 400 outpatient offices throughout the network. St. Luke’s delivers services at 12 hospitals and nearly 400 sites in Pennsylvania and New Jersey. When COVID-19 arrived, leadership worried about patients going without care and the business ramifications of empty waiting rooms. St. Luke’s was determined to recover health services—and keep patients and providers safe. Luckily, the network had already deployed Microsoft 365.
“We recognized immediately that Teams was a fantastic audio/visual solution, and that extending it to patients would help us respond to COVID-19,” says James Balshi, MD, Chief Medical Information Officer at St. Luke’s University Health Network. “The stumbling block was that we hadn’t rolled out Teams to our providers. We had this great tool in our hands. We had a health crisis going on. The government had removed restrictions around telehealth and opened the door for innovation. We had no time to lose.”
Over three days, IT staff told doctors how to download Teams. They ran nonstop training with staff on setting up appointments using the Bookings app in Teams and showing patients how to click on the Teams meeting invitation in their email to start a virtual visit. On a Monday, virtual visits were a complete unknown at St. Luke’s. By that Thursday, 1,400 providers and 500 office staff at 400 locations were ready to care for their patients. From mid-March to May, more than 135,000 virtual visits were conducted in Teams.
Reinventing the old-fashioned house call with virtual visits
In those first few months, Balshi and his colleagues discovered something. “Both patients and providers realized this virtual care paradigm is actually pretty good,” he says. “My father was a physician and he used to tell me, ‘I’ve been to every one of these houses in South Bethlehem, making house calls.’ With virtual visits, we’re rediscovering what’s good about those house calls, how it reduces the hierarchy—if you have a problem, you come to me. We are rediscovering the intimacy of chatting with patients in their home, and it’s enriching our relationships with them.”
Given our internet-enabled world, virtual visits often include family members, another extension of the old-fashioned way of practicing medicine where one family had one doctor. For Dr. Balshi, a vascular surgeon with many elderly patients, the virtual visit often brings in sons and daughters from across the United States. “I talk to the patient about the risks and alternatives to vascular treatments; there’s lots of instructions and discussions,” says Dr. Balshi. “It’s often not just the patient and the practitioner that are impacted by the decisions that have to be made. With Teams and virtual visits, I can bring the family together, so they can support each other. It’s very gratifying to see.”
So far, patients have been universally responsive to the new treatment paradigm, with a common thread of gratitude and relief that they can continue to receive care during the concerns of the COVID-19 crisis. Many of Dr. Walty’s virtual visits are with parents who are worried about their children. Through a virtual visit, Dr. Walty can ask screening questions, perform a visual assessment, and quickly provide assurance.
“I was talking with a mother of four children, and her father was in the hospital with COVID-19,” she says. “The mother had recovered from COVID-19, and she was very anxious to know if her children were also infected. We talked with them, one by one. At the same time, the mother was taking calls from the hospital to coordinate how she could donate plasma for her father. This meant I had to stop the meeting and call back several times. But it all worked in Teams. Being able to complete three or four visits with the family, assuring the mother that her kids were healthy, enabling her to make plans with the hospital about her father—it was so satisfying as a practitioner to be able to help that way.”
Reimagining virtual care to build convenience into the patient experience
The past few months have demonstrated, patient by patient, that virtual visits are a convenient way to rekindle some aspects of medicine with a twenty-first-century flavor. For many patients, and doctors, the convenience factor is a huge advantage, and practitioners can see long-term benefits of incorporating virtual care into their practices. “Many of our patients have a hard time finding transport to the clinic,” says Dr. Walty. “And for patients with mental health issues, it can be daunting to navigate public transit and sit in the waiting room. We can use virtual visits to see more patients more frequently, especially if it’s a follow-up call or we just want to maintain communication with someone we’re worried about. The ability to connect quickly is a definite advantage for practitioners.”
Virtual visits are also a boon for patients with chronic health issues who must visit their care providers frequently. Kathleen Simak is winning her battle with lymphedema thanks to successful bariatric surgery a year ago, but she still meets with her dietitian, Lauren Myhren, RD, LDN at St. Luke’s Weight Management Center. Thanks to Teams, Simak continued her weight-loss program right through the COVID-19 crisis.
“Kathleen is doing amazing,” says Myhren. “And the virtual visits have been helpful because we can look at food labels together, see what’s in her pantry, and go over her vitamins. It feels great to walk along the journey with her through the virtual visits.”
“The virtual visits with Microsoft Teams are very easy,” says Simak. “You join, put your name in, and boom, you’re on. I look forward to my monthly virtual visit to meet with the dietitians and the whole bariatric team. I feel like I’ve won something, and I’m staying on track.”
Dr. Balshi is convinced virtual visits are destined to be a permanent facet of care at St. Luke’s. The benefits of the new method—the ability to scale visits with care specialists to many patients, the immediacy of care that’s just a click away—solve some of the pressures in healthcare today. “Imagine our toxicologists, who deal with poisoning across our 11 emergency rooms, being available immediately on a virtual visit in Teams to help a patient who’s swallowed an unknown substance and is entering cardiac arrest,” says Dr. Balshi.
With the initial rush of COVID-19 patients behind them, Dr. Balshi and the St. Luke’s leadership team have more time to evaluate how to incorporate Teams and virtual care into the network’s future. They had already vetted the solution from a security standpoint so it could be used during the health crisis. “We are very security oriented, and our Chief of Security is passionate about keeping things by the book,” says Dr. Balshi. “We’ve never had a security breach in Teams, and we are in the process of converting our entire security infrastructure to the Microsoft security stack.”
As St. Luke’s reimagines digital health in a patient-centric model, it’s introducing a new concept called Connected Care. “We have a plan going forward to engage our patients at every touchpoint with St. Luke’s in the virtual space,” says Dr. Balshi. “It’s designed to get them over the initial hurdles: How do I download this app? How do I use this device? Our experience with COVID-19 has thrown many challenges our way. As we go about solving them, we discover new ways to improve the patient experience. Scheduling a virtual visit for a mom who would have taken a day off to bring her four-year-old to the doctor is a whole new paradigm of efficient care. Thanks to Teams, it’s part of the future at St. Luke’s.”
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Learn more about St. Luke’s University Health Network in the St. Luke’s virtual command center story and St. Luke’s Microsoft 365 story.
“Microsoft Teams rapidly became the foundation of our practice. We went from 0 virtual visits to 800 in seven days. So far, we have had more than 11,000 encounters. That’s 11,000 opportunities to care for our patients who couldn’t come to the clinic. As a practitioner, I can’t tell you how much this means.”
Alycia Walty, MD, Chief Medical Officer, Star Wellness
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