WEBVTT 00:00:00.000 --> 00:00:12.180 Welcome, everybody, to today's edition of the Self Regional podcast, Medically Speaking. 00:00:12.180 --> 00:00:14.760 I'm excited to have today with us Graham Sullivan. 00:00:14.760 --> 00:00:17.680 Graham is the Director of Virtual Services for Self Regional Healthcare. 00:00:17.680 --> 00:00:24.080 We're going to be talking today about virtual services and telehealth and how telehealth 00:00:24.080 --> 00:00:28.640 is becoming more incorporated into medicine in general, what we're doing here in Greenwood 00:00:28.640 --> 00:00:33.820 and Self Regional and the communities that we serve to grow telehealth, and the services 00:00:33.820 --> 00:00:35.980 that we're able to provide with telehealth. 00:00:35.980 --> 00:00:37.820 So super excited to have you with us today, Graham. 00:00:37.820 --> 00:00:40.880 Why don't we start by just maybe just tell us a little bit about your background. 00:00:40.880 --> 00:00:41.880 All right. 00:00:41.880 --> 00:00:45.820 Well, thank you, Dr. Logan, for allowing me to speak with you this morning and kind of 00:00:45.820 --> 00:00:49.400 expose the community to our telehealth efforts. 00:00:49.400 --> 00:00:54.980 Started at Self Regional about 11 years ago and had an IT background working on different 00:00:54.980 --> 00:00:58.640 systems in the organization to kind of implement. 00:00:58.640 --> 00:01:03.960 In our EPIC environment and then really when the pandemic hit, we had a committee that 00:01:03.960 --> 00:01:07.920 was established to assess how are we going to continue care with some of the reductions 00:01:07.920 --> 00:01:12.260 in waiting rooms and the reduction in visitation. 00:01:12.260 --> 00:01:16.860 So with that group, we looked at what's the right way to access care from a technical 00:01:16.860 --> 00:01:22.560 standpoint, what's the easiest path for our patients, for our physicians, and supported 00:01:22.560 --> 00:01:26.880 that committee for about two years and then was able to assume the role of Director of 00:01:26.880 --> 00:01:27.880 Virtual Services. 00:01:27.880 --> 00:01:34.160 Which includes the new self-medical group virtual services office that we opened, as 00:01:34.160 --> 00:01:39.400 well as our MyChart team, because we really feel a big access point for our patients is 00:01:39.400 --> 00:01:45.360 using their MyChart to not only do some type of a telehealth experience, but also request 00:01:45.360 --> 00:01:47.240 an appointment, message their provider. 00:01:47.240 --> 00:01:52.180 So we're really, from a virtual standpoint, hoping to grow the MyChart integration along 00:01:52.180 --> 00:01:53.180 with telehealth. 00:01:53.180 --> 00:01:55.640 So we were able to establish the virtual services department. 00:01:55.640 --> 00:01:57.880 Well, I know you've done a lot of good work. 00:01:57.880 --> 00:01:58.880 I know you've done a lot of good work. 00:01:58.880 --> 00:02:01.340 And I think the pandemic kind of forced us into the telehealth world. 00:02:01.340 --> 00:02:05.640 We honestly, we were probably a little slow maybe to adopt at Self Regional, say three 00:02:05.640 --> 00:02:10.680 or four years ago, and then the pandemic hit and we all of a sudden had to figure it out. 00:02:10.680 --> 00:02:14.760 So thank you and the team that you work with for really helping us work through that. 00:02:14.760 --> 00:02:20.100 We dramatically increased the number, as you know, the number of televisits that we did 00:02:20.100 --> 00:02:24.100 during the pandemic, and it really just made a big difference for the community to have 00:02:24.100 --> 00:02:25.100 that as an option. 00:02:25.100 --> 00:02:27.880 So I just want to first thank you for the work that you and the team have done. 00:02:27.880 --> 00:02:32.260 So why don't we just kind of start at a high level, why don't you just kind of tell us 00:02:32.260 --> 00:02:38.320 a little bit about maybe the history of telehealth and virtual care and how it's used here and 00:02:38.320 --> 00:02:39.320 other places? 00:02:39.320 --> 00:02:40.320 Okay. 00:02:40.320 --> 00:02:45.200 Well, you know, recently, I was doing some some reading and saw it was an article by 00:02:45.200 --> 00:02:47.160 Thomas Nesbitt. 00:02:47.160 --> 00:02:49.500 And he wrote, what's the evolution of telehealth. 00:02:49.500 --> 00:02:53.180 And it was interesting to see that, you know, telehealth comes in a lot of different fashions 00:02:53.180 --> 00:02:57.880 and virtual care and telehealth can kind of be parallel. 00:02:57.880 --> 00:03:02.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:02.320 --> 00:03:05.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:05.320 --> 00:03:08.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:08.320 --> 00:03:09.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:09.320 --> 00:03:10.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:10.320 --> 00:03:11.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:11.320 --> 00:03:12.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:12.320 --> 00:03:13.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:13.320 --> 00:03:14.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:14.320 --> 00:03:15.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:15.320 --> 00:03:16.320 And so I think that's a really good example of how telehealth can be parallel. 00:03:27.880 --> 00:03:42.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:42.880 --> 00:03:52.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:52.880 --> 00:03:53.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:53.880 --> 00:03:54.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:54.880 --> 00:03:55.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:55.880 --> 00:03:56.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:56.880 --> 00:03:57.880 And so I think that's a really good example of how telehealth can be parallel. 00:03:57.880 --> 00:04:03.460 with our patients, not necessarily as just a way to treat during COVID, but now moving forward 00:04:03.460 --> 00:04:07.540 with our patients that'll say, hey, that's a two-hour drive for me to come and do that post-op 00:04:07.540 --> 00:04:15.020 follow-up. Or my wife's working until five, we have one car. I think my only opportunity is to 00:04:15.020 --> 00:04:18.860 go to the emergency room at night. I'd really like to see my primary care physician. How can we do 00:04:18.860 --> 00:04:24.080 this? Well, let's host a virtual video call so that we can move forward with that care and keep 00:04:24.080 --> 00:04:29.240 you out of the ER. So it's really come in a lot of different forms and it's continuing to evolve 00:04:29.240 --> 00:04:35.260 from say that, you know, very primitive, maybe just a phone call for a care consult to now 00:04:35.260 --> 00:04:40.560 we've got the video interaction and we've even are working towards, you know, remote patient 00:04:40.560 --> 00:04:46.160 monitoring so we can really manage that care from home and then also have the episodic kind of video 00:04:46.160 --> 00:04:52.860 experiences. But in general, it's just continuing to recognize that patients are, they're busy. 00:04:52.860 --> 00:04:54.060 They've got busy lives. 00:04:54.080 --> 00:04:59.360 Um, so sometimes it's just convenience. Hey, I can step out of work for five minutes or 10 minutes 00:04:59.360 --> 00:05:05.620 at home to have this video session with my provider. Um, or it's as, you know, integrated 00:05:05.620 --> 00:05:09.960 as, Hey, we really want to manage your care to prevent something from happening with some of 00:05:09.960 --> 00:05:14.020 that in-home monitoring, which we're looking, looking ahead at trying to stand up some of those 00:05:14.020 --> 00:05:20.740 systems. So, um, I know there's, there's type of several different types of, uh, like virtual 00:05:20.740 --> 00:05:24.060 visit options, for example. And, um, you know, 00:05:24.080 --> 00:05:27.540 I know that, uh, one of the big areas y'all are working on is like kind of an, almost like an 00:05:27.540 --> 00:05:32.360 urgent care type system, but then there's also other areas where it's being used in some of our 00:05:32.360 --> 00:05:36.720 practices, like say neurosurgery or in our behavioral health, uh, outpatient behavioral 00:05:36.720 --> 00:05:41.760 health options. Um, can you kind of talk to us a little bit about like, um, you know, I guess 00:05:41.760 --> 00:05:46.180 specifically like what services we're providing right now and what you see as it potentially 00:05:46.180 --> 00:05:51.940 growing into in the future here. Okay. So certainly our primary care physicians continue to lead, 00:05:51.940 --> 00:05:53.960 you know, the, the, I would say the pack, 00:05:54.080 --> 00:05:59.100 with offering, uh, virtual care. And we certainly have different ways they're doing that. Most of 00:05:59.100 --> 00:06:04.680 our, um, patients are having that video experience with their primary care physician through their 00:06:04.680 --> 00:06:09.840 my chart. But then we also have, um, Dr. Baruch and his team over on behavioral health. They 00:06:09.840 --> 00:06:14.900 have a mix of treating patients remotely, or even patients coming into their office and having an 00:06:14.900 --> 00:06:19.280 experience either in the hospital or the office with a physician that's offsite. So they can keep 00:06:19.280 --> 00:06:24.060 that care model. Um, Dr. Law is, I mean, he's done a phenomenal job with, um, 00:06:24.080 --> 00:06:29.300 you know, helping these patients post-operative who they may have still a little bit of pain and 00:06:29.300 --> 00:06:33.460 some things where it makes sense to have that follow-up virtually seen some really cool 00:06:33.460 --> 00:06:37.960 experiences where he's coached a patient through a wound dressing. And, you know, that patient 00:06:37.960 --> 00:06:43.960 had just applauded him for not having to make that trip to see him, um, where he got that same 00:06:43.960 --> 00:06:50.580 level of care in their home. Um, and so we've got the behavioral health, we have neurosurgery, 00:06:50.580 --> 00:06:54.060 certainly primary care. Um, we've got some other specialists, 00:06:54.080 --> 00:06:59.280 who are considering virtual care as they've had some patients, um, ask for that depending on if 00:06:59.280 --> 00:07:03.300 they've got a compromised immune system and just don't want to come out to a healthcare facility 00:07:03.300 --> 00:07:08.840 or just to go out in general. And then recently we opened our self-medical group virtual services 00:07:08.840 --> 00:07:14.880 department and that department opened, uh, June, uh, mid June, June 13th. And the goal of that 00:07:14.880 --> 00:07:20.080 is to open up access to care for sick visits. So we recognize in the community, um, we still 00:07:20.080 --> 00:07:24.060 have opportunities for patients to find a medical home. We have people constantly, 00:07:24.080 --> 00:07:29.100 moving to the area. Um, and we also have patients that they just for, you know, 00:07:29.100 --> 00:07:32.820 they just want to see a sick visit when they get sick, they may not have a need for more of that 00:07:32.820 --> 00:07:38.460 regular type care. So with our self-medical group, virtual services department, we're open, 00:07:38.460 --> 00:07:44.900 um, seven days a week, 8 AM until six 30. And our patients, um, come through our, my chart, 00:07:44.900 --> 00:07:49.320 and we've got nurse practitioners who are waiting to respond to them within five minutes. If they 00:07:49.320 --> 00:07:53.400 want an on-demand visit, or they can schedule an appointment up to two days in advance. 00:07:54.080 --> 00:07:59.600 And with that, it is just like an evaluation of management if they were in person. So we start 00:07:59.600 --> 00:08:04.020 with that virtual experience. And then from there, if something comes out where the patient says, 00:08:04.020 --> 00:08:09.960 Hey, you know, let's move to a point of care test, like for a respiratory illness. Um, we use our 00:08:09.960 --> 00:08:15.000 drive-through services that are adjacent to us. Um, we schedule register that patient and they 00:08:15.000 --> 00:08:18.640 just simply come through and get swabbed or, you know, provide that lab specimen. Cause 00:08:18.640 --> 00:08:23.920 with that office, we're really working on, Hey, I just don't know any other place to go. 00:08:24.080 --> 00:08:29.800 Or it's a big challenge to get to an urgent care somewhere else. So we can again, do that at home 00:08:29.800 --> 00:08:34.380 or, um, it's, you know, I just want something really fast. And from there, we want to make 00:08:34.380 --> 00:08:38.600 sure that we can start virtual. If we need to take you on site to suture a wound or give an 00:08:38.600 --> 00:08:42.980 injection or get testing, we can do that too. So that all that care is taken care of very 00:08:42.980 --> 00:08:48.880 conveniently. That's awesome. Yeah. So I'll just give one example of a family friend of mine and 00:08:48.880 --> 00:08:53.660 my wife's, um, uh, recently had like a cellulitis on her arm. 00:08:54.080 --> 00:08:58.280 And, um, she, uh, reached out to me and it's like, you know, do I need to go to the emergency 00:08:58.280 --> 00:09:03.060 department with this? I'm not sure what to do. And, um, you know, thinking of the virtual services 00:09:03.060 --> 00:09:08.120 option, I said, well, why don't we try this? And I encouraged her just to pull out her my chart. 00:09:08.120 --> 00:09:13.380 It's super easy. Just pull out your, my chart and scroll to like virtual visit and clicked on that. 00:09:13.380 --> 00:09:17.920 And, um, and I said, well, just let me know how the visit goes. And she called me back about 20 00:09:17.920 --> 00:09:23.000 minutes later and she said it was awesome. And she was raving about how easy it was. And an antibiotic 00:09:23.000 --> 00:09:24.060 was called in. She just, you know, she was like, I don't know. I don't know. I don't know. I don't 00:09:24.080 --> 00:09:27.780 know. I don't know. I just went directly from her home to pick up the antibiotic. Didn't have to go 00:09:27.780 --> 00:09:32.000 into the office or do any of that. Just cut out all those steps, saved her a lot of times, able 00:09:32.000 --> 00:09:36.780 to get back to work quicker. And, uh, and, and it was great. And also got follow-up the following 00:09:36.780 --> 00:09:42.200 day too, to, to check on her, to see how she was doing. So, um, so kudos to your team, just from a 00:09:42.200 --> 00:09:48.200 personal experience in a family friend of ours who went through your services. Um, and with that 00:09:48.200 --> 00:09:51.420 said, again, that was kind of the experience that I just shared that a friend of mine had, 00:09:51.420 --> 00:09:54.060 what would be the, uh, what would be the way, 00:09:54.080 --> 00:09:59.640 for someone if, uh, let's say they have kind of a minor, some condition going on. Are there 00:09:59.640 --> 00:10:04.460 different options? Is it, is it always a video visit? Like what my friend had or what are the 00:10:04.460 --> 00:10:09.820 other options for those, uh, like e-visits if we'll call it that. And that's a really good point. 00:10:09.820 --> 00:10:14.640 So we, we even have patients that, I mean, they're, they, they would rather just, you know, 00:10:14.640 --> 00:10:19.840 simply submit kind of a questionnaire of their symptoms and receive, you know, a treatment plan 00:10:19.840 --> 00:10:23.940 at another, you know, later time of the day, or in some capacity, 00:10:23.940 --> 00:10:29.100 they just don't even have time to get on that video experience. So we have also e-visits, 00:10:29.100 --> 00:10:33.400 which the patient goes in there, my chart, um, you see the e-visit heading, it's right there 00:10:33.400 --> 00:10:39.140 under menu. And there's about 10 questionnaires in there that cascade between different kind of 00:10:39.140 --> 00:10:44.120 top illnesses that we see the cough, the headache, things like that. And the patient enters that 00:10:44.120 --> 00:10:48.080 e-visit and they simply answer the questions. And it kind of asks, you know, it gets a little 00:10:48.080 --> 00:10:53.320 more specific based on the chief complaint. Um, after that submitted, it goes straight to our 00:10:53.800 --> 00:10:58.460 patients. Um, they review it and we'll respond back with a question in my chart, or they'll call 00:10:58.460 --> 00:11:02.760 the patient depending on the timeline of response. Um, and then hopefully the next step is just 00:11:02.760 --> 00:11:08.220 getting that, that medicine or, or that over the counter recommendation or, um, whatever that care 00:11:08.220 --> 00:11:14.060 treatment is. And what we've seen is with our video visits, those are, um, compensated. They 00:11:14.060 --> 00:11:18.540 go out to our insurance, uh, to our patient's insurance, our payers, and we're continuing to 00:11:18.540 --> 00:11:23.660 watch, you know, the policy development with telehealth. Um, but in general, most are reimbursed 00:11:23.660 --> 00:11:29.820 similar to an office visit, but with the e-visit, it's just $20 cash payment. So once you submit 00:11:29.820 --> 00:11:35.040 your e-visit, um, you electronically pay the $20 and then, you know, that goes to our provider 00:11:35.040 --> 00:11:40.200 and they review it. If we're not able to find if based on the information, we're not able to treat, 00:11:40.200 --> 00:11:45.580 we refund that $20, same thing with our virtual. Um, and we've really seen a good, a good volume 00:11:45.580 --> 00:11:51.260 of patients who have used that experience. Um, and when I do some patient satisfaction calls 00:11:51.260 --> 00:11:53.640 and follow up with them, you know, they'll say, this was great. You know, 00:11:53.640 --> 00:11:58.400 it wasn't really super quick as far as when I needed care, but I loved, I could just do it 00:11:58.400 --> 00:12:02.600 when I wanted to, I sent it in. And when I got, you know, for a particular patient I was talking 00:12:02.600 --> 00:12:06.780 to, whenever I took a break for lunch, I had all my information in there. And my next step was to 00:12:06.780 --> 00:12:11.740 go to the pharmacy and the questionnaire took me, you know, maybe a couple minutes to fill out. 00:12:11.740 --> 00:12:16.760 So we're, we're still definitely learning on, you know, the patient's kind of consumerism. Do they 00:12:16.760 --> 00:12:22.480 really want the video experience or just a quick, um, e-visit, but we've seen a good, um, utilization 00:12:22.480 --> 00:12:23.620 of both of those. 00:12:23.620 --> 00:12:30.120 Cool. Cool. So, yeah, so it sounds like there's basically two big options for someone who's 00:12:30.120 --> 00:12:34.380 seeking, like, uh, you have an acute problem that you're concerned about. So you can either 00:12:34.380 --> 00:12:39.020 fill out a questionnaire, it gets sent in, or you can do a video visit. The questionnaire gets sent 00:12:39.020 --> 00:12:44.660 in, you get follow-up and, uh, and perhaps an antibiotic or whatever treatment that may be 00:12:44.660 --> 00:12:49.360 recommended based on the answers to the questions, or you can do an in-person video or not in person. 00:12:49.360 --> 00:12:53.060 Well, I guess live, live video visit with a, with a provider right then. 00:12:53.600 --> 00:12:56.900 So that's neat. One of the things I think is really cool about what you guys are doing and 00:12:56.900 --> 00:13:00.340 set up over there is it's, you know, when we were talking about telehealth, it's like, well, 00:13:00.340 --> 00:13:04.920 you know, a lot of times like, boy, I really kind of would like to have a strep throat swab or 00:13:04.920 --> 00:13:09.380 someone's having say urine symptoms or hurts when they pee or whatever. And you're like, well, 00:13:09.380 --> 00:13:14.060 boy, really, really nice to have a urinalysis. How do you do virtual visit without having test 00:13:14.060 --> 00:13:18.380 results? And you've touched on this already for a little bit. I just wanted to just maybe just 00:13:18.380 --> 00:13:22.760 reemphasize that a little bit. So you can do testing and you can come directly through the 00:13:23.580 --> 00:13:28.020 services area right here itself, beside the hospital and, and have those tests collected. 00:13:28.020 --> 00:13:32.940 Tell me a little bit about how that process works from ordering into test results and what, 00:13:32.940 --> 00:13:37.140 what someone could expect for like that total time to get the results back and get some follow up. 00:13:37.140 --> 00:13:41.820 Okay. I'm glad you asked the question and we can expand on our, our drive through services 00:13:41.820 --> 00:13:47.160 department is just phenomenal and they're continuing to evolve and look for ways to 00:13:47.160 --> 00:13:53.040 make the patient experience more convenient. I'll, I'll just use an example. We saw a little bit of 00:13:53.560 --> 00:13:59.740 flu last week, last Friday, it was very busy and it was patient after patient, after patient were 00:13:59.740 --> 00:14:03.520 coming in with the same symptoms and they all kind of lived around the same area. So we kind 00:14:03.520 --> 00:14:06.760 of started putting the dots together and realized, Whoa, you know, the flu is kind of jumping out 00:14:06.760 --> 00:14:12.040 there. So we start with the virtual visit, go through those symptoms and for those patients, 00:14:12.040 --> 00:14:17.200 they needed a flu swab. So what we do is we go into the drive through services department. We 00:14:17.200 --> 00:14:20.860 schedule that as we're talking to the patient, you know, which time works for you. Most of them 00:14:20.860 --> 00:14:25.540 will say, Hey, you know, I'd like to get it as soon as I can. So just depending on, you know, 00:14:25.540 --> 00:14:30.280 the schedule, usually we can have a patient get swabbed. And as soon as 30 minutes after our visit 00:14:30.280 --> 00:14:34.960 could be shorter, depending on what's open on the drive through services schedule. Um, but one 00:14:34.960 --> 00:14:39.880 particular patient, um, as soon as we had finished, uh, the encounter, they were parked at the front 00:14:39.880 --> 00:14:45.100 of the drive through line. Um, so as soon as we hit sign order, um, we had about a minute to get 00:14:45.100 --> 00:14:49.060 them scheduled and the drive through services team did a great job as we partnered. And really, 00:14:49.060 --> 00:14:50.840 they just went through and swabbed because we're taking care of them and they were able to get 00:14:50.840 --> 00:14:56.080 that scheduling and registration step from our department before they get there. Um, and then 00:14:56.080 --> 00:15:00.280 from time to take swab into the building, run the point of care tests, you know, around 20, 00:15:00.280 --> 00:15:06.160 25 minutes. So altogether patient had a five to eight minute visit with us. They went through 00:15:06.160 --> 00:15:10.920 the drive through, got the results and say 25 minutes. So really within about a 30 minute 00:15:10.920 --> 00:15:15.560 experience, they talked to a provider, had their flu. And then we already had the letter to them 00:15:15.560 --> 00:15:20.820 for school. Um, you know, that they, um, uh, that they were flu positive. And then of course, 00:15:20.820 --> 00:15:25.840 they needed that for, for the exemption at school. So the patient, uh, and their family were really, 00:15:25.840 --> 00:15:31.640 really pleased with the, the quickness of it. Um, and the child was, um, was indicating, 00:15:31.640 --> 00:15:35.020 oh, I don't have to go sit in a waiting room. You know, I don't feel good. And it was really 00:15:35.020 --> 00:15:39.980 cool to see that we were able to get them through that quickly. So we start virtually 00:15:39.980 --> 00:15:45.200 and then we order those point of care tests. And right now we, we are testing for strep RSV 00:15:45.200 --> 00:15:50.640 flu COVID. And, um, to your point, we have a lot of urinary, uh, infections that come through. 00:15:50.800 --> 00:15:55.620 And we'll do the same process and they'll provide the specimen in our building. Um, it's right off 00:15:55.620 --> 00:16:00.160 the end of the drive-through line. And then, um, if we have a patient that we start virtually and, 00:16:00.160 --> 00:16:03.620 you know, it's just a little more complex or something comes out that we just weren't 00:16:03.620 --> 00:16:08.300 originally aware of, we do have multiple exam rooms. So we, from time to time, we'll bring a 00:16:08.300 --> 00:16:13.160 patient on, on site. If we need to do a little more scoping in the ear or if a physical exam 00:16:13.160 --> 00:16:19.520 is really required, um, or in the, the, um, in some situations where we'll do like a steroid injection 00:16:20.780 --> 00:16:26.160 suit or a really minor wound. Um, cause our, really our goal is if these patients feel like 00:16:26.160 --> 00:16:30.560 their only opportunity for some of those things is just to go to the ER. We really want to try 00:16:30.560 --> 00:16:35.360 to capture that experience first, if we can, um, to help with some of those acuity patients in the 00:16:35.360 --> 00:16:40.080 ER. Well, that, that brings up a good thought. So maybe we could talk briefly and you've already 00:16:40.080 --> 00:16:46.160 touched on it. Like what are the types of conditions or symptoms that patients have 00:16:46.160 --> 00:16:50.560 that would be appropriate for a virtual care visit or an e-visit versus, 00:16:50.760 --> 00:16:54.260 like what you'd like? Oh, no, you really should go to the ER and not even bother with virtual 00:16:54.260 --> 00:16:57.840 visits. Can you, can you talk about that a little bit? Well, that's a great point because certainly 00:16:57.840 --> 00:17:03.060 we'll have some folks that will, um, kind of arrive in the virtual queue, the request appointment with 00:17:03.060 --> 00:17:07.260 us. And they're a little bit more acute than really, they probably should even have an on-site 00:17:07.260 --> 00:17:14.080 visit. Um, usually those are your sinus stroke, dehydration. If anyone's got chest pain, um, 00:17:14.080 --> 00:17:20.520 if major anxiety attack, things like that. Um, we've had a handful of patients who've started 00:17:20.740 --> 00:17:27.160 virtually and our process from there is to call the ER and say, Hey, we've got patient X who isn't 00:17:27.160 --> 00:17:32.860 in a very acute situation. We're working with them to get transportation to the ER, or we've called, 00:17:32.860 --> 00:17:39.640 you know, um, EMS to come assist. Luckily very few, but generally it's those, um, it's those 00:17:39.640 --> 00:17:46.240 sicknesses or those chief complaints that, um, are really, are going to need more in-depth care. 00:17:46.240 --> 00:17:50.720 Mm-hmm . Um, and then I would say probably 99% of the patients that we've, 00:17:50.720 --> 00:17:55.880 uh, that we received in the self medical group virtual services, um, fortunately we've been able 00:17:55.880 --> 00:18:00.260 to treat or we've brought them on site to take care of it. Um, but for the few that have been 00:18:00.260 --> 00:18:03.860 pretty emergent, it's, it's been a, you know, a little bit, a little bit of an interesting 00:18:03.860 --> 00:18:08.180 situation to, to get them that care from home if they didn't have a loved one, et cetera. But, 00:18:08.180 --> 00:18:13.820 um, really feel like our strong partnership with the ER and, uh, with those providers to kind of 00:18:13.820 --> 00:18:18.860 give that insight, Hey, they're coming. That process, um, further makes that a, a, a better 00:18:18.860 --> 00:18:20.240 experience for them. Yeah. 00:18:20.700 --> 00:18:26.040 For sure. So, yeah, certainly. So things like, uh, severe chest pain, stroke-like symptoms where 00:18:26.040 --> 00:18:31.920 something's not working right. Um, you know, you know, high fever with confusion or things 00:18:31.920 --> 00:18:36.780 like that, that would kind of maybe, maybe indicate something more severe. Sounds like 00:18:36.780 --> 00:18:40.140 the probably shouldn't start with virtual care, but if they ended up there, then we have a good 00:18:40.140 --> 00:18:44.220 plan in place to get them where they need to go to get acute treatment. So that's, that's awesome. 00:18:44.220 --> 00:18:50.680 Um, well, good. Um, you know, I think I've kind of covered like the highlights a little bit. One, I 00:18:50.680 --> 00:18:54.900 guess on one other, one other note on the, you know, we talked about behavioral health, um, 00:18:54.900 --> 00:18:59.860 mental health options as well as what we're doing in neurosurgery. Um, you know, that's not something 00:18:59.860 --> 00:19:04.060 that necessarily every patient could just access the neurosurgery via virtual health without going 00:19:04.060 --> 00:19:07.520 through their practice. Well, let's talk about, so we talked about the acute visit. What about, 00:19:07.520 --> 00:19:12.520 how are we using a virtual care services in our practices right now? And I know you've touched on 00:19:12.520 --> 00:19:17.360 it some, but let's talk about that a little bit more. And then, um, uh, where do you see virtual 00:19:17.360 --> 00:19:20.660 services going into the future at self regional? Okay. 00:19:20.660 --> 00:19:24.800 Um, I think really what we see in the primary care area is when I've been able to, 00:19:24.800 --> 00:19:29.400 when they've been great to allow me to observe and talking with some of the self-medical group 00:19:29.400 --> 00:19:35.480 leadership, um, is, you know, it could be as simple as patient was COVID positive and they 00:19:35.480 --> 00:19:38.760 wanted to do the followup with them because they had more chronic illnesses. And of course we didn't 00:19:38.760 --> 00:19:43.060 want to bring that patient on site if they're still symptomatic, still testing positive. Um, 00:19:43.060 --> 00:19:49.080 we see a lot of the patients that, um, they may have a controlled substance like a ADHD medicine, 00:19:50.640 --> 00:19:55.820 you know, by the, you know, the regulation, you need to have that face-to-face visit within say 00:19:55.820 --> 00:20:00.960 90 days or 60 days, you know, having that virtually, especially, um, we've got a lot 00:20:00.960 --> 00:20:04.840 of students who went back to school, you know, and they're at a distance and that's missing class, 00:20:04.840 --> 00:20:09.560 et cetera. If they've got to travel all the way back. Um, uh, it's a lot of the chronic care 00:20:09.560 --> 00:20:14.820 management, um, is also where if that patient's diabetic and if there's something going on, 00:20:14.820 --> 00:20:19.260 you know, that they need some of that tracking again, they can't get to the office. Um, primary 00:20:19.260 --> 00:20:20.260 care has been awesome to, 00:20:20.620 --> 00:20:25.640 extend an opportunity for a virtual visit. Um, so they're really, I think using a plethora of, 00:20:25.640 --> 00:20:32.560 of patient types, um, to, to make sure that access to care continues, um, around some of 00:20:32.560 --> 00:20:38.240 those patient specific situations. Um, but in general, I think we certainly have patients that 00:20:38.240 --> 00:20:43.800 ask that they'll say, Hey, you know, um, a recent poll I was, I was reading from a forms magazine, 00:20:43.800 --> 00:20:50.600 um, from prosper analytics and insights indicated that 36% of adults had a virtual visit during 00:20:50.600 --> 00:20:55.360 the pandemic. So I think now we've got patients who are kind of aware of, Hey, I can do this, 00:20:55.360 --> 00:20:59.360 this worked great before. So I think they're getting a lot of requests from patients that'll 00:20:59.360 --> 00:21:04.860 say, can we just do this virtually? Um, and I think depending on probably the providers, um, 00:21:04.860 --> 00:21:09.600 kind of judgment on, is that the right thing, um, from some of their protocols, they'll do that 00:21:09.600 --> 00:21:14.580 virtually. But, um, from what I've seen just in general, it's, it's usually, is there a patient 00:21:14.580 --> 00:21:18.660 challenge to get into the office or is it a specific, you know, treatment option that can 00:21:18.660 --> 00:21:20.580 be managed virtually? Um, and I think that's, I think that's, I think that's, I think that's 00:21:20.580 --> 00:21:25.280 like a, you know, a followup visit or something like that. Um, and they're, they're using that 00:21:25.280 --> 00:21:31.500 technology to create that best patient experience. So Graham, tell me for a second, um, the, uh, 00:21:31.500 --> 00:21:36.080 the ages that you, uh, can take care of through the virtual services. I know, I think some of the 00:21:36.080 --> 00:21:40.500 youngest of the children that we may not do. Tell me about that for a second. So, um, the 00:21:40.500 --> 00:21:46.060 population that we serve is five years and older. Okay. Um, and then of course we've had, you know, 00:21:46.060 --> 00:21:50.180 folks that have used our services that are in their eighties, you know, so we, 00:21:50.560 --> 00:21:55.440 um, we, from a five years and older, we felt like that was the best age to be able to have 00:21:55.440 --> 00:22:00.120 the patient really explain some of the symptoms they're having with the parent. And through that 00:22:00.120 --> 00:22:06.660 process, the patient, um, within their, my chart, uh, their parent will have proxy access and can 00:22:06.660 --> 00:22:12.520 schedule that, um, that youth in our office. So, um, five years and older for all of our family 00:22:12.520 --> 00:22:20.540 medicine type, you know, issues, um, is our current population. Okay. Well, good. So, you 00:22:20.540 --> 00:22:22.460 know, I think that's, that's a good point. Um, I think that's, I think that's a good point. Um, 00:22:22.460 --> 00:22:29.020 tell us what you have to do to access telehealth. Um, if I know we've touched on it, but it sounds 00:22:29.020 --> 00:22:32.640 kind of complicated if you've never done it before, what do you have to have to access 00:22:32.640 --> 00:22:38.180 telehealth? I believe just a cell phone, um, or a computer access. So walk us through the steps. 00:22:38.180 --> 00:22:42.480 So let's say I'm at home and I have a condition and I want to access telehealth services. What do 00:22:42.480 --> 00:22:49.300 I do? So, uh, having connectivity to really cellular or the internet is, is really the basic 00:22:49.300 --> 00:22:50.520 foundation of it. So, um, I think that's a good point. I think that's a good point. I think that's 00:22:50.520 --> 00:22:54.500 a good point. So, um, we're, we're working to continue to assess what is the, you know, 00:22:54.500 --> 00:23:00.760 how do we get to a more, I would say appropriate tool, um, that is the most convenient for our 00:23:00.760 --> 00:23:06.020 providers and for our patients. But most of our patients, um, we work and as just in general in 00:23:06.020 --> 00:23:10.540 our community, we're really working hard to expand our my chart activation because we've got not only 00:23:10.540 --> 00:23:14.940 the ability to do virtual care, but a lot of the great patient engagement tools, you know, 00:23:14.940 --> 00:23:19.720 messaging the provider, seeing your lab results, seeing your, your physician's note. So really 00:23:19.720 --> 00:23:20.500 trying to leverage that. And I think that's a good point. I think that's a good point. I think 00:23:20.500 --> 00:23:20.520 that's a good point. I think that's a good point. I think that's a good point. I think that's a good 00:23:20.520 --> 00:23:20.540 point. I think that's a good point. I think that's a good point. I think that's a good point. I think 00:23:20.540 --> 00:23:20.580 that's a good point. I think that's a good point. I think that's a good point. I think that's a good point. 00:23:20.580 --> 00:23:27.340 But for most of our virtual, um, opportunities, um, you simply having my chart and then the 00:23:27.340 --> 00:23:32.500 practice scheduling you, um, for that visit and then onboarding into what that experience is going 00:23:32.500 --> 00:23:38.360 to be those instructions. Um, and then with that, our patients do an e-check in. So what that 00:23:38.360 --> 00:23:43.820 experience is, is our patients basically confirm their insurance, um, their clinical, some of 00:23:43.820 --> 00:23:47.580 their clinical questions. Are you still, you know, taking that medicine or do you still have that 00:23:47.580 --> 00:23:52.440 problem? Do you still have that allergy? Um, and then there's some specific, you know, questionnaires 00:23:52.440 --> 00:23:57.020 depending on if they're Medicare, et cetera. Um, and then they simply join the video and they can 00:23:57.020 --> 00:24:01.820 do it from their cell phone or from their laptop. Um, we, we've seen all kinds of, of interesting 00:24:01.820 --> 00:24:05.860 scenarios, you know, a lot of people driving and we'll, we'll say, Hey, please drive, please pull 00:24:05.860 --> 00:24:11.360 over, um, people out, you know, um, on vacation, people that are out by their pool. And then we 00:24:11.360 --> 00:24:15.500 have, of course, folks that are, you know, on their sofa and their living room and their office. 00:24:15.500 --> 00:24:17.100 So we've really seen a cool, 00:24:17.560 --> 00:24:23.680 blend of how the patients are using whatever technology they have to access that care. Um, 00:24:23.680 --> 00:24:30.060 but in general, most folks use their smartphone or their, their computer. And, um, I realized that I 00:24:30.060 --> 00:24:34.120 need to go back to that previous question of where is telehealth kind of going forward. And I think, 00:24:34.120 --> 00:24:39.680 um, a lot of that's going to be that investment in our, my chart expansion, um, and having just 00:24:39.680 --> 00:24:44.580 more awareness of that tool and continuing to support our medical providers with, um, 00:24:44.580 --> 00:24:47.540 enhancements to those tools so that, you know, they can continue to, you know, 00:24:47.540 --> 00:24:53.920 continue to be as, as efficient as, as we can with our virtual tools. Um, as well as how do we 00:24:53.920 --> 00:24:59.460 take not only the video experience, but more of that patient monitoring experience and more of 00:24:59.460 --> 00:25:04.500 that, more of that management of care outside of episodic care, um, which I think is going to be 00:25:04.500 --> 00:25:11.300 that investment in more data tracking and working with our home health, um, you know, folks, as we 00:25:11.300 --> 00:25:16.980 really, um, help a lot of these chronic care patients, um, stay out of the hospital and, 00:25:17.520 --> 00:25:20.840 and hopefully avoid an acute episode because we caught it on the front end. 00:25:20.840 --> 00:25:26.180 Sure. Yeah. And, uh, you just mentioned my chart. Um, I think it's important people know how easy 00:25:26.180 --> 00:25:30.980 that is. So it literally is just a, on your phone, going to the app store and looking for my chart 00:25:30.980 --> 00:25:36.620 and downloading that app onto your phone. And then, um, when you click on that, the first time 00:25:36.620 --> 00:25:41.140 it walks you through a registration process, you choose self-regional healthcare. You really just 00:25:41.140 --> 00:25:44.540 put in your date of birth, your name, those types of things. And it automatically will pull up any 00:25:44.540 --> 00:25:47.500 records that you have and pull it right in there. I help my parents with that. I help my parents with 00:25:47.500 --> 00:25:51.920 it recently. And I was kind of surprised how easy it was. And my parents are in their seventies 00:25:51.920 --> 00:25:56.440 and, um, within probably about five minutes, I had them up and going on my chart, really just 00:25:56.440 --> 00:26:00.200 downloading the app on the phone. And I showed them where the virtual visits are. It's just, 00:26:00.200 --> 00:26:03.620 you just scroll right down and it's right there. Just tap it virtual visit. And it takes you right 00:26:03.620 --> 00:26:08.760 to the, uh, virtual visit. And it's, it's really become very easy for folks. The other really cool 00:26:08.760 --> 00:26:13.400 thing about my chart is an instant access to your lab results, lab results, pathology results, 00:26:13.400 --> 00:26:17.480 x-ray reports, um, office notes, those types of things, which are just auto 00:26:17.480 --> 00:26:21.340 populated in there. And you get a little ding on your phone when those tests are back 00:26:21.340 --> 00:26:26.060 and, uh, and you can see it. And, uh, and it's really, it's helpful. And I think it's really, 00:26:26.060 --> 00:26:31.480 uh, getting patients more engaged with their care. And, um, you know, sometimes labs may be a little 00:26:31.480 --> 00:26:34.900 confusing to someone if they don't, haven't looked at them before, maybe not understand 00:26:34.900 --> 00:26:40.580 like what they mean. Um, as you know, um, we're required by federal law under the cures act to 00:26:40.580 --> 00:26:44.480 instantly give them to them as soon as we'd need to. But we just ask everybody to just, 00:26:44.480 --> 00:26:47.460 if you're not sure, talk to your doctor about what that means. Cause sometimes 00:26:47.460 --> 00:26:52.620 something might look real scary, but really it's not that big of a deal or really clinically 00:26:52.620 --> 00:26:57.020 significant at all. So always talk to your doctor as something comes back on there and you're not 00:26:57.020 --> 00:27:02.140 sure what it is. But, um, I just wanted to just point out how easy it is to get my chart. And 00:27:02.140 --> 00:27:06.420 that's one of our big goals for this year at the hospital, as you know, is to get more people on my 00:27:06.420 --> 00:27:12.180 chart so we can get more engagement with our, with our community. Um, and, and the cool thing is it's 00:27:12.180 --> 00:27:16.140 not just getting your results back. It's about ability to communicate with your, your healthcare 00:27:17.440 --> 00:27:22.600 provider. So it's about being able to communicate over the, my chart where you can send a message 00:27:22.600 --> 00:27:27.340 to your provider team and they can give messages back to you, refill your medicines, do all that 00:27:27.340 --> 00:27:33.220 thing right there. Um, so, uh, so such a great tool opens up the virtual options for folks. Um, 00:27:33.220 --> 00:27:38.320 and, uh, as far as, uh, you know, long-term wise, um, the more people we can get on our electronic 00:27:38.320 --> 00:27:44.300 medical record through the, my chart on your phone, the more access and the more, uh, convenience and 00:27:44.300 --> 00:27:47.420 also, uh, just that engagement with your own health, I think is, which is going to be so 00:27:47.420 --> 00:27:52.940 important. So, well, Graham, listen, uh, thank you so much for visiting with me today. Uh, this 00:27:52.940 --> 00:27:56.800 has been real helpful for me, uh, hopefully for our listeners, you have anything else that you 00:27:56.800 --> 00:28:02.860 want to add today or share with our community? Um, just gonna, again, thank you, Dr. Logan, 00:28:02.860 --> 00:28:08.040 for allowing me to speak on our virtual, uh, services and our virtual tools. And we're really 00:28:08.040 --> 00:28:12.940 excited about continuing to hopefully act, you know, grow our access to care, especially in our 00:28:12.940 --> 00:28:17.360 rural areas. Um, and again, you know, it's very important to sign up for my chart, 00:28:17.400 --> 00:28:22.260 it's a great, great tool to stay connected in our community. You can go to my chart.selfregional.org 00:28:22.260 --> 00:28:27.100 and sign up. You can go to our virtual services, selfregional.virtual, uh, selfregional.com 00:28:27.100 --> 00:28:32.260 slash virtual care. You can also in, um, find a way to sign up there or see more on our virtual 00:28:32.260 --> 00:28:37.140 services. And then, um, our, we have a phone number with a team who's waiting to help with 00:28:37.140 --> 00:28:45.960 my chart support or enrollment. And that's 864-725-2737 also on our website. So, um, we're 00:28:45.960 --> 00:28:47.080 really, again, excited. 00:28:47.380 --> 00:28:51.820 As our organization is going to continue to try to expand my chart and layer in telehealth along 00:28:51.820 --> 00:28:55.660 with other tools to keep that patient connected to our health system. 00:28:55.660 --> 00:29:00.020 Awesome. Graham, we are so excited about the work you and your team are doing. 00:29:00.020 --> 00:29:05.120 And I think going forward, this is just opens up so many new opportunities for our patients to be 00:29:05.120 --> 00:29:09.740 able to get convenient access, um, that quick turnaround service that we want to be able to 00:29:09.740 --> 00:29:14.680 provide and, uh, really take our services up, up a couple levels. So listen, thank you for the work 00:29:14.680 --> 00:29:17.120 and thank you for your time today. Thank you, Dr. Logan. Absolutely. 00:29:17.360 --> 00:29:20.360 ♪ ♪