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COVID-19 prompts businesses, organizations to turn to telemedicine, virtual support groups

By Staff | Mar 26, 2020

With the COVID-19 pandemic sweeping the world, many health professionals locally are switching to virtual services to keep everyone involved safe.

Lee Health Senior Project Manager Jonathan Witenko said they began using telemedicine in 2014 for inpatient care for those in the emergency rooms for strokes. From there, the platform expanded to stroke patients anywhere in the hospital.

Witenko said they then realized that they had an amazing platform on their hands and started expanding it to certain service lines throughout the system.

“Throughout the system, over the last six years, we have expanded into 19, roughly 20 different service lines,” he said.

A few weeks ago telemedicine came into play for a mom and her baby at the Cape Coral Hospital. Witenko said the baby was not ready for NICU, but they wanted to keep tabs on the little one. Health professionals from Golisano Children’s Hospital were able to use the service to check on the baby once a day to make sure the mom and child were doing well.

With the service, if the baby had to be transferred to NICU at Golisano Children’s Hospital, again health professionals would be able to connect in and help while the baby is being driven to the campus.

“The mom was able to stay with the baby at Cape Coral Hospital instead of transferring,” Witenko said.

Since the launch of telemedicine with Lee Health, it has always been about access, how to get patients connected with such individuals as their health providers. He said sometimes the patient is in the emergency department, or on one of the hospital floors, while the physicians are on campus, or at home.

“Some of them are contracted physicians and some are (medical) community partners, or outside community physicians. Sometimes they are national physicians accredited with the state of Florida,” Witenko said. “We have over 100 different physicians, or medical providers trained on the system and 10,000 encounters from inside and outside.”

Another example he provided was a stethoscope on a telemedicine cart. The provider can be in a different part of the hospital, or a different hospital altogether and listen to the sounds of the patient’s chest and lungs and make an accurate assessment.

“That technology we have been using for the last few years,” Witenko said.

It has been beneficial.

Over the last three weeks amidst the COVID-19 pandemic, those numbers have drastically increased. He said there has been upwards of 10 different programs that have spun off in the last week alone to continue to give patients access to care that is quick, efficient and safe.

One of those telemedicine new programs is coming into the hospital. The patient goes through a triage process to rapidly evaluate them to determine whether they are suspected COVID-19, or not.

“We are using tele-med to connect the providers to the patients to help screen them,” Witenko said.

There is currently one pathway individuals can use to receive service, Lee TeleHealth either on their phone, or on the internet through their web browser. The service, which was $49 for self pay, is currently free. Patients can utilize this service 24/7 and connect to such health professionals an urgent care providers, family practice physicians, pediatricians, or emergency doctors.

“Yesterday we saw 200 patients that way,” Witenko said Tuesday afternoon, adding that number is steadily climbing.

He has been training physicians all hours of the day to teach them about TeleHealth.

“I know it’s difficult from the patient’s side. I see it from the provider’s side and they really want to help. We have some amazing docs. My phone is ringing off the hook – ‘John help me, I want to help my patients,'” Witenko said.

There is a desire from the doctors to make sure their patients are comforted and cared for, while getting the medicine they need. Tuesday morning there were seven physicians receiving training at 7 a.m.

There are around-the-clock training sessions taking place with videos and tip sheets so physicians can stay connected with their patients.

“They do it because they believe in the vision of the health system to really care for the community,” Witenko said. “These guys really want to do what is right.”

The next step, which staff is currently working on, is connecting all of Lee Physician Group through MyChart. He said they have opened it to their employees and testing it now.

Witenko said for him telemedicine has been building for the last six years.

“This is a way we can get through this together, the benefit of technology,” he said, adding that when someone is in quarantine or “lock down” “people still have medical conditions that need to be treated, seen and diagnosed.”

A dermatology business has also stepped into the direction of telemedicine.

Florida Skin Center Founder and Chief Medical Officer Dr. Aurora Badia said about seven years ago they began their first telemedicine platform with Store and Forward. This platform is used by the patient taking a picture and sending it to Florida Skin Center.

She explained that they communicate with the patient through the photograph.

“It’s not video conferencing. It’s just a picture and they send us information. We might ask some questions back and forth,” Badia said, adding that a prescription may be prescribed from Store and Forward. “Store and Forward, we have done hundreds of patients with Tele-Dermatology.”

She explained that the government expanded the technology by adding video conferencing to telemedicine in light of the COVID-19 pandemic, which is covered under existing insurances, such as Medicare, United Health Care, Florida Blue, Aetna or Cigna. The new regulation, Badia said also includes Facetime.

“We are very excited that the insurance plans would cover (this). We are trying to meet their (patients’) needs and make sure we are still here for them,” Badia said.

Through April 15, Florida Skin Center is waiving copays for patients with participating insurance plans, but federal restrictions do not allow the center to apply this policy to deductibles. Self-pay is also available for $59 per visit for telemedicine.

“We thought it was a great decision. It targets the most vulnerable population. There is a live stream. It’s quicker, easier to understand what is going on with the patient,” Badia said of the live video chat that replaces a regular office visit.

As of Tuesday afternoon they have had 15 patients utilize the Doxy.me technology.

“Not bad for a couple of days,” she said. “It’s going great. Patients have really loved it. They love the ease of being able to call in.”

A patient, new, or existing, has to call the office, (239) 561-3376 and set up an appointment. Within 24 hours, someone from Florida Skin Center will return the call and set up a time for the appointment. An email is sent to the patient with a link to the platform, which is very user friendly, and sign in information, which is all HIPPA-compliant.

Before the appointment, patients are asked to ensure they have proper internet service, using Google Chrome, or another telemedicine-supported browser, have a camera and microphone on and working from the digital device and have adequate lighting and a little flashlight.

“We can see them live. For dermatology it is such a visual field. Seeing them virtually we can treat them. They don’t have to leave the comfort of their home. It’s a similar experience of being in the office,” Badia said. “Something we have a question about, we can have them come in for a biopsy, or to see more clearly. They have the option of coming in directly to the office.”

With that said, she said that they remain open for those who wish to have a more direct experience.

In addition, she said if they need a prescription, it can either be e-scribed to their pharmacy, or sent directly to their home due to Florida Skin Center having medications on site.

“They don’t have to leave the house,” Badia said.

Florida Skin Center is contacting its patients through their campaign “Hello, Skin Health” with personalized text messages regarding a person’s dermatology status, as well as emails pertaining to telemedicine, prescriptions and CDC guidelines.

“During this trying situation, our practice is applying the technology that we’ve been preparing at current levels for 16 months to protect those we serve, while saving them money and their most precious resource, time,” Badia said in a prepared statement. “We’re ahead of the curve in this market, thereby sending a message to others in our industry that it’s time to help stop the spread of COVID-19.”

For more information about telemedicine at Florida Skin Care visit www.FloridaSkinCenter.com.

A nonprofit organization, whose sole purpose is to help children grieve, is also going to digital platform to continue to help those they serve. Valerie’s House offers a safe, comfortable place for children and their families to heal together following the death of someone they love.

Founder and CEO Angela Melvin said they knew immediately when the CDC said that groups larger than 50 people getting together were strongly discouraged and putting the community at risk, they had to do something because it would significantly impact what they offer at Valerie’s House.

When the grief support groups get together there can be anywhere between 40 to 50 people per night when counting families, kids, parents and volunteers.

“There was no way we could move forward in that setting,” Melvin said, which began the exploration of virtual support groups. “Right away my team and I were able to explore a software that could be HIPAA compliant.”

The software, Zoom for Healthcare, is both HIPAA compliment and offers a safe space in the virtual world.

“It’s another layer of protection for families,” she said. “We have purchased it and are training our volunteers on the software and are rolling it out Monday, March 30.”

The great part of the platform is families are still able to continue to meet with the same grief support group online out of the comfort of their own home.

“All the families will stay in their same groups. Now they are virtual groups in chat rooms. The kids will be with the same group of kids that they have been previously,” Melvin said.

In addition the peer support groups will be led by the trained group facilitator, both the children and families, are already comfortable with and trust.

“We are going to have 35 to 40 groups running. It’s a lot of work putting it all together. It is essential for our families to stay connected. Many of the kids have already gone through so much. It’s another dagger for them, for ‘why me?’ First the loss of a mom, or dad, and now I can’t go to school, give up friends and sports . . . it’s to keep them connected and cared for,” Melvin said.

What makes the software extra special, she said is it’s an opportunity for them to understand the technology and use it the rest of the year. Melvin said it will be helpful for the families than cannot make it to Valerie’s House because they work late, or have transportation issues.

“It’s another platform that we will hopefully be able to implement year round,” she said.

Another highlight is keeping in touch with families that have had to move away after a mother or father has passed away. Melvin said they may be in the child and family’s life for six to eight months before circumstances take them out of the area.

Now with Zoom for Healthcare, Valerie’s House is connecting with a family that moved to Alaska and North Carolina. She said these families are able to jump in during the virtual grief support groups Monday night.

Valerie’s House also is sending out weekly newsletters that shares quotes from kids of what they are doing, as well as different activities the kiddos can do in person. Melvin said with the COVID-19 pandemic it is providing time for families that typically do not have the opportunity to be together, to spend time with one another.

“What can they do to make their relationship stronger,” she said is tidbits of what is included in the newsletter.

Valerie’s House, although closed for in-person services, is still here for the community.

“We are still available for families that are grieving. It’s easy to get involved. Give us a call, email, or go to our website (www.valerieshouseswfl.org),” Melvin said, adding that within 24 hours the person will get a call back and plugged into the group. “The intake interview is over the phone for now. We will share with you about what we do and the resources there are to help you as you experience a loss. We will connect you to other people who are grieving, so you are not alone.”

For new enrollments, families can also reach Program Director Amy Strom at (239) 841-9186, or email amy@valerieshouseswfl.org.