Rhys Haydon, a family medicine advanced registered nurse practitioner based in Port Orchard, says virtual visits are the favorite part of his workday. (Virginia Mason Franciscan Health photo)

Rhys Haydon, a family medicine advanced registered nurse practitioner based in Port Orchard, says virtual visits are the favorite part of his workday. (Virginia Mason Franciscan Health photo)

Virtual health visits of the COVID era are here to stay

Virginia Mason Franciscan Health has facilitated 425,000 virtual clinical visits since March 2020

PORT ORCHARD — A little over one year ago, Rhys Haydon, a family medicine advanced registered nurse practitioner (ARNP) working at Franciscan Medical Clinic in Port Orchard, part of Virginia Mason Franciscan Health, was a busy professional working alongside 11 other health care providers who practice independently.

With a daily schedule of approximately 18 appointments from among the 900 patients on his “panel,” the 35-year-old Gig Harbor native and ARNP of three years had his hands’ full dispensing health care guidance at the Port Orchard clinic.

But as busy as he was seeing patients, suddenly it all went quiet about a year ago. That’s when the once-in-a-lifetime coronavirus pandemic swept into the Pacific Northwest after ravaging Wuhan, China, where it originated, forcing medical staff into personal protective gear featuring now-omnipresent facemasks. And, in most cases involving non-emergent care, the virulent virus forced medical clinics to close their doors to patients.

“It was an almost overnight change,” Haydon said of the dramatic overnight upheaval. Health care officials struggled how to react to the looming global crisis challenged by the need for drastic COVID-19 restrictions and abrupt new medical protocols.

While clinics and hospitals drastically curtailed non-emergency patient visits and focused much of their attention on containing and fighting the virus, system providers subsequently turned to a relatively new, underused means of dispensing their medical services: patient appointments with physicians, clinicians and nurse practitioners conducted remotely through online technology: telehealth, otherwise known as virtual visits.

Haydon’s health care network and others across the nation kickstarted their existing telehealth infrastructure into high gear so that patients could get medical care as they had in the past, overriding COVID-19 limitations and out of harm’s way posed by the virus through face-to-face contact.

In the case of Virginia Mason Franciscan Health, the organization rapidly escalated its telehealth capabilities to facilitate more than 425,000 virtual clinical and urgent care visits that began a year ago in March. According to VMFH officials, appointments conducted virtually range from annual check-ups to pre- and post-surgical check-ins.

“We’ve been able to provide good care to patients, on their terms,” Haydon said. “We are able to meet with people, wherever they are.”

And he’s met with patients remotely from just about anywhere they happen to be — some have driven over to the side of the road and parked their car in order to meet with him online.

COVID-19 has been the catalyst of change leading to the surge of virtual medical visits, but Haydon and others in the medical field see them becoming a standard option for provider-patient interactions.

“Setting up a virtual visit is a simple process. We will set it up for the patient if they’d like.”

Virtual visits make too much sense to providers and patients for them to disappear. As the need for social distancing slowly dissipates along with the virus, the benefits of virtual visits will continue to make sense to patients who otherwise might need to take several hours away from their work schedule or deal with assorted transportation or childcare hassles.

In most cases, Haydon said, a virtual appointment offers a provider and patient just as good, or a better, experience.

Data from a national research study conducted by CommonSpirit Health, VMFH’s parent company, found that 83% of patients in 2020 said their virtual visit was “just as good, or much better” than an in-person visit.

That patient confidence is reflected in national statistics showing nearly 30% of health care visits are now conducted electronically, according to an article in the Minneapolis Star-Tribune. The rise also has been driven by a relaxation of some rules and requirements by state and federal regulators that previously made it more difficult to use telehealth technology.

Before the pandemic, telehealth accounted for 3% of patient visits, according to a Minnesota Medical Association survey. During the last week of March 2020, however, the U.S. Centers for Disease Control and Prevention reported a 154% increase in telehealth visits.

In the Star-Tribune story on telehealth, James Hereford, chief executive at Fairview Health Services, said his previous employer, a Seattle-based health care system, made great use of what his former organization called “virtual care.”

“The addition of virtual care clearly was a benefit to the patient, their satisfaction went up, quality went up and overall costs went down because we really architected our system to take advantage of virtual care,” Hereford said.

Haydon said there are some limitations to virtual visits — a dermatologist, for example, might need a closer, more precise view of a patient’s skin lesion than what a virtual view could provide — but these virtual visits generally have proven to be beneficial in most cases.

The nurse practitioner said virtual visits have worked best for patients who have an established relationship with their health care provider and clinic, and where hands-on care, such as physical exams or blood draws, was not needed.

The virtual visits also have become extremely popular, he said, in mental health and substance-use treatment, with many health care organizations reporting high volumes of therapy visits.

Daniel Z. Sands, an assistant professor at Harvard Medical School and a digital health consultant, told the Wall Street Journal: “We’ve learned so much about the many different things doctors can do to connect with patients, in ways they never did before, that it will be hard to turn back the clock.”

At Stanford Health Care in Palo Alto, California, even as practices there have resumed in-person appointments, 30% to 40% of all visits remain virtual. And about a third of new-patient visits are using telemedicine.

That’s something Port Orchard’s Haydon is happy about. The ARNP said virtual visits — now comprising about 25% of his practice — are the best part of his day.

“I really love what I do, and that includes meeting virtually with my patients,” he said.

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