Virtual Visits: Connecting with Patients Online

As COVID-19 began to show up in Harrisonburg and surrounding counties earlier this year, the Sentara Medical Group responded by shifting most outpatient clinic visits to an online platform. During these “virtual visits,” which were implemented to reduce the risk of spreading the virus among patients and staff, and to conserve the limited supply of available personal protective equipment, patients can receive the care they need from the convenience and comfort of home. Instead of traveling to the doctor’s office and sitting in a waiting room prior to an appointment, the patient simply checks in online at the designated appointment time and connects to the healthcare provider remotely.

Although the Medical Group had been offering some virtual visits before the pandemic began, the number of virtual visits skyrocketed when the government issued coronavirus-related social distancing and stay-at-home policies. In fact, during the early weeks of the pandemic, about 85% of all Medical Group appointments were taking place virtually.

“The virtual visits worked very well, and patients really seemed to like the experience,” says Edward Sandy, MD, executive director for specialty services and provider solutions for the Blue Ridge territory of the Sentara Medical Group. “Of course, some patients still needed to be seen in face-to-face visits with their care provider, and we arranged for those to take place in a safe environment.”

Virtual visits were taking place in both primary care and specialty practices, according to Dr. Sandy. Most virtual visits occur via the Sentara app, which patients can download to a computer, tablet or smartphone. The app enables patients to check in with their provider, wait in a “virtual waiting room,” and connect by video and audio linkup. Once connected, a nurse or other medical provider will gather some information before the patient speaks with the doctor. During the virtual visit, providers can take a patient’s medical history, examine the patient visually (if the patient has video capability), provide medical advice and, if appropriate, prescribe medications or offer other treatment recommendations.

“Virtual visits provided us with a great solution for patient appointments when we were in the early stages of the pandemic,” says Dr. Sandy. “Now we understand the virus better, and our supply of PPE has greatly improved. We have gradually reopened our medical practices to offer more in-person appointments, and are strictly following safety protocols. Virtual visits have become less frequent, but they will continue to be a valuable option, when appropriate, for some patients.” 

Virtual Family Hospital Visits

Ordinarily, when a patient goes to the hospital, family members and friends are free to come along. If the patient is admitted as an inpatient, family and friends also are typically allowed to visit with the patient—and in fact often play an important role in a hospitalized patient’s care, helping caregivers get to know their patients better and speaking for patients when they cannot speak for themselves. During the COVID-19 pandemic, however, hospital visitation has been challenging. 

During those weeks when the hospital severely limited visitors to help prevent the further spread of COVID-19, Sentara RMH nurses, the hospital chaplains and other staff members became very resourceful at finding ways to link patients digitally with family members and friends. Using funding provided by the RMH Foundation, Sentara RMH purchased a number of Samsung tablets that nurses and chaplains could use, along with the Google Duo app, to set up virtual video visits for patients. 

“As a palliative care chaplain and an end-of-life doula (helper), the visitation restrictions relating to COVID went against everything I most value about patient and family care,” says Sentara RMH chaplain Rene Hostetter, who spent many days helping patients and families make these virtual connections. “The most difficult phone calls were with family members, listening to their pain due to feeling disconnected and isolated from their loved ones. As I would set up video calls with patients and their families, I watched their faces become filled with joy and gratitude when they could see each other.” 

For several weekends, Sentara RMH chaplains provided extra in-house coverage. “They were specifically focused on setting up video visits for patients,” says Robin Martin, MDiv, BCC, manager of Sentara RMH chaplain services. 

Patients who had smartphones were able to connect with their loved ones by that means, often with the assistance of the nurses and chaplains. 

“Compassion lies at the core of nursing care,” says Lesley Cook, MSN, RN, NE-BC, director of nursing excellence for Sentara RMH. “It was very difficult for our nurses and other caregivers to see patients who were suffering—not only from a physical condition, but also from the loneliness and isolation brought on by the pandemic. Nursing staff used their personal cell phones to help connect patients with their families and, using the hospital’s Acts of Kindness Program, purchased small gifts from the gift shop to help brighten the day for many of our patients. All of our staff really stepped up, often going above and beyond the normal call of duty, to be flexible and innovative in caring for our patients and community.”

If you need to make an appointment with your Sentara Medical Group provider, please call your provider’s office and discuss whether an in-person or virtual visit would be more appropriate. Office staff will be happy to answer your questions and determine the best course of care to keep you safe.

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