Atlanta-based Georgia Spine and Orthopaedics has been ahead of the telemedicine trend after implementing the technology one year ago.
The six-location practice began using virtual appointments with 10 percent of its patients and was well-positioned to expand the technology after CMS lifted the lid on the range of services that can be provided through telemedicine.
Laurri Wallace, CEO & COO of Georgia Spine and Orthopaedics spoke to Becker's Spine Review about how telemedicine has progressed at the practice and how she hopes the technology can develop after the COVID-19 pandemic.
Note: Responses are lightly edited for style and clarity.
Question: How has the telemedicine program developed at your practice since it was initiated last year?
Laurri Wallace: We specialize in orthopedics and ortho spine and see patients from all around the state. About a year ago, we implemented telemedicine to improve access to care because a lot of the follow-up appointments we do are MRI reviews and check-ups — things that don't necessarily need to be seen in person. Initially, about 10 percent of our patients took us up on it but now we've really kicked it up a notch. Currently, about 90 percent of the practice is operating with telemedicine, and we did that within a week.
Q: How have the physicians at your practice reacted to the jump to telemedicine?
LW: Our spine surgeon Erik Bendiks, MD, led the charge about a year ago. My general orthopedic physician wasn't as excited about it because of the physical exam part but now that he understands the idea and has seen it implemented, he's doing really well with it.
Q: How about the reaction on the patient side?
LW: Initially, we did have some hang-ups with patients who didn't like the technology. We have a lot of Spanish speakers and Dr. Bendiks speaks Spanish, so we were sort of limited to him doing a lot of the telemedicine visits. However, we figured out that the platform we use allows three-way calls. So, now if we have a physician assistant helping out with a telemedicine visit, we can conference in one of our Spanish-speaking medical assistants. If the telemedicine visit turns into a surgical consult or the patient needs Dr. Bendiks to get involved, they'll call him into the video call.
Q: How has your practice pivoted in the two weeks since CMS expanded Medicare coverage for telemedicine?
LW: It's been great. We're not a Medicare provider but I sincerely hope that the administration keeps telemedicine open. We do have times when the technology doesn't work, so now we're able to flip to Facetime or WhatsApp, which most people are familiar with. Previously, we had to stay on the HIPAA compliance platform with certain rules. The change has been fantastic. I’m thrilled that some of the barriers to delivering great care have been removed.
Q: How do you see telemedicine and telehealth developing in spine and orthopedics after we push through this challenging COVID-19 period?
LW: I hope people learn to embrace it and keep it. For a lot of the services we provide, it's perfectly effective medicine and keeps the patient from travelling, even after COVID-19. It also limits travel as well as congestion and traffic on the roads. We've had patients attend telemedicine visits over their lunch break at work, where they would typically have to drive to our office, have the appointment and leave. From the provider's perspective, we're still offering the same high-quality care and we still produce the same notes. There's a very minimal decrease on the administrative staff's workload, however I can see this as being a time/space saver on practices going forward.
Q: How has your practice been impacted since the COVID-19 outbreak?
LW: We continued with what we deemed as urgent surgeries. We looked at the patients who would suffer greater deficits if we didn't continue as planned. We did a couple of procedures this week, we're not scheduled for any patients next week and we're now going on a week-by-week basis. In terms of the visits in the clinic, last week we were able to maintain our normal load with about half of the appointments in telemedicine. This week, we will probably see about 80 percent of our normal load.
I know everything is gloomy right now but I hope people take the opportunity to look at the bright side of telemedicine. Hopefully, there will be some great things that come out of this period we are going through, so we should try and embrace it.