After being thrust into telemedicine, doctors, physician practices and health care organizations now have a little more time to step back and consider how to make the most of the technology for physicians and patients.
One way to optimize telemedicine—and to better care for patients, streamline efficiencies and reduce professional burnout—is by using a team-based care model similar to the ones in place for face-to-face visits, family physician Kevin Hopkins, MD, told listeners in a recent episode of the AMA STEPS Forward® podcast. Dr. Hopkins is Cleveland Clinic’s primary care medical director and senior physician adviser at the AMA.
Team-based care—something Dr. Hopkins embedded in his practice more than a decade ago—is an office workflow that allows physicians and other health professionals to work together, each performing tasks at the top of their licenses, skill set and training to take care of a patient.
But when the pandemic hit, those hard-won team-based care lessons seemed to fade.
“What became a stark reality very quickly was that we reverted very quickly to what we know from the past and that was a physician-does-it-all mentality,” Dr. Hopkins said. That “mentality is no more sustainable in a virtual visit environment than it is in a face-to-face environment.”
Once the shock of the quick pivot to telehealth at the beginning of the COVID-19 pandemic wore off—a time when Cleveland Clinic went from seeing 3.2% of primary care patients via telehealth to more than 90%—Dr. Hopkins said they were able to create a team-based approach for their telemedicine visits based on knowledge they had from their in-office system.
The gains and improvements the health system saw for patients and physicians using the team-based care model in a telehealth setting are very similar to the ones patients, physicians and other care givers experienced when the model was implemented in for in-office visits. Dr. Hopkins co-wrote the AMA STEPS Forward™ toolkit, “Telemedicine and Team-Based Care,” that outlines five key steps to follow.
Team-based care can help your practice improve patient safety and reduce burnout. Learn about these four benefits.
Dr. Hopkins joked that he is not the most tech savvy person, and that when had to use the EHR before moving to team-based care he received a comment on a patient survey in which the patient said they weren’t sure if the doctor spent more time examining them or the computer during the visit.
“Having someone else perform a lot of the documentation, a lot of the navigation through the electronic health record, has allowed the physician to be 100% focused on the patient. And our patients appreciate that,” he said.
A medical assistant or nurse in the exam room with the physician adds an extra advocate for the patient. For example, a physician may get talking with a patient and forget to listen to the patient’s lungs. The nurse or medical assistant can step in to say something to remind the physician before the exam is over.
“The same types of things can happen in a telemedicine environment too,” Dr. Hopkins said. “There is an extra set of eyes and ears advocating for the patient making sure we have completed all the work we have set out to do in the context of that visit.”
Dr. Hopkins believes there are few more sacred relationships than the one between a patient and physician. Bringing another caregiver into the telemedicine visit offers the opportunity for the patient to build that kind of relationship with a second person. The patient may tell the clinical staff something important that they don’t mention to the physician.
“It goes a long way towards delivering the world-class type of care that my patients deserve,” Dr. Hopkins said.
After working together on a regular basis, trust builds between the clinical staff member and the physician. Often, the clinical team member can anticipate what tests a physician may order in a certain situation.
Learn how the AMA has helped assure telehealth flexibilities will remain in place for the bulk of 2022.