Enhancing Care with Video Visits
During COVID-19, ensuring that patients continue to receive care in a safe and responsive manner without having to leave home is critical. As a result, virtual visits, particularly video visits, have accelerated dramatically over the last five months at Women’s College Hospital (WCH) as part of the Women’s Virtual Strategy. Prior to the COVID-19 pandemic, WCH averaged roughly 20 video visits per month. In May alone, providers completed over 1,200 video visits.
“We know that this rapid shift in how care is offered has been a significant change for practitioners and staff alike. It has required teams to re-think how they work and engage with patients. However, by leveraging this technology, we have been better positioned to enhance care during COVID-19 and ensure that our patients continue to receive access to their providers,” said Laura Pus, administrative director for Women’s Virtual.
Patients report that virtual care saves time, prevents taking time off work, reduces the burden of having to make caregiving arrangements and provides quicker access than in-person care. An evaluation by WCH’s Institute for Health System Solutions and Virtual Care (WIHV) has demonstrated that patients in primary care are overwhelmingly satisfied with virtual visits and feel that they are the same or better than in-person visits.
In a postpartum mental health study, researchers from WCH found that patients who received a combination of in-person treatment and video visits were highly satisfied with the virtual option and reported both financial and travel time savings. In terms of patient outcomes, there were no significant differences between those who received virtual care and those that solely received in-person care. Provider experiences with virtual care have varied across studies. In some studies, providers have reported that virtual visits saved them time, allowed them to conduct more visits and allowed them to increase their patient roster. Others report that virtual visits required the same time and the same degree of effort.
For virtual visits to succeed for both providers and patients, up-front investment is required. Thoughtful implementation strategies, dedicated resources and staff capacity all impact the uptake of virtual visits.
“After significant research, we decided to integrate Zoom video visits into our electronic medical record (EMR), Epic. As a result, we can securely schedule, launch and document the visit within Epic, reducing the implementation barrier,” Pus explained.
“While the implementation of video visits is recent at WCH, we have already seen positive experiences for both patients and providers alike,” said Ian McMillan, project manager for Women’s Virtual. “Patients like that they can access other aspects of their care, like test results and consultation notes, from the same portal. While providers like that they can take notes in the patient’s chart while conducting the video visit. We have also seen some administrative efficiencies, like scheduling directly within the EMR using existing scheduling workflows.”
WIHV is currently leading the evaluation of video visits at WCH. “Our aim is to broadly learn how video visits impact the quadruple aim: patient experience, provider experience, population health and health system cost," said Dr. Geetha Mukerji, Women’s Virtual Evaluation co-Lead and WIHV Innovation Fellow. “The insights gained from the evaluation will allow the organization to adjust and implement quality improvement strategies to improve our video visit offering, better serving the needs of patients, providers and the broader health system.”
Over the coming months, group video visits will be rolled out across the hospital, as well as digital patient questionnaires in myHealthRecord.