I recently co-hosted the second webinar in our two-part Survive and Thrive webinar series with Houston-based endocrinologist, Dr. Medhavi Jogi. His clinic, the Houston Thyroid and Endocrine Specialists (HTES), is a great example of how medical practices can leverage technology to flexibly adapt to this unprecedented situation. While the first webinar focused on preparing for operational disruption, this second webinar paints an inspiring picture of how re-imagining your practice’s operations to react to the immediate situation can deliver positive long-term results for you and your patients.
Social Distancing in the World of Medicine
As of this post, most U.S. states are currently in Stage 4 of our COVID-19 pandemic framework — De-Escalation of Crisis Conditions. The immediate measures that providers had set in place during Phases 1 and 2, like implementing telehealth visits if they weren’t previously offering them before, are up and running. But now, providers are realizing that the workflows that were once clinic mainstays just aren’t going to work in this new world. They need to re-evaluate how they are operating for the safety of their patients and staff, and for the overall health of their business.
How do you keep people six feet apart in a standard clinic waiting room? How do you eliminate the potential vectors of transmission inherent in typical office visit? These were just two of the questions that Dr. Jogi and his staff at HTES tackled as they prepared a COVID-19 operational plan.
Lessons from the Houston Thyroid and Endocrine Specialists (HTES)
Clinics across the nation have unique experiences with COVID-19 depending on their specialties, locations, and patient profiles. And while every response plan should be customized for each clinic, there are certainly best practices that can be shared. One of the leaders that has emerged in the response to the COVID-19 pandemic is Dr. Jogi and the HTES. Immediately out of the gate, Dr. Jogi and his staff focused on communication and safety, and have really set the standard for how to transition — quickly — to provide continuity of care for their patients AND keep the business afloat.
“Initially, we didn’t know what the rules would be and the state hadn’t decided. We were anticipating that we were going to close down and there were a lot of questions: Do we go to the office, do we not go to the office, can staff come in or not? There was a lot of confusion,” Dr. Jogi said, when speaking about navigating phases 1 and 2 of the five-stage pandemic response framework. “Old patient portal systems through Electronic Medical Records (EMRs) are too slow and didn’t have enough utilization by patients for the information to get there fast enough.”
HTES used its existing Luma Broadcast solution to get messages out to patients, fast. “With the situation changing daily, the ability to communicate with patients easily — and know they were actually receiving the messages — was essential,” Dr. Jogi said. “Luma Health’s broadcast tool is super useful on a Friday night when you realize that the Governor has just shut down your clinic starting Monday of the coming week.”
With communication under control, the next question became: How does our practice handle in-office visits that need to happen? While the vast majority of patients were fine with converting to telehealth visits, there were some patients that simply required in-person visits.
Moving to telehealth made it obvious that it was important to batch in-office visits to allow for efficiency. However, with a reduced window for those visits, the team needed to figure out how to effectively implement social distancing in the clinic with re-designed workflows that limited unnecessary interaction between patients and staff.
“First and foremost, we changed the process of how patients pay,” said Dr. Jogi. “We started requiring patients to pre-pay for their co-pays and deductibles the day prior to their visit so when they arrive, there is no need to hand off a credit card or touch a kiosk. When patients arrive, they’ve already paid and go straight to a room.”
As well, when the exam and waiting rooms are full per social distancing guidelines, the clinic is able to send patients back to their cars or elsewhere to wait. When a freshly sanitized room becomes available, patients are alerted via the Luma Health messaging platform. This simple zero-contact check-in strategy effectively enables HTES to extend its waiting room outside of the clinic.
By optimizing in-office time, and shifting quickly to telehealth visits where possible, HTES was able to minimize the revenue disruption they were facing and simultaneously maintain continuity of care for its patients.
“How much disruption you want for your clinic depends on how much technology you’re willing to use. If you’re unwilling to use any technology, you’ve got a problem because you’re going to have a lot less people in your physical waiting room and your office with the same amount of overhead,” Dr. Jogi said. “But if you utilize technology like Luma Health’s Zero-Contact Check-In Solution, you can extend your waiting room infinitely and therefore it doesn’t really matter how much space you have in your office.”
What’s Your Stage 5?
Out of necessity, the COVID-19 pandemic required HTES to move to telehealth visits delivered by practitioners working from home, with limited time spent on in-office visits. But seeing how effective that model has been, how it has been embraced by patients, and how it gives him (and his staff) the flexibility to work from nearly anywhere, Dr. Jogi has imagined a new way of practicing medicine.
Dr. Jogi’s Stage 5 — The New Normal is supported by technology that allows his clinic to seamlessly transition between office visits and telehealth visits, build a schedule tailored to his lifestyle, and introduce automated workflows to maximize efficiency.
Early on, as he started to use technology to design new patient workflows around telehealth and in-office visits, he realized that the days of being in the clinic, with in-person visits as the rule, were unnecessary. “My stage 5 is a new type of future for me,” Dr. Jogi said.
Regardless of your practice type, technology can enable you to design a new reality for your clinic that prioritizes patient care, protects your profitability and simultaneously gives you more flexibility regarding how you choose to provide care.
The lesson learned from Dr. Jogi and HTES is that the fundamental changes to clinic operations that were born out of necessity can end up creating a better “new normal” for you and your patients, if you implement the technology to support it.
I encourage you to watch the on-demand recording of my webinar with Dr. Jogi to find out how the HTES approached the COVID-19 pandemic framework, and the solutions implemented, have allowed him to look forward to a re-imagined practice.
While every practice is different, Dr. Jogi’s experience includes actionable advice for clinics of all types and sizes, along with some hands-on tips to make sure you account for the various factors impacting your operations.