Alameda Health System’s Dr. Jenny Cohen has cared for her 75-year-old patient for more than five years. Diagnosed with cancer, the patient was now receiving hospice care. On their March 23 telephone visit, Dr. Cohen discovered the cancer was getting worse and she worried she would not be able to see her patient in clinic again.

by Victoria Balladares

“I didn’t want to let COVID be the reason I couldn’t see her one last time. This was my patient, who I had been caring for. You build a bond with your patients. I got to know her. I needed to see her more than ever and I’m so grateful we had implemented telemedicine,” said Cohen.

AHS implemented telemedicine on March 16 to treat patients during the mandated shelter-in-place order. According to Cohen 99% of AHS Ambulatory Care visits are now taking place via telephone or video.

“While most of our visits are by telephone, we are piloting video visits with a few clinicians. I was fortunate to be able to utilize the video feature to connect with my patient. She was frightened and in denial. It meant the world to me to be able to connect with her during this difficult period of her life,” said Cohen.

Ambulatory Care is partnering with Information Services (IS) to build video visits into Epic and make it available to AHS patients enrolled in MyAlamedaHealth. Other options are being explored for patients who are not enrolled.

“I truly believe this is going to transform how we deliver care in the future. While we know some patients will prefer the in-office visit, we also know that getting to a medical appointment can be challenging for some of our patients. They’ve told us, they have transportation and daycare issues and some struggle to take time off from work to come into clinic. Telemedicine will allow them to receive care in the comfort of their own homes at a time that’s convenient for them,” said Cohen.

Telephone and video visits put AHS patients at the front and center leading to an improved patient experience. To further leverage technology and to ensure equity, teams are building an online classroom to prepare and share best practice with patients and clinicians.

“At AHS we serve very complex patients and we’re being very thoughtful about how we leverage technology without widening disparities. We’re looking at how we continue to provide robust care while keeping our patients healthy and safe, that includes using a HIPAA compliant platform and asking patients for video and care consent,” said Cohen.

The use of technology during the COVID-19 pandemic has proved to be advantageous for AHS. A birthing mom who had been identified as potentially positive for COVID-19 had been put on isolation and was not able to visit with her husband or newborn. Staff in the birthing center utilized iPads to connect mom, dad and baby.

“We placed an iPad in the baby’s room and one in the mother’s. We called dad and the family was able to connect virtually. The baby girl yawned, stretched, slept, and wrinkle her face as the nurse showed her hands, her tiny feet, and her flushed cheeks. The new mom shed tears of happiness and frustration as she asked when she would get to hold her. Her husband exclaimed at how dark her hair was, how her furrowed brow reminded him of her mother. It was so meaningful,” said Rachel Witter Serious Illness Care Coordinator with AHS Palliative Care Medicine.

Witter said the family was overjoyed for the virtual visit and shared many words of gratitude for the care they were receiving and for the opportunity to see each other together for the first time since the birth.