Dr. Mary Ann Yehl, medical director, telemedicine and ambulatory quality at AtlantiCare, will be the first to admit: Primary care visits are supposed to be one-on-one meetings with a patient and a doctor — visits that can be essential in treating issues before they become too complicated.
That being said, Yehl said one of the successful outgrowths of AtlantiCare’s wildly successful Virtualist program — where these all-important primary care conversations are now taking place over the internet — is that they often bring more people to the meeting.
That, Yehl said, often leads to a more relaxed conversation and to more medical information, which always is a good thing.
“When patients are at home, they tend to be very free and relaxed and more organized than in the office,” she said. “In the office, they’ll come in with a giant bag, and sometimes they forget what medications they are taking because left one home in the upstairs bathroom and whatnot.
“It’s really nice, because they can actually take you to the medicine cabinet and kind of walk you through it. And, since they’re just very comfortable in their houses, they’re very freely speaking.”
They aren’t the only ones.
“Sometimes, you’ll have a spouse yell, ‘Don’t forget to tell them about this.’ Obviously, we urge them to be in a private spot, but many of them have their spouses or a family member join and they add information. Often times, we’ll see a caregiver — a parent with a child or someone taking care of an older relative.”
Patients are given a half-hour window of time, so they are not rushed. And, in most cases, it leads to a follow-up visit to a specialist or for an additional test.
The good thing: Most patients can be seen the same day they log into the system.
Yehl estimates that 20% of those logging in are those who do not have a primary care doctor or who have not been to a doctor in many years.
The importance — and the need — is obvious. Studies show there was a 25% drop in the number of adult visits to primary care providers in 2008-16, or pre-pandemic. The number of adults going one year or more without a primary care visit was more than 46%.
Yehl hopes that will change.
“We know patients who have primary care docs are overall healthier,” she said. “We initiate screenings earlier and we identify potential problems and can get patients labs or procedures and help identify health issues.”
And not just among older people.
“It is really important for patients who are under 50,” she said. “They all think: ‘I’m totally healthy. I’m young. I don’t need a primary care doc.’ Often times, when we go through family history, we see (potential issues). We have to say, ‘Wait a minute, we’re going to make sure you’re healthy and make sure you’re on the right road.’ So, it really works out nicely when we can get patients connected earlier.”
The connections are happening.
Virtual visits at AtlantiCare are skyrocketing, with telehealth services up 170% from just July to August. (To set up an appointment, click here or call 833-692-7436.)
ROI-NJ spoke with Yehl — virtually — about all things involving the Virtualist program. This week is National Primary Care Week.
Here’s a look at the conversation, edited for space and clarity.
ROI-NJ: How and why did the Virtualist program start — and how does it work?
Mary Ann Yehl: It started in June. Basically, we were just trying to fill a need. We found a lot of patients were busy, or patients didn’t really want to come out of the house, but they still needed care from primary care doctors.
New patients or established patients can call in and see a virtual primary care doctor. It’s a really great way for patients to establish care. They don’t have to leave their houses, but they can follow up with in-person visits. We can get the ball rolling, start doing bloodwork, imaging and health maintenance — all that good stuff.
ROI: How long are the visits?
MAY: We give it about 30 minutes start to finish. But not all 30 minutes is talking to the provider. We have a medical assistant call or log on the video to walk the patient through it to make sure that it works. Then, the provider jumps on, and we meet with a patient for as long as it takes. And then, we call in the patients’ medications or imaging or follow-ups or whatever else they need.
ROI: How often does the virtual meeting led to a follow-up visit, either virtual or in-person?
MAY: We hope everyone does. This isn’t urgent care, it’s a primary care model. So, if you come in as a new patient to AtlantiCare, I start order testing for whatever we need. But the goal is that you would follow up in person with a primary care doctor for the EKG and the blood pressure or whatever else that you need. All of our providers do telemedicine. So, it’s not like you can’t do telemedicine beyond that. But that’s our goal, is to have you established with a provider to have regular health care — screening and preventative tests.
ROI: The virtual shift is four hours, or eight patients. On average, how often are you discovering issues that need urgent attention, where you are saying, ‘I’m so grateful we began treating this?’
MAY: They are all satisfying, because everyone who’s calling really wanted to see a doctor that day and got to. But there are a few patients, two or three, where I think, ‘Oh my goodness, we really caught something early.’
ROI: The pandemic may eventually go away — or be lessened in significance. Telehealth, however, is here to stay. Talk about its importance going forward.
MAY: It’s definitely here to stay, but I really think it has to be a hybrid model. As much as I love telehealth, it’s not the be-all, end-all for every patient all the time. And I think we have to manage those expectations. For someone who’s having chest pain, telehealth is not a good visit. But, for a lot of things, it is. For a patient who takes ADHD medicine or for someone who is seeking behavioral therapy, telehealth is a fantastic option.
So, I think some kind of a hybrid model where most providers are offering some sort of telemedicine is really where we want to be. We know that it’s convenient for patients and it’s cost-effective. We’re expanding our program because we see such a need for it.
ROI: How will it evolve?
MAY: I think, as we move along, things will be even more sophisticated. For example, wearables. They’ll integrate more into the (electronic medical records) and we’ll actually get objective information. Right now, we’re using remote patient monitoring. So, if you call me with high blood pressure, I can drop ship a monitor to your house that will look at your blood pressure and send the information to a team of nurses. It will be monitored every day, so that I don’t even have to see you and I can adjust your blood pressure medication. That works so nicely for both the physician and for the patient. I think all those technological things will just be more advanced and more sophisticated.
ROI: Last question. This service is only as good as people sign up for it. How are you getting the word out?
MAY: That’s a credit to our marketing specialists. They’ve been using some great social media avenues. We’ve been doing a lot of patient stories, internet advertising, even in our offices. Most of our primary care docs do a good amount of telemedicine, even our specialists. So, once patients get introduced to it, they really become very comfortable, very quickly.
The pandemic has really been the best advertiser for us. Because that initiated it. And it ended up being really nice, because so many of them really enjoyed it.