6/22/2023 0 Comments Kaiser video visits![]() ![]() However, providers still needed to learn how to launch the video visit, conduct basic troubleshooting, document the visit, and order the appropriate tests from the video platform. Any temporary glitches in the video platform or with internet connectivity were sources of provider and patient frustration. Sometimes these obstacles resulted in just a phone call to the patient which did not have the same patient appeal, and which did not have the added visual images for the provider, that a video visit afforded. The second main obstacle to the adoption of video care technology was the accessibility of the technology including adequate connection quality. At Kaiser, the video care platform is embedded in the electronic medical record. ![]() We overcame this obstacle by having each department identify a list of patient chief complaints for which the providers would feel comfortable handling over a video visit. Typically these chief complaints involved little to no physical exam to make the diagnosis. In other words, most of the diagnosis was sourced in the clinical history provided by the patient. We then promoted video visits to the members based on the provider approved criteria. Subsequent use and practice of video visits added to provider confidence in correctly diagnosing over video. In specialty departments such as Head and Neck Surgery or Ophthalmology, the provider concern was even greater as often a focused physical exam is essential to their practice. Let’s look at each of these concerns and let me explain how I led a team effort to solve these barriers.Ĭoncern about being able to diagnose the patient’s clinical question effectively was a major barrier for some providers in adopting video care technology. Many patient chief complaints in APC that required little to no physical exam (such as allergies, cold symptoms, Covid 19 concerns, rashes, insomnia, anxiety and depression) could be adequately addressed over video. Some conditions could not be safely addressed with a video visit, such as shortness of breath, abdominal pain, or chest pain, which required an in-depth, physical exam in the office, or even in the Emergency Department. In 2016, video visits at my medical center accounted for less than 1% of total patient encounters across all departments. By the beginning of 2021, this had grown to 30% of all encounters in APC with most other specialty departments showing robust utilization of the Kaiser video visit platform as well. Based on my five years experience as the Video Visit Implementation Lead, I found there were three major concerns for provider reluctance to adopt video care technology:ġ) Effective telediagnosis: Did the video technology allow the provider to correctly diagnose and treat the patients’ clinical concern?Ģ) Access to the technology: Was the technology easily accessible, integrated into the electronic medical record, and was it reliable?ģ) Alternate methods to video care: Were there equally effective methods already available for delivering the same high quality health care without needing to use video technology? ![]() ![]() The internet and digital technology have enabled health care providers and patients to connect remotely for a wide variety of health conditions. The Covid 19 pandemic has further fueled this rapid growth as technology allows providers to deliver high quality health care to patients in their homes. But there can be some significant barriers to provider adoption of novel digital technologies.Īs an internal medicine physician in Adult Primary Care (APC) at Kaiser Permanente in Northern California (Kaiser) for over 17 years, I led the effort at my medical center in San Rafael, California to promote and implement the use of patient care video visits across all departments. Kaiser is a not-for-profit, fully integrated HMO with the health plan, hospitals and physicians all being under one umbrella organization. The physicians are salaried and are not subject to fee-for-service constraints. The promise of telemedicine is huge but so are the barriers to adoption. ![]()
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