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“When physicians typically round with patients, they (seek) to understand what's happening with the patients and at many points in time,” Bharadwaj said. “There are several physicians who are talking to patients, reviewing patients’ charts as part of the care team. For particularly an inpatient, you have a neurologist, a hospitalist, a pulmonologist. Particularly with COVID, we had a combination of pulmonologists (and) cardiologists taking care of patients. So we wanted to make sure that the patients were not disturbed as many times (by having) a way to … see them remotely.”
“So we found out that the way to actually accelerate care and improve care is to share the data simultaneously with several specialists (at) the same time,” he said. “Come together as a physician team and solve that specific diagnosis or problem for the patient in a much, much easier manner. That was how we actually brought through the multi-specialty rounding process for our patients.”
The process is particularly helpful during the ongoing coronavirus pandemic, when a hospital has to go to great lengths to isolate patients and staff. By using telehealth, staff can avoid the cumbersome process of climbing into and out of PPE gear before meeting each patient, and they can keep all the care providers in one room while seeing multiple patients in their own rooms. Instead, one staff member goes into a room with an iPad and coordinates the discussion with the care team.
“If you bring all the physicians together in one room, share the data and share what they are doing together, then it makes it a lot easier for them to see six patients in half an hour, meaning six consulting physicians talking to the same patient, looking at the chart and making determination of care,” Bharadwaj said. “That is (a) radical change. … (We) used video visits to actually have a conversation with the patient, using a conference room type setup, where physicians will all gather together at a specified time to review all of the data of that specific patient at that specified time, while one of the physicians or nurses folks will be in the patient's room. That's how we did the entire process.”
More importantly, and as a strategy for using telehealth beyond COVID-19, the process allows for better collaboration among care providers, and in the long run better outcomes.
“What they used to do was … go and take a look at the patient, call somebody, call another specialist and say, ‘Hey, I'm seeing this patient. This is what you prescribed. This may not be working. What do you suggest we do?’” Bharadwaj said. “What we just did is accelerated the process 10 times over because we brought everybody in one room, had the conversation within 15 minutes, (and) the care plan was changed. The medication was modified. The appropriate action was taken both from a nursing as well as physician perspective, to completely transform the patient experience as part of that process. Less patient intervention, right?”