Telehealth Takes Center Stage for Outpatient Visits during Pandemic

Rapid creation of telehealth services benefits patients, providers

Lahey met the multitude of changes demanded by the pandemic with the innovation and teamwork embedded in the hospital’s DNA.

Thanks to the work of Department of Medicine Chair Sheri Keitz, MD, PhD, strategic innovation has indelibly changed patient care models. As a member of the hospital’s COVID-19 Incident Command Team, Keitz helped to staff critical care units that operated at 176 percent capacity at the peak of the pandemic, while also leading Lahey’s rapid creation and implementation of telehealth services.

“We take care of patients wherever they are, whenever they need us, using whatever technology they may have,” she said. “Starting up telehealth was a moral imperative. We were literally saving lives by keeping our patients home, keeping providers safe from unnecessary exposure to the virus, and conserving personal protective equipment (PPE).”

Keitz and Lahey’s Information Technology team got the telehealth program up and running in just a few days. Complexities included expanding the telehealth visit capabilities within the Epic electronic health record and the patient-centered Lahey MyChart; teaching staff how to conduct and document virtual visits; setting up workflows; guiding staff and patients through the process, including cultural and technological barriers, and more. Providers completed 500 patient telehealth visits when the telehealth initiative launched on March 16; in a week, those daily visits escalated to 3,000, or about 53 percent of normal volume for outpatient visits by March 23. Providers logged an average of 5,700 telehealth visits daily in May — 66 percent of normal volume for outpatient visits.

While telehealth was first implemented for one-on-one physician visits, it has continued to expand. “We quickly realized so many more ways to use it,” Keitz said. Virtual consults helped clinicians screen and triage COVID-19 patients and determine the need for testing. At the same time, the technology allowed doctors and advanced practitioners to safely continue caring for many medically vulnerable patients when coming to the hospital might risk unnecessary exposure at the height of the pandemic. Critical care teams and medical liaisons used telehealth to help patients and families connect, while the medical weight loss team has begun conducting virtual group program meetings. “And we soon will gather patient’s vitals when we integrate the Apple Health app,” she said.

Keitz, who came to Lahey from UMass Memorial Medical Center last year, is a passionate educator, clinician and leader eager to remove barriers and solve problems to maximize all aspects of patient care. “Sheri has been a spectacular addition to the leadership at LHMC,” said Tonya Hongsermeier, the hospital’s chief medical informatics officer. “We are particularly fortunate that she joined us before the COVID-19 pandemic because she has been so helpful to the success of our telehealth deployment… She declared, early in our process, that we would prioritize taking care of our patients, no matter what. And we did.”

For her part, Keitz was drawn to Lahey because of its people. “Lahey has a heartbeat that is related to collegiality and shared mission,” she explained. “This is a place where extraordinary things happen every day because of extraordinary people working in clinical care, research and education programs.” The pandemic, Keitz says, has only amplified Lahey’s heartbeat. “I am so proud of the work we are doing every minute because of the can-do spirit of every person in the organization. I wouldn’t want to be anywhere else on earth!”