COVID-19 forced Oak Orchard Health, a health system based in Brockport, New York, to change the way it did almost everything at its health centers – beginning with its inability to see patients face to face.

THE PROBLEM

But services were needed more than ever. As a rural FQHC, Oak Orchard typically faced many challenges – challenges inflamed by the pandemic. Typically, patients are unable to get reliable transportation. The solution Oak Orchard found was telehealth, which it continues to use today.

Patients can stay at home while providers work at the health center or other safe location to provide care. Telehealth has helped the health system with medical, dental and behavioral health services.

"We are using eClinicalWorks’ healow telehealth platform, which allows our providers, who are also using new laptops, webcams and headphones, to be able to see patients from any location," said CIO Jason Kuder. "When patients started to come back to the office, we used in-room telemedicine equipment from Elo and Logitech.

"Patients were roomed by a nurse at one of our offices where the telemedicine equipment was already set up, and our providers would be at another one of our offices or possibly working from home," he continued. "We would do a Microsoft Teams call to connect the two."

Similarly, using Ergontron carts, Oak Orchard could do the same thing as the in-room system but in a mobile fashion, moving from room to room when needed.

Dentists also use Microsoft Teams along with an oral camera by MouthWatch. The hygienist would work the camera while the dentist performed the exam from a health center.

PROPOSAL

Telemedicine technology has resolved several problems for Oak Orchard, explained CEO Karen Kinter.

"The first was during COVID, when it helped to alleviate access problems when face-to-face appointments were often not possible," she said. "Second, our patients also experience problems given the rural nature of our community, which includes a lack of transportation or inability to drive long distances.

"Now they can 'see' a provider without coming to the health center," she continued. "And third and most recently, we have been experiencing a shortage of providers in medical, dental and behavioral health services. In fact, we're located in a designated Health Provider Shortage Area. So, telehealth helps us extend services."

A good example is Oak Orchard does not have a nutritionist in every office; therefore, it uses telehealth so patients in all offices have access to one. This helps the health system extend services remotely in shortage areas.

MARKETPLACE

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MEETING THE CHALLENGE

Oak Orchard Health has used telehealth services in most areas of its healthcare delivery.

"Our behavioral health team continues to use telehealth services post-pandemic," Kinter said. "Patients find it very convenient – fewer missed appointments – they feel more at ease, and therapists can get a bigger picture of the patient’s home life with the video component.

"We continue to use telehealth with dental and medical services when access is an issue," she reported. "With a shortage of providers, telehealth has helped us continue to provide access to services and providers. We don't need to have providers drive for hours from office to office to see patients. A huge plus."

RESULTS

Telehealth visits helped Oak Orchard Health keep patient visits up in 2020. In the two following years, it supplemented visits when in-person wasn’t possible.

Following is the number of patients seen via telemedicine per year:

• 2018: 0
• 2019: 55
• 2020: 17,975
• 2021: 7,688
• 2022: 5,690

ADVICE FOR OTHERS

"Telehealth is the norm for us now," Kinter said. "It is part of the way we treat our patients, and it improves many access issues. We’ve experienced the benefits. I would advise other community health centers, particularly rural ones, to adopt telehealth if they haven’t already.

"Encourage patients to use it and educate them on the benefits," she advised. "You may be surprised to know that you have some of the resources already, such as your electronic health records system. Once telehealth is implemented, its uses are endless. Patients can be connected to specialists across town or across the country."

Telehealth helps to eliminate some of the multiple in-person office visits that often are a barrier to caring for patients, Kinter added.

"Currently, we partner with the Eastman Institute of Oral Health when complex dental care is needed, especially with children," she noted. "And we continue to look for ways to use telehealth. So don’t miss out on the opportunities that telehealth provides."

Kuder suggested healthcare provider organizations be aware of what an EHR can do.

"Using the functionality that you already have, but might not know about, is so important," he concluded. "Once patients get used to telehealth, they often want to continue to use it. So be ready to support it into the future."

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