St. Jude staff and patients have had to embrace new ways of connecting during the pandemic. Elyse Heidelberg, PsyD, meets with 3-year-old Maddie Kate Harris during a psychology telehealth appointment.

Tune in for Telehealth

Telehealth services connect patients and providers amid coronavirus concerns.

By Keith Crabtree, PhD; Photos by Seth Dixon

It’s Monday morning, and a patient at St. Jude Children’s Research Hospital is scheduled for a checkup. But because of the COVID-19 pandemic, he and his parent will not be taking a shuttle bus from his housing facility to the hospital. Instead, the checkup comes to him.

Thanks to telehealth, patients can now undergo some medical exams from the safety of their rooms or apartments—avoiding the risk of traveling to and from the hospital during the pandemic. Using digital stethoscopes and fiberoptic otoscopes, telepresenters meet with the patients, allowing physicians and advanced practice providers back at the hospital to conduct in-depth physical exams.

Safe and sound

A telehealth visit is a viable option for many patients.

Once the patient and provider connect, the provider can do the usual things: obtain history, assess symptoms, conduct a physical exam, review labs and diagnostic imaging test results, explain the treatment plan and schedule the next visit. If needed, a telepresenter collects vital signs and uses exam equipment to share digital images and data with the provider—as if the provider and patient are in the same room.

For patients who test positive for COVID-19, families are given a telehealth kit and are taught how to use the equipment, reducing the risk to telepresenters and the need for personal protective equipment.

Patients usually access the telehealth app via tablets and laptops. The hospital’s telehealth carts also include an on-demand feature for interpreter services.

The smart option

Suzette Stone, PhD, director of the Center for Advanced Practice at St. Jude, says that telepresenters go to Target House and other patient housing facilities with carts that carry the medical scopes and a kit. Kits are packed with gowns, gloves, goggles and masks; antibacterial wipes; ear specula; laptops and vital signs monitors; thermometers; and a few other essentials.

Smart tablets sit atop the telehealth carts, which are located in the hospital’s housing facilities and clinics. Carts are also located on each hospital floor. The hospital provides full telehealth kits to a small number of patients at home.  

Nina Antoniotti, David White and Sarina Horn test equipment.

Teletest

To ensure telehealth appointments run smoothly, Information Services staff Nina Antoniotti, RN, PhD (on screen), David White and Sarina Horn test equipment.

Sidestepping anxiety

When the COVID-19 pandemic began, Nina Antoniotti, RN, PhD, director of Interoperability and Patient Engagement, and her colleagues realized that telehealth services—already in the planning stages—would be crucial during the coming weeks and months. The team purchased equipment and, during a three-day span, assembled 15 telehealth carts.

 “We were about two weeks away from starting the program when COVID-19 hit,” Antoniotti says.

The team refocused to accelerate telehealth training for physicians, advanced practice providers and psychosocial staff, among others. More than 160 providers and 20 nurse telepresenters trained in the program’s first month, with the numbers increasing weekly.

“We went from zero to up to 20 patient visits a day within a month,” says Ellie Reece, Clinical Operations director in Ambulatory Procedures.

About 1,200 patients received telehealth services between April 16 and June 25.

“Psychology was willing and able to do their visits via telehealth,” Reece says. “They showed up as leaders and got all their staff trained early on.”

“To this day, they’re our biggest user, and they’ve spread it across all Psychosocial Services,” she adds.

St. Jude has also begun getting clinicians licensed in other states so the program can expand. The team has helped identify new uses for telehealth that can begin while clinicians and patients are still at home.

“Once they’ve used telehealth, they keep requesting it,” says Stone, who explains that families appreciate the option to shelter in family housing during the pandemic and sidestep the anxiety of unnecessary community travel.

Joyful connections

On a busy Monday morning, an advanced practice provider quietly waits for a telehealth visit to begin. When the child’s picture suddenly snaps into place, both the clinician and patient exclaim with excitement.

“It’s so good to see you!” the St. Jude provider says.

“I miss you!” the child replies.

It’s more than a routine appointment. For both clinician and patient, it’s a joyful connection. It’s another St. Jude moment.

 
 

From Promise, Autumn 2020

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