Short Stories of People Going Above and Beyond the Call of Duty
Author: Pam Malinoski
Provider Stays Late to Reassure College Students
“Early during the pandemic, we had a college student call in around 4:30 p.m. who had tested positive, and we provided a telehealth visit,” said Lynn Brown, office manager at MercyOne in Iowa. “This student then started spreading the word by text to others on campus who were symptomatic, and within an hour, we had 55 college students calling us after hours. This provider stayed late that night doing telehealth visits. All these kids were away from their parents and scared. We were able to calm them down and just reassure them that they would be okay.”
Unexpected Tech Support
“We had an older couple who really wanted to take advantage of telehealth visits, but they were struggling with pop-up blockers on their phone,” said Barbara Barnett, clinic informatics analyst at MercyOne in Iowa. “We found out that they always went to Taco Bell for lunch on Fridays, so we had them drop their phone with us before their date. Our staff looked at their phone, called the local Verizon store, deleted the problem pop-up blockers and downloaded the necessary apps to get their phone working properly. Now, these older patients are telehealth technology wizards. They can schedule a telehealth appointment whenever they need to talk with a provider.”
Dealing With a Mountain of Burdens
A counselor with Horizon Health Care in South Dakota conducts telehealth virtual appointments with a struggling patient. Besides facing common stressors including an inability to work and pandemic worries, this patient lost a family member in early 2020. She is now caring for and homeschooling this deceased relative’s children, who are also suffering from health and behavioral health issues. With no insurance and no support, she is thankful for the ability to connect with a Horizon counselor to help her through depression, stress, and grief.
Arming Isolated Mother With Self-Care Tools
A single mother who recently moved to rural South Dakota is homeschooling her small child but was experiencing isolation due to the pandemic. A Horizon Health Care primary care provider referred her for virtual counseling. She has since been working through her stressors by implementing a routine of self-care and developing coping skills to deal with her anxiety.
Someone Willing to Listen
Although a Horizon Health Care counselor is providing a South Dakota patient with various tools to better manage her mental health challenges, the patient says virtual telehealth visits are valuable because she simply has someone to talk to. Suffering from depression, anxiety, and pain, the patient is also managing multiple foster children. A counselor meets with this patient twice a month, providing her with ways to cope with anxiety and depression, self-care tools, and progressive muscle relaxation exercises.
Managing Behavioral and Medical Issues Despite Transportation Difficulties
A challenge that many Horizon Health Care patients face in rural South Dakota is overcoming transportation issues in order to receive needed medical and behavioral health care. One such patient, suffering from bipolar issues as well as anger, hallucinations, and paranoia, successfully connects through telehealth appointments both with a Horizon psychiatrist and counselor. By connecting virtually with her psychiatrist, she can consistently manage her medications to get her symptoms under control. She is then able to discuss the stressors of homeschooling her older children along with caring for her baby. Without telehealth services, transportation issues would prevent this patient from securing the care she needs.
Telehealth Provides Care for Suicidal Teenager
A young teenager is participating in virtual mental health visits with a Horizon Health Care counselor in South Dakota. Suffering from depression and anxiety, this patient has a history of suicide attempts. While at school, she has met virtually with a Horizon counselor each week. Other members of the family are being treated through Horizon as well for issues such as substance abuse.
Virtual Visits Provides Respite From COVID-19 Stress
Just about everyone has experienced increased stress and worry from the current global pandemic. When a single mother in South Dakota added COVID-related stress to her existing mental health issues, she needed help. Because she lives 50 miles from her Volunteers of America outpatient therapist, she would have been unable to obtain therapy without the availability of telehealth options. Today, she meets weekly with her therapist and completes all her homework, allowing her to manage better through the pandemic.
Telehealth Allows High-Risk Patient to Continue Therapy
Although a South Dakota behavioral health patient of the Volunteers of America has been dedicated to her therapy for years, she considered pausing her work this past spring. Due to co-occurring issues and an autoimmune health condition, she became very concerned about the COVID-19 pandemic and worked hard to limit her outings and exposure. She has shared that without telehealth options, she would have put her therapy on hold. She is grateful to be receiving services during these dark times.
Virtual Visit From a Combine
Scott Frank, a retired high school agriculture teacher, has been a patient at UnityPoint Health in Iowa for years. He spends much of the spring working with a local farmer driving a tractor and putting crops in the fields. When it came time for his annual well visit, Frank called the clinic to cancel as he said, “It’s hard to give up good weather when you can be planting. Spending three hours going to the doctor and with the current pandemic, I was reluctant to go in.”
In lieu of canceling his appointment, the UnityPoint Clinic team suggested a virtual visit with his provider. Frank, a novice to this type of technology, agreed to give it a try. While Frank was discing a field, he stopped his tractor to have his appointment. “It was much easier and convenient with the same results. I would highly encourage everyone to consider the ease and convenience of virtual visits.”
Video Visit Helps Pediatrician Catch Potentially Serious Condition
When a Minnesota mother was worried about her toddler son, she scheduled a virtual appointment with Dr. Lori DeFrance, a pediatrician at Essentia Health. The child had been diagnosed with allergies, but his mother was concerned about the ongoing swelling he was experiencing.
“By my being able to see his puffy eyes and distended tummy, I agreed it wasn’t an allergy or infection,” said Dr. DeFrance. After ordering same-day labs, Dr. DeFrance confirmed her initial suspicion. The child had a potentially serious kidney condition. The patient was transferred to a pediatric nephrologist and is doing well with treatment.
Telehealth Provides Safe, Effective Concussion Follow-up Visits
Blaire Ziebol, a 23-year-old Superior resident, appreciates the convenience of virtual visits. Ziebol suffered a concussion about five months ago. Initially, she would meet in person with Kelly Kleinschmidt, a nurse practitioner at Essentia Health in Wisconsin. Ziebol’s past three visits, however, have been conducted virtually. They last between 10-15 minutes. Ziebol shares her symptoms and will do balance exercises so Kleinschmidt can further assess her progress.
“It’s really quick and easy, and I don’t have to worry about coming in and being exposed to others who might be sick,” Ziebol said. “It gives me peace of mind. I really appreciate being able to do them from home.”
Healthcare on the Road
When a trucker was en route during a job and started to feel ill, he simply pulled over at a truck stop and called his Catholic Health Initiatives provider in North Dakota for a telehealth appointment. After the virtual visit, his provider was able to call in a prescription at the pharmacy near the trucker’s current location and get him back on the road.
Urgent Call During Bike Ride
Dr. Clete Younger, physician and medical director at UnityPoint Health, works with many local and rural nursing homes in Cedar Rapids, Iowa. “One Sunday morning, I received an urgent call on my cell phone while I was on a bike ride,” Younger said. “A Cedar County nursing home resident had fallen and lacerated her head. I was two hours away from the facility and 16 miles from home. Thankfully, I was able to virtually assess the patient using my phone. I was also able to work with the nursing home’s care team to create a treatment plan that kept the patient within the facility and avoided a long and costly transfer to a hospital Emergency Department.”
Addiction Patients Receive Med-Checks Virtually
Dr. Rachel Hartline, a physician with Upland Hills Health in rural Wisconsin, has been able to use telehealth to conduct regular medication checks with some of her addiction patients. “I have some patients who have been admitted to rehab in the Madison area,” Hartline said. “It would be fairly disruptive to have them come back to our rural clinic regularly for continuation of their medication to treat their addictions. With telehealth technology, I can conduct a video visit and e-prescribe medications without the patients needing to leave the rehab facility. This has helped not only reduce their risk to COVID exposure but also saved travel time and kept them consistently within a structured rehab setting.”
CDC Appreciative of gpTRAC Billing Guidelines
When an Epidemic Intelligence Service (EIS) officer from the Center for Disease Control (CDC) in Athens, Georgia, was struggling to identify billing codes that indicated telehealth services, the individual reached out to the Great Plains Telehealth Resource Assistance Center (gpTRAC) for help.
gpTRAC’s team shared access to the state-specific billing guides, developed in collaboration with Nebraska-based ruralMED Revenue Cycle Resources. These resources were developed to assist organizations in understanding the complexity of telehealth billing requirements and are available online at no charge. These resources were developed for all states officially served by gpTRAC (Iowa, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin). Feedback from the CDC was very supportive and positive, and they are using these resources to assist in their understanding of the types and volume of telehealth visits among the millions of submitted claims.
|Organization||Connection to the Great Plains Telehealth Resource & Assistance Center (gpTRAC)|
|MercyOne||Member of gpTRAC’s Program Advisory Council (PAC)|
|Horizon Health Care||Member of gpTRAC’s Program Advisory Council (PAC)|
|Volunteers of America||The gpTRAC team has worked with Volunteers of America, Dakotas over the years to help them implement telehealth programs successfully|
|UnityPoint Health||UnityPoint Health has been in contact with gpTRAC occasionally over several years|
|Essentia Health||Member of gpTRAC’s Program Advisory Council (PAC)|
|CHI - Physician Enterprise||Physician Enterprise of CHI has visited with gpTRAC several times over the years|
|Upland Hills Health||Located in the gpTRAC region and has benefited from previous training conducted by Jonathan Neufeld, Director of gpTRAC|