Telemedicine: “Someday” is Today

By on March 25, 2020

We launched a telemedicine platform in 72 hours. Here’s what we learned.

Like many practices, we thought of telemedicine as one of those projects we wanted to implement someday. When CDC and state regulations started to severely limit our ability to see patients in clinic, we realized that someday had arrived.

In just three days, Drs. Katie Bassett and Lauren Boudreaux led an initiative to select, test and roll out a telemedicine platform to nearly 100 providers.

“The COVID-19 outbreak has felt close to home from the beginning,” says Dr. Bassett, a board certified dermatologist with North Sound Dermatology in Washington state. “Kirkland, the first epicenter of the disease in the US, is a few miles from my house. One of the first reported cases of community transmission was in Mill Creek where my main office is located.”

As school closures and business regulations mounted, Frontier’s COVID-19 Task Force recognized the urgency of getting a telemedicine platform up and running. Drs. Bassett and Boudreaux teamed up to research options and lead the implementation. “It felt like we were racing against time as more and more restrictions in movement were coming from the Governors of Washington and Oregon,” says Dr. Bassett.

“Dr. Bassett and I began researching both HIPAA-compliant and standard live synchronous platforms for telemedicine,” says Dr. Boudreaux, a board certified dermatologist with Silver Falls Dermatology in Vancouver, WA. “We collaborated with dermatologists around the country to work out which platform best served our patients. Ultimately, we decided Doxy.me was the best fit for us, and with the most user-friendly platform.”

“For the better part of a week, Dr. Boudreaux and I spent hours researching different platforms and options,” says Dr. Bassett. Challenges came up when platforms the providers liked didn’t match well with IT systems currently in place. Then, it was back to the drawing board.

“We found doxy.me through postings on a dermatology industry Facebook page,” says Dr. Bassett. “Unfortunately the online demo was cancelled suddenly because the company was overwhelmed with questions from practices in the same boat.”

Drs. Bassett and Boudreaux had a call with Dr. Dieter Schmidt, legacy owner of North Sound Dermatology, and the chair of Frontier’s Medical Advisory Board. Along with IT, the group decided to move ahead with doxy.me.

“That night, after the kids were in bed, my husband and I stayed up late calling each other on the platform figuring out tricks for better resolution,” said Dr. Bassett. “Dr. Boudreaux worked around the clock with our operations team to get the workflows implemented.” Because roughly half of our partner practices are on separate medical records (integration is in progress) there was a need for not one, but two workflows.

By Wednesday March 18, Dr. Bassett saw her first few telederm test patients from home, followed by Dr. Boudreaux over the next two days. The telemedicine platform, workflow and billing were rolled out company-wide the week of March 23.

For patients, as well as for providers, there is a learning curve. Though we have successfully converted the majority of our patients to telemedicine, it’s not without challenges. Unfamiliarity with devices, as well as individuals’ broadband capability can hamper the experience. Providers, too, are learning to adapt, and are sharing tips with other teammates through our provider messaging platform, TigerConnect. Worfklows and updated FAQs have been compiled in a comprehensive user guide.

Make sure you know your codes and modifiers for telemed.

Be familiar with which plans allow telemed visits.

Improve audio quality and reduce feedback by wearing earbuds with a microphone. 

Start by booking patients every 30 minutes until you’re comfortable with the platform. Ultimately, you should be able to do one visit every 15 minutes.

Have your medical assistant participate in the call by doing a group call. That way they can scribe for you and get the bulk of your chart note completed. 

– Dr. Lauren Boudreaux

Telemedicine is also being used as a screening tool to help triage patients that may need urgent, in-office care.

“This is still a work in progress, but I am very proud of how rapidly we were all able to implement this service,” says Dr. Bassett. “In these unusual times, the safety of our patients and teammates is still top priority.”