As COVID-19 began to show up in Charlottesville and surrounding counties, the Sentara Medical Group responded by shifting most outpatient clinic visits to an online platform. During these “virtual visits,” which were implemented to reduce the risk of spreading the virus among patients and staff, and to conserve the limited supply of available personal protective equipment, patients can receive the care they need from the convenience and comfort of home. Instead of traveling to the doctor’s office and sitting in a waiting room prior to an appointment, the patient simply checks in online at the designated appointment time and connects to the healthcare provider remotely.
Although the Medical Group had been offering some virtual visits before the pandemic began, the number of virtual visits skyrocketed when the government issued coronavirus-related social distancing and stay-at-home policies. In fact, by the first week of April, 86% of all Medical Group appointments were taking place virtually.
“The learning curve was steep, but we were up to speed with providing care virtually within a week,” says Joseph Evans, MD, director of medical operations for the Sentara Medical Group. “I have enjoyed the opportunity to connect with patients in their home environments. Now, as we transition back to greater numbers of face-to-face office visits, we are still offering virtual options to help manage patient needs more conveniently.”
Virtual visits have been taking place in both primary care and specialty practices, according to Dr. Evans. Most virtual visits occur via the Sentara app, which patients can download to a computer, tablet or smartphone. The app enables patients to check in with their provider, wait in a “virtual waiting room,” and connect by video and audio linkup. Once connected, a nurse or other medical provider will gather some information before the patient speaks with the doctor. During the virtual visit, providers can take a patient’s medical history, examine the patient visually (if the patient has video capability), provide medical advice and, if appropriate, prescribe medications or offer other treatment recommendations.
“In preparation for opening our offices for more in-person care, we have taken a lot of precautions to keep our patients and staff safe,” Dr. Evans adds. “For example, we removed a lot of nonessential items from the patient care areas to enable more thorough cleaning of surfaces. We also have tried to minimize—and sometimes eliminate—time spent in the waiting rooms, and we screen all patients and staff for fever and other COVID-19 symptoms before they enter the office.”
Virtual Family Hospital Visits
Ordinarily, when a patient goes to the hospital, family members and friends are free to visit. Family and friends often play an important role in a hospitalized patient’s care, helping caregivers get to know their patients better and speaking for patients when they cannot speak for themselves. During the COVID-19 pandemic, however, hospital visitation has been challenging.
During those first several weeks when the hospital severely limited visitation to help prevent the further spread of COVID-19, Sentara Martha Jefferson nurses, the hospital chaplains and other staff members became very resourceful at finding ways to link patients digitally with family members and friends. Using funding generously provided by community donors to the COVID-19 Emergency Response Fund, the Martha Jefferson Hospital Foundation purchased a number of iPads that nurses, chaplains and our Caregiver Center staff could use, along with the Google Duo app, to set up virtual video visits for patients and their families.
“COVID-19 has put distance between us, our patients and their families, affecting the way we usually provide emotional and spiritual support,” says Tammy James, RN, MDiv, BCC, chaplain for Sentara Martha Jefferson and the hospital’s Cancer Center. “So we started relying on technology, including bedside telephones, videoconferencing, mobile phones and iPads, to help patients stay in touch with their families and loved ones.”
James notes that it grieves nurses and other caregivers to hear patients express their feelings of isolation, loneliness and fear when their loved ones can’t be with them at the hospital.
“In some cases during the pandemic, couples who haven’t spent a night apart during 50 years of marriage have had to endure long periods of separation,” says James. “Our caregivers—and especially the nurses and patient care assistants—have experienced great sadness witnessing the isolation and loneliness of our patients.”
For that reason, nurses have asked the chaplains for prayers to read to their patients to offer hope and strength, or solicited suggestions for music to play for patients to provide comfort and connect them with their faith traditions.
“Our nurses are looking beyond the physical needs of their patients in these challenging times and attending to the anxiety and fears so many of their patients share,” says James.
Although nothing completely replaces the comfort that can be provided by a personal visit, enabling patients and families to see each other via iPads can have a much greater impact than is possible with a standard telephone call, says Abby Denby, MSN, RN, NE-BC, director of patient care services.
The nursing staff also used the iPads to provide discharge instructions and education to family or friends before patients left the hospital, allowing everyone to be better prepared for the patient’s return home.
“Being in the hospital can be scary for patients—particularly if it’s a new experience for them and they cannot have family members or friends visit,” says Denby. “But thanks to the generosity of our community and its support of the Martha Jefferson Foundation, our nursing staff has been able to maintain our Caring Tradition in ways that would not have been possible otherwise.”
If you need to make an appointment with your Sentara Medical Group provider, please call your provider’s office and discuss whether an in-person or virtual visit would be more appropriate. Office staff will be happy to answer your questions and determine the best course of care to keep you safe.