How CHOC Children’s transformed its telehealth services during COVID-19

Between July 2019 and mid-March 2020, CHOC Children’s had completed 182 telehealth visits. After the onset of COVID-19 and to date? Since then, tens of thousands of visits have provided safe, high-quality care for pediatric patients at CHOC — and that number continues to grow.

So, how did CHOC elevate its telehealth offering so quickly and seamlessly?

It took a whole lot of teamwork, says Lisa Stofko, CHOC’s telehealth manager.

Tech steps

“We collaborated with CHOC’s information services department and had video technology set up within 72 hours,” she says. “This was essential, as we wanted to ensure patients were still getting the care they needed, and clinicians had the technology they needed to carry out appointments.”

To conduct telehealth appointments, CHOC clinicians primarily use a special version of Zoom, a video conferencing software with extra layers of protection. Clinicians also have access to InTouch, Health, PingMD and Doxy.me as well.

Patient safety remains paramount to providers, regardless of whether a visit is in-person or virtual. To ensure the protection of private health information during virtual visits, the telehealth team at CHOC collaborates closely compliance and information security.

“We want to remind families that CHOC’s doors have remained open, whether that be in person or virtually,” Lisa says. “We serve some vulnerable populations and we want to accommodate them safely.”

Increasing physician and patient comfort level

Although telehealth offerings predated the COVID-19 pandemic, some physicians had more experience conducting virtual visits than others. To increase comfort levels with new platforms, training videos were delivered to more than 700 providers.

Many patients and families were new to virtual visits as well. The telehealth team at CHOC wanted to make visits as easy as possible on families, so they prioritized replicating the in-person visit as closely as they could.

For clinic visits where patients are visited by multiple specialties, Zoom breakout rooms are utilized. This complex workflow requires close coordination with compliance and information services to ensure HIPAA compliance.

“Telehealth is not one-size-fits-all. The way one specialty care clinic operates may have a different flow than another,” Lisa says. “To make the process of adapting to virtual visits as easy as possible on families, we have interviewed providers and clinical staff on their typical in-person workflow and done our best to replicate that virtually.”

Before the appointment begins, families receive clear communication from their provider’s office on how to prepare themselves for a telehealth visit. The team recognizes patient-facing tech support as an essential part of ensuring a seamless appointment. Care coordinators empower patients with education and support for the continuum of care. Materials are translated into Spanish and Vietnamese. And just like with in-person appointments, translators are available during virtual visits, too.

Ensuring patient satisfaction

To measure patient satisfaction with the telehealth experience, CHOC’s telehealth team launched a satisfaction survey which is sent to patients within 24 hours after their appointment via text, email or phone. To date, results have consistently hovered around 91%, compared to a benchmark of 86%.

“We continue to monitor survey results and identify opportunities to further improve patient experience,” Lisa says.

Ongoing optimization

A 20-member steering committee was established from key stakeholders from across CHOC’s health system — including administrative executives and physicians — to further improve the telehealth experience and capabilities at CHOC.

Future plans include additional features to further replicate the in-person experience. The team is working toward kicking off and wrapping up a patient’s online appointment with a virtual visit from the same medical assistant. This would provide not only proper intake protocols, but also quality customer service and a personal touch.

Another tactic the team is working on implementing is streamlined notifications for parents – especially those of medically complex children who may have multiple telehealth visits with various specialists in the same day.

“We want to make sure that parents are easily able to keep track of appointments, and that we are not under or over communicating to them, causing additional stress,” Lisa says.

Moving forward, the CHOC telehealth team is doubling down on its commitment to ensuring telehealth remains a safe, high-quality and stress-free experience for providers and patients alike.

“There is a difference between a two-way video and telehealth,” Lisa says. “We are committed to making telehealth a seamless experience for both patients and providers, and ensuring that it replicates the safe, quality care patients are used to receiving in person.”

Learn more about telehealth at CHOC.