Health Check: Innovations in Primary Care
PARKERSBURG, W.Va. (WTAP) - Over the past two years, innovations in healthcare have provided the best access to care that patients have needed.
The use of telehealth and the use of Advanced Practice Providers are two innovations that have changed the course of primary care.
In a Fairhealth 2020 study, the use of telehealth services increased from less than one percent of visits to as much as 80 percent from March to April of 2020.
“I mean, the thing is, prior to COVID, we had all the structure in place in terms of an electronic medical record, all these things were in the last 15 years, it’s been started,” Dr. Bairava Kuppuswamy, Chief Medical Information Officer for WVU Medicine Camden Clark Medical Center. “And each one is slowly adopting more and more people. In fact, by the time COVID hit, we were just in the right time, in the right place, sort of things we were just piloting before how to do virtual care, and the moment COVID head, we could immediately within a day or two, we could make everything work.”
Dr. Kuppuswamy says it has opened up accessibility and improved quality in terms of care, such as scheduling appointments, access to test results and historical data, and to hold virtual appointments, all at a patient’s leisure.
“With technology, you know, what I could do is hey, can we set up what we call a virtual visit, where either it’s a telephone or a video visit, that you just pick up and they can, then you not, you know, take off from their job and waste half a day, they can just pick up the phone and discuss with me and that way their health care is taken care of,” Dr. Kuppuswamy said.
Dr. Shari Vance is a practicing family physician and the Medical Director of Primary Care for WVU Medicine Camden Clark Medical Center. Dr. Vance has been practicing in the Mid-Ohio Valley for 25 years and said one of the most impressive innovations that have come about from the pandemic is telemedicine.
“Before COVID, we really didn’t have the ability to provide care through video or telephone means, partly because of restraints by the insurances,” Dr. Vance said. “But with that, it necessitated the need to open up. Especially the video component of this where I can see a patient on my computer terminal and take care of them for many things, just like I would if they were in the office, and that I think, during COVID especially was invaluable. And it’s something that’s persisted after that, that we’re really excited about.”
Dr. Vance said technology had advanced dramatically to communicate better between patients, their primary care physicians, and other specialists to better care for their patients.
“The advancements of our medical record system are just amazing,” Dr. Vance said. “So in 10 years, just like every other technological advancement, it’s just blossomed for lack of a better word. And what before would take us a lot of time to go through and find charts when we are on paper charts. Now it’s at the touch of our fingertips.”
Physicians communicating with each other has made patient care even better. They can communicate with each other to order different tests or access a patient’s charts, so the patient doesn’t have to re-explain the reason for their visit.
Telehealth can improve access to health care services by reducing travel costs and wait times, especially for patients living in rural areas.
“But this new option is basically more of an access to the patient, you know, helps patient, particularly in our rural areas, you know, there are patients who sometimes have difficulty in finding a transportation to come, or it’s so distant, they have to see specialists, particularly if they have to see a specialist in Morgantown, for example, you know, they can do what’s called a telemedicine visit, which at least supports, you know, a continuation of care,” Dr. Kuppuswamy said. “So, a lot of advantages. It’s an added layer for health care, which will help patients.”
In a study by the American Hospital Association in 2019, 76 percent of U.S. hospitals connected with patients and consulted with practitioners at a distance through video and other technology.
Besides technological innovations, the improved access to care from utilizing advanced practice providers, such as nurse practitioners and physician assistants, as part of a team effort to meet the community’s healthcare needs has also been beneficial.
“So advanced practice providers include physician assistants, or all also known as APPs, and nurse practitioners, which can be known as NPS or APRs, they are meant to be a great asset to health care and to help provide more access and easier timely access to care for patients,” said Mandy Holman, Lead Advanced Practice Professionals at WVU Medicine Camden Clark Medical Center. “We sometimes work independently and sometimes in collaboration with our physician colleagues.”
Holman says nurse practitioners and physician assistants in the state of West Virginia can provide the same access to care as their physician colleagues, such as seeing their patients, providing telemedicine care, and prescribing medicine.
Dr. Vance says there has been an increased demand for APPs in the Healthcare field.
“And part of that is due to an aging population and larger Medicare population that then starts requiring more services,” Dr. Vance said. “So I think the aging population is part of that answer. You also have a little bit of an aging medical community. So as doctors retire, we need to fill those spaces as well. And there’s just a little need for health care providers across the country.”
Holman says the APPs at her community practice clinic work together as a team with the physicians to take care of their patients.
“So, for example, if that physician is out of town, or maybe they’re they don’t have the opportunity, and they’re scheduled to see a patient with an acute need, that patient will be offered to see one of the nurse practitioners or physician assistants here to make sure that they’re cared for appropriately,” Holman said. “When a nurse practitioner or PA is seeing another physicians patient, we have a great communication method between the two of us; we’re very fortunate with the electronic health record that we collaborate with that provider, and we make sure that we communicate with the physician on what was going on with that patient at the time of their care. Every now and then, we might ask that physician to come in and evaluate that patient with us. If there’s some complexity that the individual PA or NP maybe doesn’t have as much experience with yet, or maybe their confidence isn’t as high. We work together, and we collaborate really well to make sure the patient’s needs are met.”
Dr. Vance says nurse practitioners and physician assistants have been invaluable during the COVID-19 pandemic.
“You know, the health care system has been overwhelmed over the last two and a half years,” Dr. Vance said. “And without nurse practitioners and physician assistants, there would have been no way we could have managed to see everybody that needs to be seen.”
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