Dr Sara Horst Shares Telehealth Benefits, Tips for Clinicians

Sara Horst, MD, MPH, FACG, shared tips for physicians on how to keep appointments personable in the digital age. She also discussed how digital health has helped her to treat patients.

Horst is an associate professor at Vanderbilt University Medical Center (VUMC) within the division of gastroenterology, hepatology, and nutrition. She is also the ambulatory director of VUMC Telehealth and Specialty Pharmacy and associate vice chair of digital health operations of the Department of Medicine.

Transcript

How can clinicians maintain the personable aspects of in-person appointments within telehealth appointments?

I think ease of use is really key. I think that's one of the most important things about telehealth. In our system, we have a workflow that makes it hopefully easy for the patients and the providers. Our clinicians can click on a link that brings them right to their video access for the patient. It's the same way on the patient portal side. We need to do things to streamline it for clinicians as well as patients. We have our patients do their intake online prior to the visit. The clinician has access to all that patient-entered information so that their time in front of the clinician is better utilized.

When I do a telehealth visit, it's very much like my clinic visits. I establish goals of the visit; we really spend time talking about the concerns and focusing on management. I think one thing that's a little bit different is your schedule might be a little bit more rigid just because you have these very set time slots. It's not as easy and agile as a patient coming late to clinic versus late to a telehealth. So, I do try to make sure that I establish with the patient the time that we have at the beginning of the visit so they aren't caught off guard and think that you're cutting the visit off quickly.

How has digital health helped you to treat patients?

I'm so excited about what things look like now and what we can do going forward. As I mentioned, I'm a gastroenterologist. I specialize in the care of patients with inflammatory bowel disease (IBD), which is a chronic illness. Things like telehealth have really opened the door for us.

In our practice, we actually continue to see about 40%-50% of our patients in follow up as telehealth. We have a large catchment area; we're seeing people who could live 4 or 5 hours away. We're able to continue that chronic care where we need to see them frequently without having to have them come to clinic every time.

It works well for our disease state, it doesn't work well for all disease states, but I think finding these pockets is really important to be able to give access to these kind of digital health strategies.

We also have done a lot of work in our electronic medical record (EMR). We have organized information so it's easily accessible to our clinicians. Increasingly, I think other organizations are starting to think about this. I'm on a national steering committee that works with Epic, which is our EMR. We've been working on building things like IBD registries that could be shared across institutions so that everybody can get involved in the same level of quality of care and try to standardize these treatment strategies using things like digital health and the EMR.