Telehealth Best Practices: Erica Land On How To Best Care For Your Patients When They Are Not Physically In Front Of You
An Interview with Dave Philistin’
Technology. We must meet the needs of patients and expand on newly adopted technology. Healthcare systems need to invest in a platform that replicates the in-person visit experience as much as possible and that is easy for patients to set up on their own before the appointment.
One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?
In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Erica Land.
Erica Land is an award-winning healthcare professional with over 12 years of research, clinical, and healthcare experience. Awarded Associate of the Year Award in 2020 for VirtualMed Staff, where she works as a clinical operations specialist, Erica continues to make an impact on healthcare systems with her passion for telemedicine, as she strives to improve patient outcomes by removing barriers that increase access across the United States. Erica is committed in particular to ending the stigma around mental health and has made it her mission to help educate communities on the impact telemedicine can have in tackling the drug crisis in the United States, and a promising solution to a public health crisis.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
Thank you so much for allowing me to have this opportunity and be able to share some insight into telemedicine from my perspective. If you would have asked me five years ago where I would be in life, I would be working in the operating room putting people to sleep. My entire life I had one dream which was anesthesia and thought I only had one passion in life but here I am five years later to tell you I was wrong. I have since found another passion in life other than anesthesia. I’m living my passion for telemedicine and helping communities and healthcare systems improve access for patients. I have the privilege of working in telemedicine and operating the clinical side of telemedicine programs across the United States. Having been on both the clinical provider side of healthcare and now the business side, I am more motivated than ever to continuously improve how we leverage technology to deliver healthcare, and to bring awareness to the impact that telemedicine can have in improving outcomes in treatment for mental health. I have many aspirations for my career and where I want to go in life so be on the lookout, big things ahead.
Can you share the most interesting story that happened to you since you began your career?
One night, a patient came in as a level one trauma after being jumped by someone with a box cutter. As he came barreling through the operating room (OR) doors, I could vividly see his carotid artery pulsating through the open wound on his neck. When I heard the surgeon say someone needs to hold pressure while we move him, I did not waste any time. I grabbed the sterile packet of gloves out of my back pocket and jumped right in. As I felt his carotid artery pulsating under my hand, I felt oddly serene. When I am in the OR I feel at home. I find the OR to be stimulating, challenging, and rewarding. I never thought I would find anything else in life that compared to the joy I got while saving someone’s life. Since working in the field of telemedicine I have been able to combine my love for science and medicine with my passion for telemedicine and find that joy again. Telemedicine represents an opportunity to save lives virtually just like that man in the OR. When we provide options for treatment to communities, we can save more lives and expand treatment for patients across the United States.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“You may be the only person left who believes in you. But it’s enough. It takes just one star to pierce a universe of darkness. Never give up.” I live every single day by this quote from Richelle E. Goodrich, an American author, novelist and poet, and think it is extremely important for people to understand that people are going to always try to limit your abilities and diminish your successes but at the end of the day the only person who understands your passion and worth is yourself. I strive every single day to be the change and will always fight for what I believe in despite the norm and what other people may think. When I see the impact my hard work is having on healthcare systems, I am reminded that I might be that star that pierces the universe of darkness.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
Since working in the field of telemedicine I have had the honor to meet a few physicians who will forever be a part of my life and inspire me daily with their expertise, knowledge, and support. When your passion becomes your purpose and are surrounded by others who motivate and support your accomplishments, there is no greater feeling. A few people who I am grateful toward are Dr. Hetal Brahmbhatt, Dr. Maged Botros, Dr. Tomrul Tuzel, Dr. Rajiv Narula, Dr. Kirtan Patel, Dr. Tahir Khan, and Dr. Chelsea Pluta. Every day I work with these physicians to collaborate on solutions that result in the best quality of care for patients and hospitals. I have never experienced being surrounded by so many talented people who believe in you and see the passion you have and welcome every opportunity to make an impact together.
Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?
People naturally crave a human connection, especially for something as personal as healthcare. It’s in our nature, so to speak. When you treat patients in person it allows people to feel that social connection and provides a sense of familiarity, comfort, and personal connection that a virtual visit otherwise lacks. With that being said, telemedicine was never meant to replace in-person care, but rather, to create additional options and access for patients and a choice in how they receive treatment and care.
On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?
When you treat patients virtually there are always going to be challenges, especially with the use of technology. One of the main challenges is simply having a technology platform that can replicate the in-person visit experience. It’s vital to ensure the design of a telehealth program within a healthcare system that is centered on patients’ needs and experiences. That means having onsite staff present to assist with the more hands-on aspect of patient care, standards in place in regard to documentation, and clear communication between all the various touchpoints throughout the patient journey.
Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)
In my opinion the 5 things that I think you need to know to best care for patients when they are not physically in front of you include: Technology, Culture Training, Empathy from Providers, Communication both Verbal and Non-Verbal, and lastly your Appearance while treating patients.
1. Technology. We must meet the needs of patients and expand on newly adopted technology. Healthcare systems need to invest in a platform that replicates the in-person visit experience as much as possible and that is easy for patients to set up on their own before the appointment.
2. Culture. I think it is extremely important for every doctor to understand the culture of the community they are providing coverage for. Different regions of the United States are accustomed to different communication styles. It is critical for every doctor to understand the community of their patients and be conscious of how they are speaking and communicating with patients and hospital staff. For example, I find that doctors originally trained in the North have to change how they communicate with patients they treat in the South.
3. Empathy. I think it is extremely important for doctors to practice empathy for patients as they are adjusting to virtual visits. To ensure patients feel as though they are cared for it is helpful if, before the video visit ends, clinicians make sure the patient has a clear understanding of next steps and the treatment needing to be followed.
4. Communication. Doctors must introduce themselves and explain their role. Having the patient know about the physician improves engagement, ultimately making the patient feel more comfortable and confident about the clinician as a contributor to their healthcare treatment.
5. Appearance. To continue improving telemedicine we must ensure the virtual video mimics the same experience as an in-person visit would be. It is extremely important doctors do not dress in work-from-home attire and/or be eating or driving while seeing patients. Yes, that is a real thing! For example, I have had to let a physician go because he would not stop eating while treating a patient. It is very important to provide patients with exceptional customer service, which includes dressing as professionally as one would in an office.
Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?
Working for a telemedicine company and operating over 400 hospitals across the United States, I have witnessed firsthand the miracles that are happening everyday with treating patients virtually. Teleneurology and Telestroke offers a solution for improving the overall treatment of stroke patients and enables hospitals to save lives. The element of time when caring for a stroke patient is critical. Many hospitals are struggling with achieving a TPA time <45 mins which in turn allows a patient to reverse the effects of a stroke on the brain. Working hand in hand with Sevaro, a group of teleneurologists, we have been able to collaborate with the onsite Emergency Department staff to improve their workflow to create an efficient stroke code process which allowed the hospital to break record door-to-needle times. Teleneurology allowed the hospital to go from an average door-to-needle time of 67 minutes to 34 minutes. When a patient has a stroke, time is of the essence. Millions of brain cells are dying every minute that your brain is having a stroke. Teleneurology is making an impact on the delivery of emergent neurological care improving patient outcomes.
Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?
Advancements in both video conferencing technology and improved broadband speeds have been the two biggest tools in replicating the benefits of being in the same space. Nothing takes a patient or provider out of a situation more than a dropped signal, or interrupted video. These two technologies have combined to create seamless video conferencing and allowed patients and providers to communicate effectively, without interruptions or dropped connections.
If you could design the perfect Telehealth feature or system to help your patients, what would it be?
I would expand access to mental health care for children and adolescents. More health care systems and hospitals need to implement Intensive Outpatient Programs and Partial Hospitalization Programs that allow children the opportunity to heal from mental illness and trauma. Not addressing mental health conditions in children and adolescents could impair both physical and mental health and limit opportunities to lead fulfilling lives as adults. These programs are specifically designed for children and adolescents that are led by an experienced multi-disciplinary team of licensed therapists, psychiatrists, nurse practitioners, and other professionals.
Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?
It is extremely important for patients to understand how they can prepare for their virtual visit in advance to ensure the technology during the visit goes smoothly. It is always best for the patient to download the virtual visit application in advance and log into your visit at least 15 minutes in case there are technology issues that need to be troubleshooted.
The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?
Sevaro Health, a leader in telestroke and teleneurology launched an artificial intelligence platform called OneCall, which enables immediate access to neurologists within 45 seconds or less and eliminates the barriers hospital systems are facing in telestroke response times in working with call centers. Sevaro’s Chief Medical Officer and Founder, Rajiv Narula, MD delivered a solution driven by the data that is saving lives and improving patient outcomes by immediately connecting hospitals with a neurologist to start making treatment decisions.
Is there a part of this future vision that concerns you? Can you explain?
In the current state of telemedicine there are limitations to telemedicine involving the credentialing process of new providers for hospitals and healthcare systems. If healthcare systems and hospitals could implement credentialing by proxy it would be a step forward to remove this telemedicine barrier. Physicians are deterred away from telemedicine with the overwhelming paperwork and applications for each facility. With a growing shortage of board-certified psychiatrists and a rise in mental health crisis, healthcare systems must collaborate to implement state by state regulations to continue recruiting high quality physicians.
Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
If I could inspire a movement, I would encourage people to share their stories about trauma, addiction, and other mental health issues to end the stigma around mental health. Together we can educate friends, neighbors, policymakers, and the media about the reality of mental health and the importance of continuing removing barriers to help people suffering get the help they deserve. Telemedicine is aiding in the fight against addiction and other mental illnesses, and I am proud to say I am part of that fight. You can read my story about how telemedicine gave my father, who struggles with addiction, a fighting chance at life.
How can our readers further follow your work online?
You can connect with me and follow VirtualMed Staff on LinkedIn at
https://www.linkedin.com/in/ericalland/
and
https://www.linkedin.com/company/virtual-medical-staff/.
Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.
