Digital Health Update

Speaker 1: Well, welcome back to HealthTalks NOW, a podcast brought to you by Baptist Health, where I ask the experts the health and wellness questions that matter most. We are so excited to be back kicking off our third season of the show. And I have to say, we have quite the season lined up for you, including some surprises and some special guests. So, right now make sure you’re subscribed to the show so you don’t miss an episode, go click that subscribe button so that you’ll be getting notification every time we drop a new episode.

We’re kicking off this season talking about one of the fastest growing segments of the healthcare industry, digital health. When the pandemic started two years ago, many health systems were catapulted into the realm of telehealth and online care delivery because of the inability to gather together in person. And if you’ve been following us for a while, you’ll remember that back in season one we did a show very early on in the pandemic about the ways Baptist Health had adapted to begin moving care to a virtual space. But it’s been over two years, which honestly is really still hard to believe, and a lot has changed.

                                                Today, we’re talking with the Director of Digital Health Services for Baptist Health, Nick Sarantis. Nick has been at the frontline of the development and implementation of some really incredible growth in the digital healthcare realm. And we’re going to learn what’s new, what’s to come and how healthcare has become more accessible since we last talk. Let’s get into it.

Well, Nick, thank you so much for coming back to the show and for joining us on an update on digital health. A lot has happened in the year and a half, I believe, since you were here the last time. And I don’t think any of us imagined we would still be living in a pandemic world in 2022, but here we are. Since we last talked, we now have vaccinations for COVID 19 for everyone ages five and over, and we also have several new mutations of the virus that have caused additional surges like the one we’re in the middle of right now with the Omicron variant.

So, let’s recap a bit from where we were in terms of digital health as a society and specifically within Baptist Health and how things have evolved and changed over the last year and a half. Catch us up a little bit.

Nick Sarantis: Yeah, certainly it’s been quite the deja vu, pretty much every three to six months it seems like.

We certainly were on a digital path prior to COVID ever coming right to the United States is going to be certainly a slow role both due to resources, provider adoption, patient adoption, those kind of things. But the one thing COVID did do was push us forward very quickly. And so basically over the last 18 months, our focus really has been enhancement and optimization of things as much as possible. So, due to COVID originally all of our providers are able to do video visits and telephone visits through MyChart or through other platforms in any regard we’ve got 24/7 access in terms of urgent care video visits. And we had eVisit as well. So really our focus has been, like I said, how do we improve those things both on the provider side of things as well as the patient side of things.

Speaker 1: That’s huge. I just want to go back and give the credit where credits due, because I think the last time we talked we had a pool of providers who were able to provide these services and now we’re looking at every provider in the Baptist network has this capability and you can get care literally around the clock. Which is huge in terms of access for patients, in terms of convenience, in terms of being able to see your own provider, should you choose. I just think that’s amazing the work your team has done and how that is really providing such a service to patients.

Nick Sarantis: Yeah. It’s so important. With these great opportunities in terms of where healthcare has been going over the past 18 months, there’s lots of challengers out there and lots of non-traditional players in the marketplace now as well. That you have big technology that are sticking their noses into healthcare because they’ve got the technology certainly, and so now they’re trying to provide these services. And so where it is so important for us as a system for both our providers and our patients to offer these services is to have that continuum of care because we’ve worked so hard with our Epic go live and integration, and really as a society to have electronic health records.

But what could possibly happen is if you have all these non-traditional players, let’s say Amazon or Walmart, that if they offer a very convenient and low price service, then patients will seek that out. But what would happen then is really a disjointed of the medical record. And so at that point, there really is, even though we are all electronic, there’s a very disjointed approach to the care of the patient. So having the ability to offer those exact services, 24/7 access to our patients and our patients being able to have that information feed back into their medical records so that their normal providers can view it. But then also for the virtual urgent care providers to be able to view the patient’s medical record in all their history, to be able to provide the appropriate amount of care is massive as well.

Speaker 1: It’s such a good point because I think it speaks to even a larger issue that we’re seeing in healthcare. As you know, we get into certainly Gen Z, but even in millennials of moving away from primary care providers. So many people are relying on things like minute clinics and urgent cares and things like that to get their primary care. You really lose that touchpoint with a primary care provider who’s able to keep their eyes on your conditions over a long period of time and who’s able to evaluate where you were and where you’re going and know your medical history. And that level of touch with a provider is so important in being able to predict outcomes and to be able to follow your health history over the years.

I think what I’m hearing you say is that having all of the Baptist Health providers digitally ensures that if you need a virtual care visit, if you need something convenient at midnight you can get that and it will be logged in your Baptist Health medical records so that your primary care provider can access it. The urgent care provider seeing you has access to all of your medical history so that they have the full scope of how to best treat you. Which you don’t get when you go to like a one off place that just doesn’t know you.

Nick Sarantis: No. And unfortunately you don’t, and it’s always been that challenge as a patient in kind of previous life to walk into a new provider and remember all your medical history and answer the same questions over and over again. Bringing in your zip block bag full of your latest prescription, [inaudible 00:07:31] of things, and obviously things are missed. And so again, that was really the point of systems going to electronic health records is to avoid those type of things. And so with that, with all this technology now again comes great opportunity but also there are definitely some red flags to this potential disjointing.

So again, as a system from a strategy and a continuum of care perspective, it’s vital that we offer these services, we’re really proud that we’re offering the services and we’ve been able to expand this access as much as we can. Because, to your point millennials, Gen Z we’ve seen this shifting of patient journey, maybe patient [inaudible 00:08:08]-

Speaker 1: Patient behavior.

Nick Sarantis: As far as when they are going to go see a provider or where they’re going to see a provider, whatever may be, a little bit different for even males versus females, how often they’re going to go to the doctor and those kind of things. And so as a health system rather than us continue to try to get patients to do the traditional route of having a primary care provider and seeing them certain amount of times a year and everything goes through them. Which again, let me be clear, that is great care. No one is denying that as great care. If that could be followed suit, if everyone had the access and if patients were willing to do that is fantastic care. There is no doubt about it. So what we’re asking ourselves now is really what, not necessarily all that a patient wants to do, but really what is the patient willing to do as far as their healthcare?

Rather than us saying and demanding well for a patient to really be in our health system, they need a primary care provider, they need to be able to see them certain amount of times a year, those kind of things. Is now, well, what services can we provide them? If they are going to go traditionally right to an urgent care then certainly we have those services.

But now having these digital services available all the time, that’s providing the convenience and the access for patients that they are demanding now and frankly they’ve demanded it in every other aspect of their life. Us, as consumers, we have demanded convenience and digital access in every other aspect, whether it’s retail, banking, entertainment, insurance, whatever it may be. We’ve been very clear in our expectations that you must have a good website, you must have a good app, you must be available all the time, I must be able to pay online, all those kind of things. We demanded it in every other aspect of our life. But healthcare has been given a pass for a long time.

I think what this pandemic has done is really opened the eyes and opened doors. Maybe some didn’t want the doors open, but they’ve been open at this point where, oh yeah, healthcare is another avenue where us as consumers or patients can really demand that type of convenience and access. And if my current provider or health system is not providing that, then there are going to be other avenues and other opportunities out there. And so that’s, again, why it’s so important for us as a system to provide these services. Because, again, the continuum of care of having the patients all in our health record is so important.

Speaker 1: Yeah, no, you totally nailed it. I think the digital world we’re living in has exploded over the past couple years. And like you said, it’s every industry, it’s travel. It’s even the workplace, more people are working remotely and using teleconferencing and refusing to work in person than ever before. And like you said, we expect to be able to make purchases and get our care and get the services we need when we want them and when we need them and how we want them. And the pandemic has forced the entire society to innovate, to be able to do things online that had never been done before, like kids going to school online and now that’s just kind of part of normal life.

So, talk to us a little bit about how Baptist Health responded to that sudden need for digital access and how that’s influenced our offerings, where we’re going to go in the future.

Nick Sarantis: Yeah. So what we needed to do really quickly when the pandemic first started was basically turn on features. And luckily with our integration and partnership with Epic, they had a lot of things ready to go. We weren’t ready as a system both in terms of adoption and kind of the operations workflow for it. So we’re able to turn those things on very quickly, but really these were buttons turned on over the course of a long weekend, not over the course of a six month rollout. So naturally with that came additional projects for us as both on the operations side, as well as the IT side of how we can enhance those things. And those are things we’re certainly still working on.

Then from there it was how do we increase access. So kind of like we said earlier virtual urgent care, for example really was just one provider at one point working eight to four, Monday through Friday. It was there, it was an available service, but certainly not where we saw it in the future. But the pandemic really forced it forward really quickly, now we’ve got a pool of eight providers that can see patients 24/7 via video, which is fantastic-

Speaker 1: Which is amazing.

Nick Sarantis: So eVisit is what we call it is an asynchronous dynamic medical questionnaire. So it’s not in real time, which is great for convenience because sometimes just getting patients free at this time and the provider’s free at that time, doesn’t always match up with everyone’s schedule. And then the evidence based dynamic medical questionnaire, it’s really a robust history about the problem and so the patient being able to answer these certain questions, and then depending on the answer to those questions, they could get a different series of questions. And so that was something we were able to stand up right before the pandemic. It was very limited in terms of the number of problems. It was a great starting point from us. But we saw this both in the marketplace, as well as just from patient feedback.

That number one, they loved it because it was so convenient. The ability to wake up at 3:00 AM and say, oh man, my throat is killing me. I definitely need care. And I can fill out this medical questionnaire. I maybe even have had this feeling before I know what’s going on and then the provider can review that. And by the time you wake up, you could have a prescription, if that’s appropriate, ready for you to go and a plan of care ready to go for you. The feedback was fantastic, but certainly we had a long way to go. And so we were able to over the past three months, partner with a company called Bright.md and asynchronous care is what they do.

So we’ve been able to have Bright.md integrate into Epic so it’s the exact same patient journey. They go through MyChart, now they enter this Bright.md platform. And so now we’re able to see upwards of about 20 different problems versus previously about six or seven problems in the old eVisit platform. And the medical questionnaire it’s so much better clinically, so much more robust clinically. There’s a clinical team within Bright.md that are reviewing these questionnaires all the time, us as a system are able to submit feedback for improvements as well. And so now it’s really taken off to have patients being able to access this kind of new version of eVisits. And right now you can submit an eVisit and our providers it’ll take you as the patient about 10 to 15 minutes to fill it in because it is quite robust. But again, we need that information to provide the best clinical care possible. But, that may sit in a queue for 5 to 10 minutes and generally our providers are turning that back around in another 10 to 15 minutes.

Speaker 1: That’s amazing.

Nick Sarantis: So all said and done the eVisit could be fully completed within an hour. And within that eVisit as well, let’s be honest, not everything can be completed via eVisit, Not everything can be completed digitally. And there’s lots of different steps within this new eVisit platform that basically escalates the patient out into other avenues of care as well. And so that’s something that we’re the only provider in Kentucky that is offering this new version of eVisit and so we’re really excited and really proud of that particular product right now as well.

Speaker 1: Well, and to be clear, just for those listening, the decision making, the medical decision making and the care plan and the treatment, any prescriptions that are written, this is all happening from Baptist Health providers. Bright.md is providing the platform for us to offer this service, but your care is still happening from a Baptist Health provider. But truly, in the 10 to 15 minutes that it takes you to fill out this questionnaire most people couldn’t even get in the car and drive to a doctor’s office and 10 to 15 minutes so the convenience factor is huge. Especially I’ve used the service myself and with two toddler, preschool age kids at home, this is a lifesaver to me. Not having to get in the car and load my kids up, if I’m not feeling well and drag them into an office and potentially expose them to other sick people. I mean, it’s a game changer.

Nick Sarantis: Well, and I think you bring up really good points because the question that patients are asking themselves is not, would I rather go in person or be seen digitally, but what they’re asking themselves now is if digital options are not available, really the question is, am I going to do nothing right or am I going to get childcare, get in the car, go out in the midst of a pandemic? And the answer a lot of times is no, I’m not going to do anything.

Speaker 1: I’ll just ride it out.

Nick Sarantis: Right. That’s certainly not the best care by any stretch. And so that’s where we’ve had conversations with our providers and with patients and other leaders in the organization that there is that shift. It’s not just oh, the patient should come into the office because that’s better care. Again, let me be clear. There’s no denying that, that being able to get hands on the patient, have certain diagnostic tests or certain point of care testing as well, being able to do all those things in the office, fantastic. That is absolutely the best way to go. But again, if our option is nothing or digital, nothing or a video visit, nothing or an eVisit, video visit, eVisits certainly do win out there. And I think that’s the really important factor that we’re hearing from our patients is not that they were trying to decide, oh, am I going to go into the urgent care or am I going to do a video visit? It’s not really that it. Was really, they were going to do a video visit or not do anything at all because just the convenience factor, they could not make it work logistically, especially in today’s day and age to kind of go into an office.

Speaker 1: Well, and like you said, I think there’s an expectation now that we’re able to do pretty much anything in life that we need to do. Should be able to be done via Zoom or via telephone or via some kind of technology. That’s just kind of become the baseline expectation. But digital health not only made the care accessible and convenient for patients during the pandemic, but it also helped to take some of the burden off of our urgent cares and emergency departments, which have been experiencing record volumes because of the pandemic. So, you mentioned this a little bit already, but talk to us about how these different points of care can compliment each other and work together. So digital care is certainly not taking over and eliminating the in person care, but talk to us how they’re kind of coexisting.

Nick Sarantis: Yeah, absolutely. I think a great example, especially right now is just COVID testing. There’s very limited number of tests certainly available to the public right now in terms of what you can buy for a home. And so there’s a really need for COVID testing. But, let’s talk about the process. If you go into your urgent care facility or you go into an emergency department, which I mean, let’s say you’re asymptomatic but you’ve been exposed. Really, the last place you should be is the emergency department. One, there’s there’s people that need to be there that are very ill. So being able to put a generally a healthy person into the emergency department that then there you could be exposed or could provide exposure for others, so now you’re waiting to get a COVID test. That really jams up the system, both for the patient but as well as the health system overall.

So what if we did a video visit first? So potential exposure or maybe I just have a cough, just kind of one symptom, but being able to talk with the provider online. Number one, very safe, very convenient. So able to do that and able to just kind of talk through the different levels with the provider as far as what’s going on. And then let’s say it is deemed appropriate that, you know what? You really should get it. You really should get a test based on kind of what you want to do or what you need to do in your life you should get a test. Well, what we can do then is just go ahead and place that order for you to get a test and then you could go to one of our urgent cares in person and basically walk right in. You’ve got the order placed in your chart already because you did the visit through Baptist and you do the test and then you walk right back out. Rather than again waiting in the waiting room and doing all those kind of things. So that’s really been a big wing for us in terms of kind of a hybrid model approach, especially as volumes really rise during these high times in the COVID world.

So that’s been a great example of a way that kind of a hybrid model of hey, let’s get some of the care done digitally, but then ultimately yes, we do need an in person service to happen. But what’s happened is we’ve made it a much more seamless process to be able to do that.

Speaker 1: Sure. And I think as I’m just listening and hearing you talk, it almost feels like we’re going back to when physicians were caring for people way, way back, 100 years ago, you had a really close personal relationship with your family doctor. They would come to your house and treat you. I mean, it was very relational. And then I think we moved into more of a formal setting, which is like you said, great, but it became a little more impersonal in that you came once a year, you made a visit and that was kind of that. Now this almost feels like the care is so accessible and you’ve got to provider right on the other side of your phone, talking to you over Zoom or via email or going back and forth that you feel like that access to care is so much easier to get that the relationship building part feels like it’s coming back.

Nick Sarantis: Yeah. I think it’s a great point. I think again, just from a patient journey perspective let’s say it’s 4:30 and you had to take off work and you had to get grandma to come over and watch the kids for you to then drive across town to then go into the waiting room and register and all those kind of things. And so by the time you really see your provider, it’s a bit of a stressful day thus far. Maybe the things that you were going to say or you had on your mind as far as your history or whatever it may be, maybe you kind of lose because it’s been a stressful day. So I think having that ability to be in your home environment as well, allows you to, again, be more conversational and share some different things. I think it allows the provider sometimes to pick up on some things that are a little bit different as well. Because there is potentially some more time in the visit that you, again, you can kind of converse with the patient.

So, I think we’re seeing that as well with patients. Seeing, again, we’ve talked a lot about kind of virtual urgent care, but especially with patients dedicated primary care providers or even their specialist. The ability to kind of do those appointments. That’s where, again, what we want is not digital to replace in person. That happened because of the pandemic. There’s been services that we just simply couldn’t safely do, or we had to close an office due to quarantines or whatever it may be. And so we have to transition services from in person to digital, but really where we want to be is a hybrid model of certain things could be better done virtually, and there’s no doubt certain things can be done better in person. So those are some of the things that kind of are happening naturally right now, but certainly something as a team that we’re going to be working on over the next year is, are there some opportunities to create some hybrid models?

So for example, let’s say hypertension. If you’ve kind of a new problem, you go into your primary care provider and certainly get worked out, but you get prescribed a prescription and maybe your follow up though is done virtually. And that’s kind of established beforehand. New problem, hypertension, yes, it’s an in person followed by two virtual visits. And maybe with those virtual visits comes a blood pressure cuff, maybe that’s something that we use, some other remote patient monitoring technologies potentially through MyChart or through some other means that now we’ve got some consistent readings rather than just the one or two that are happening in the office every three months. So I think there’s an example of how do we utilize the technology not to replace the in person part of care, but ultimately enhance it and ultimately make the in person part of the care journey, much more specific and much more focused on kind of what needs to happen.

Speaker 1: Yeah. I think that’s a great example.

Okay. So Baptist Health just launched an exciting new tool called Care Finder. Give us the details, what is it, how does it work and why do we need it?

Nick Sarantis: Yeah. Really excited about this. It’s due to our partnership with Bright.md, number one. So it links up with Bright.md. And so again Baptist Health is the one controlling the options as far as Care Finder goes, but it is part of that relationship, which is really exciting.

So as we think about all these different options we’ve talked eVisit, we’ve talked virtual urgent care, scheduled telephone visit and then of course, traditional care points of going to the ED, the urgent care. Number one, we still have patients that are like, what is that? What is an eVisit? What is a video visit? So we still have that problem as far as education and frankly where we are in kind of the digital journey of two years essentially, that’s certainly that should be expected and certainly something we’re working on in terms of how do we better educate patients and providers on the different options.

But, outside of digital, we have patients with a stub toe or something very minor go into the emergency department, and again that’s maybe not the best situation, both for patient and health system. So how do we get patients to the right level of care? Whether that is the highest level of care, the emergency department, or potentially the easiest and lowest level of care in an eVisit potentially. So how do we get patients to the right place at the right time as well? And so Care Finder is a tool so patients can go onto our website, Baptist Health.com/CareFinder, and they can search their problems.

So like, let’s say they search headache, for example. So headache can be a wide array of things, it could be something that is extremely, extremely dangerous with the stroke but it also could be something as simple as common, cold type situation. So from there in the Care Finder’s journey, the patient would put that in. And then from there a variety of options would appear essentially. So a headache could be treated at any number of locations. So yes, we could treat a headache via an eVisit or a virtual urgent care visit. Certainly it could be appropriate for an in person visit with their primary care provider. So, essentially all the options are available in that particular situation.

Let’s say the patient got a bone type of injury. So let’s say they were playing in their backyard and their ankle is really swollen. They go into Care Finder and for that situation, digital isn’t a great option. It would just be another step in their process. Ultimately, we need to get that patient somewhere for x-rays. And so what’s great about Care Finder is that let’s say it’s at six o’clock at night is when this happens. Well, we’ve got a wide array of urgent cares that are open at six o’clock. And so from there, they’re going to see the closest urgent care that’s available as well as the emergency departments. Now, if the patient went on at 10 o’clock at night, when that happened, well, urgent cares are closed at that point and so the urgent cares wouldn’t even appear as an option for them. So, they would know at that point, the emergency department is the only option for them.

So, it’s really about getting the patient educated on the different options, but ultimately based on their symptoms, getting them to the right type of care, but also educating them on what’s available at that time of day as well.

Speaker 1: I love that it’s dynamic. Meaning that, depending on what time of day you log on or where you are locationally or what your issue is the options available to you would change so that you have the most accurate, real time information to make a decision.

Nick Sarantis: All that information certainly was always available. I mean, certainly we had all that information available and patients could certainly Google different things and it was always there. But having all of the different options kind of pulled into one tool is what we’re really excited about. And the fact that it kind of brings in the digital services as well with a bit of education as far as what is appropriate and what it’s not, because certainly there are times that we do get patients with a serious medical issue that have gone on to do a video visit and really we point them in the right direction of where do they go. But this tool kind of helps speed that process up and provides a better service for the patient so they don’t have to wait for a video visit and then ultimately then need to go somewhere in person as well.

Speaker 1: Right. Well, yeah. And then from there, based on whatever the Care Finder tool recommends for their care, they’re able to click right into that option. For our urgent cares they could go in and check in online and get an appointment time or they could go directly into MyChart to start a video visit or to get in line. So, I think it makes it so easy instead of being like, well, I’ve got this problem now, what? What’s open? Where do I go? And how do I get started? You follow the prompts on the screen and get directly to the care that you need.

Nick Sarantis: Yep. You’re absolutely right.

Speaker 1: We’ll be right back.

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So before we wrap up, we had some questions submitted about virtual care and digital health. Are you up for a quick little Q and A?

Nick Sarantis: Absolutely. Let’s do it.

Speaker 1: All right. First, and you probably get this every day, telehealth, telemedicine, virtual care, what is the difference in all these words or is there one?

Nick Sarantis: There’s not really a difference. It’s been my great challenge when I first came into my role is trying to navigate these different terms and words. But yeah, essentially, they’re all referring to the same things. Depending on the state you’re in there could be some differences, luckily over the past two years or so, there has been kind of some gathering of the words. Kind of the organizations and the legislature has been referring to kind of the same things, but ultimately they’re the same things. There could be some minor differences or definition changes based on the state. But I think ultimately when someone says one of those words, I think they’re referring basically to a video visit generally is what they’re referring to. But they’re referring to some type of care that’s happening through technology really, but year. It is quite confusing. And that again is why some of these educational materials, Care Finder for example, helps patients kind of navigate through those different things.

Speaker 1: Yeah. It’s really just a game of semantics. It is the same as if someone was said my primary care provider or my family doctor or my PCP, they’re all talking about the same thing.

Nick Sarantis: Absolutely.

Speaker 1: All right. So what equipment do I need to do a video visit or any visit?

Nick Sarantis: Yeah. So video visit you’re going to need a smartphone or you’re going to need a camera and microphone enabled on your desktop. Either one is fine. We’ve seen both work well, I’ve personally done a visit on both desktop as well as my phone. So either one really works and that’s essentially it for a video visit. I would say the tool that helps patients get into either a video visit, both with their provider or a urgent care provider or knee visit is going to be MyChart. So having a MyChart account, and if patients don’t have a MyChart account, they can go to BaptistHealth.com, find the MyChart area, and they’re able to create an account themselves right then and there. So they don’t have to call someone to register or get an access code or anything like that. They can create an account for themselves if they forgot their username or password, there’s some self-help tools there as well. But really it’s going to be your smartphone and webcam, and really MyChart the kind of the tool that helps you kind of go to those different areas of care.

Speaker 1: Perfect. All right. We get this one a lot. I’m not very tech savvy, so can I still do a virtual care visit?

Nick Sarantis: Yeah. Absolutely. Where people struggle is when they try to do everything for the visit 30 seconds before their visit is supposed to start. So for example we mentioned MyChart. Well let’s say you had a MyChart account, but you created it a year ago and you haven’t been in since. Well, now you’re kind of going in a minute before your appointment and trying to remember your username and password, certainly I wouldn’t remember that. And so then they’re trying to reset it and then it does get a bit stressful as far as then having that and then having the appropriate camera setting and those kind of things. So for anyone I really suggest is take it step by step.

So for example, like I said, having MyChart account active, ready to go, if you have a smartphone have the app on your phone, have it logged in, make sure that step is ready to go there. Any other information as far as what you’ll need for the video visit, we’ve got a variety of educational materials and videos that’ll help you navigate. And then if there’s any trouble after that, we also have a dedicated MyChart help desk. That information is available as far as phone number, you can do a chat online as well. If you’re just struggling to get in there’s that dedicated resource as well that can help you do it. But my biggest advice would be just kind of preparation in advance, don’t try to do everything 30 seconds before you’re put thing 30 seconds before your appointment starts. At that point it would get pretty overwhelming.

Speaker 1: Yeah. That’s a good tip. We talked about this a little bit before how virtual care is obviously not right for every medical issue or condition, but what are some of maybe the most common conditions that are best treated virtually?

Nick Sarantis: Yeah, I mean, certainly our most, especially right now is cough, sinus congestion, upper respiratory infections are the most commonly used right now. UTIs or urinary tract infections, that’s a really common one that certainly ideally there be some urine analysis with a condition like that, but there’s obviously some key symptoms there that providers can make that appropriate diagnosis for that as well. Rash is something that is… Pink eye, those kind of things, again with the camera and as well as our new eVisit platform that you’re able to submit pictures. Those things are being treated really well. So yeah, I mean, I’d say those are our most kind of used and popular scenarios with the platform right now.

Speaker 1: Great. And again, those are probably the things that you most commonly wake up with and realize, oh man, I really need to get something done about this quickly. It’s great that you can have that access so easily and so quickly on things that are the most common to come on overnight or quickly or unexpectedly. We talked a little bit about this when you mentioned the UTI, but how can a provider diagnose me without doing a physical exam?

Nick Sarantis: I mean, I think there’s a lot of evidence based literature that providers are obviously well versed in, in terms of symptoms and questions in a patient’s history that leads them to the right direction. So again, that’s really where it’s nice having again, if the patient is established having a patient’s history and let’s say they have a history of UTI and they have these symptoms again, that really helps paint the picture a little bit better as far as what could be going on here. But there’s also some physical exam things that we can have the patient do themselves as well.

So, let’s say lymph nodes for example. Well, yes, traditionally the provider would palpate those lymph nodes themselves, but certainly we can tell the patient, hey, just right here under the jawbone, go ahead and palpate there, it’s that tender? Yes, it is. Okay, great. So there are some things like that providers are getting more creative in, frankly, and because this is not… No one went to medical school with the understanding that they were going to treat things virtually or digitally. So I think we’ve seen the physical exam being done virtually come a long way over the past 18 months. And I think this is something that will continue to evolve over time, both with provider experience, but then as tools as well. I think we’ll see a lot of at home technology being able to help expand the physical exam as well. So for example, like at home otoscopes or at home blood pressure cuffs or stethoscopes, those kind of things as well, I think we’re going to see a lot of advancement over the next couple years.

Speaker 1: Man, I would’ve killed for an at home otoscope when my kids were getting back to back to back to back ear infections. Because you wake up, especially if it’s something that’s recurrent like that, they’ve got the symptoms, you’ve done this before, you know exactly what it is. To load the kids up in the car, drive them, take off work, get to the office, wait just for them to look in their ear and confirm what you already knew. It would be so nice to be able to do that in 30 minutes at home.

Nick Sarantis: Absolutely.

Speaker 1: That is exciting.

Nick Sarantis: What about after the 10th ear infection, this is what happened to my kids is they get tubes in their ears, right? And so they do need to get that procedure, but the next couple follow up visits, that’s what the surgeon is doing is looking at their ear. If we have an at home otoscope, which is something we are actively working on, that could enable that process to be much easier as well. So there’s a lot of different use cases or things like that.

Speaker 1: That’s really exciting. All right, next question is, can I get a prescription from a virtual visit?

Nick Sarantis: You can, yes. If that is clinically appropriate, then absolutely. If a patient comes on and present themselves as sick and going through the medical history and that is what the provider deems clinically appropriate and yes, just like an in person visit that is absolutely what’s going to happen because that’s what is needed as far as the clinical care journey goes.

There’s maybe some thoughts that it’s easier to get a prescription virtually versus other places. What we’ve seen with that is really not. For years and years now, we’ve seen providers work on not overprescribing antibiotics for things, and that holds true. What we’ve seen is providers that they’re treating things in much the same way, and frankly again, having a lot of the documentation just right up front and having the provider some time, let’s say, as they review the eVisit by themselves, they’re really able to make that determination of saying, yeah this is viral though. It doesn’t need a prescription. Here’s some at home over the counter thinks that’s need. So yes you can. But again, if it’s clinically appropriate and it’s not going to be something that’s, again, overprescribed or something that can be kind of the system has worked in some way that prescriptions are overprescribed.

Speaker 1: Totally makes sense. Probably the most important question to the listeners is what does it cost me?

Nick Sarantis: Sure, absolutely. So an eVisit is $30 and that is cash paid. We do not put that through insurance at this time. We made that decision because there’s a lot of just back and forth right now with different payers, government payers, private payers, as far as what they are going to cover long term. When we are in the heat of the pandemic early on everything was essentially waived in terms of copays and those kind of things. So the last thing we want to do is saddle a patient with an unexpected cost of if we put this through insurance and they don’t cover it. So we thought for eVisit, let’s make it simple, let’s make it about the cost of copay at $30. And there’s no fuss, you just pay that with your credit card or your HSA card and very simple.

For the other visits, we’re going to bill them exactly like we would in office visit. So for a video visit for example, again, it’s going to get billed the exact same way as you would in the provider office. So depending on your copay for an in-office visit we’re going to bill it, that would be your copay for the video visit as well. So like, let’s say your senior orthopedic surgeon via video, if you have a specialist copay, it would be the same way. It’s the same codes that are billed to your insurance. So it’s going to end up being the same thing. And that’s the good news, especially in Kentucky, Kentucky’s been ahead of the curve for quite some time in terms of parody, in terms of digital visits versus in person visits, they’ve viewed it as the same, so they’re billed the same. And that’s really what we’re seeing across the country now, both in terms of Medicare and other kind of things. So there is some consistency now in terms of that billing process, at least in the short term. So that’s going to get billed the exact same way as you would in the office.

Speaker 1: That’s great. I think this has really been helpful to kind of answer some of those questions about that may prevent someone from seeking care, right? Like this is going to be so expensive or I’m going to need equipment that I don’t have, or it’s not going to be as effective or as accurate. And I think it’s really helping to break down some of those barriers that may prevent someone from going on and getting the care that they need in a convenient setting when they need it. And it’s been fun, I think, to take a look back at, gosh, how much innovation and how much just change and growth has happened in the last year, year and a half, and some exciting things to look forward to in the coming year.

So I really appreciate you taking the time out today to just recap with us, to answer some of these questions and to look at where we’re going in the future. So thank you.

Nick Sarantis: Absolutely. My pleasure.

Speaker 1: Thanks so much for tuning in today. If you enjoyed the episode, please leave us a review wherever you’re listening and share it with a friend. I really can’t stress enough, the convenience and ease of using our virtual care services for those minor illnesses that we all experience. In minutes, you can connect with one of over 700 Baptist Health providers. Baptist Health Virtual Care provides fast, easy, and affordable access to those urgent care video visits, a scheduled appointment video visit with your own provider or those eVisits, these symptom specific questionnaires that we talked about earlier in the episode. If you want to get started today with a virtual care visit, you can visit BaptistHealth.com or go ahead and get started in our app via MyChart. We will catch you next time on HealthTalks NOW. Stay well.