KILLEEN — In what started as an idea to incorporate a telehealth platform into regular health clinics has now become commonplace for Carl R. Darnall Army Medical Center’s Killeen Medical Home and Harker Heights Medical Home during this period of social distancing.
Long before words like quarantine, coronavirus and COVID-19 were part of a person’s everyday vocabulary, Nicole Hawkins, a health system administrator for the medical homes in Killeen and Harker Heights, said she had lobbied for the Virtual Video Visit program in mid-December, believing it would be beneficial to the military and retirees who use the clinic. After working several months to bring the program to fruition, they officially began seeing patients virtually on March 24.
Partnering with Veterans Affairs, they incorporated the VA Video Connect with the Virtual Video Visit platform to provide the doctors virtual visits with their patients.
“The goal was initially to see follow-up care, but I think what helped our platform, with patients really wanting our care, is COVID. Because of that, we have expanded our capabilities,” she said. “The doctors are learning, adapting and transitioning very well into the virtual world.”
Hawkins explained the most common types of appointments that would be seen virtually are follow-up appointments, allergies, common cold, ear ache, sore throat, sinus infection, medication renewal, test results, rashes and insect bites. She said a patient can also set up a virtual visit if the he or she needs paperwork completed. In that sort of case, the patient would need to ensure the doctor receives the paperwork beforehand.
“I think what’s really good is for the patients who don’t have a real need to come to the clinic, there’s an inclusion and exclusion list that we developed on what types of appointments could be seen face-to-face and those that could not be,” Hawkins said. “Anyone who has coughing, sneezing, baseline fever – with the exception of current world conditions – if it were just a person with a normal upper respiratory illness, we could do this and see them over the telephone or whatever the connective device is.”
She said the individual health providers have the option to expand their list of symptoms they can take care of virtually as they become more proficient screening their patients through telehealth.
Hawkins said to begin seeing a doctor through the Virtual Video Visit, the patient needs to be enrolled in secure messaging, which is what the medical personnel will use to send information to and from the patient. She said a person may call central appointments at 254-288-8888 and ask for a “T-COM” (telephone communication) to set up video health.
After the patient is set up and books an appointment, they should receive a reminder the day prior, along with a link to connect with their virtual room, with the provider receiving a link that matches the room. The patient should enter the room around 15 minutes prior to the visit to ensure there are no connectivity issues. Just like a normal visit at a doctor’s office, a nurse will come into the room and conduct an initial patient screening.
“Then the provider comes in and locks the room virtually, that keeps it secure, so nobody can infiltrate the room and nobody can hear what’s discussed,” Hawkins explained.
After the visit, patients may access their medical records through TRICARE online. Prescriptions, refills and other information will be sent to the patients through secure messaging.
Since the Department of Defense urged non-essential personnel to remain in their residences to prevent the spread of coronavirus, Dr. Charles Hoge, psychiatrist and senior scientist at the Office of the Surgeon General, said virtual treatment requests have had a significant spike.
“At no time in our history have we had to ramp up telehealth this quickly for this many patients,” Hoge said.
Col. Dennis Sarmiento, psychiatrist and chief of the Behavioral Health Division at U.S. Army Medical Command, noted that with increased anxiety, there may be an increase of depression. Adding to the strain, he said Soldiers are currently facing a dual role of full-time Soldiers and homeschool teacher for their children, which adds to the anxiety.
“For some populations, there may be an increase in anxiety, there may be an increase of depression, but we want to ensure that the information gets out that access to care is still available, it just may not be face-to-face,” Sarmiento added. “I think we can learn from others and each other. I think this is where leadership at every echelon has a key role in sharing best practices and ensuring no Soldier, although some may be isolated, is never alone.”
Hawkins said she believes the Virtual Video Visit is an ideal way to see a doctor for a routine, non-emergency appointment, especially now. If a person is concerned about leaving their home or if a person has mobility issues, this will allow them to still have the ability to see their healthcare provider face-to-face.
“I think it’s a safer way, considering the current constraints we have, and they still can receive their care,” she said. “And their information is not going to be compromised.”
To set up Virtual Video Visit, call 254-288-8888 and ask for a T-COM.