COVID -19 Chronicle - Update December 2020

In Waterville, Northern Light Inland Hospital medical staff chief Cathie Kimball, DO is finding telehealth very helpful managing her elderly patients, who are particularly vulnerable to COVID-19. “It has encouraged me to be creative in assessing my patients. It is challenging my assumptions about what I need to assess — and reinforcing what we know about taking a careful history and listening to the patient. Telehealth also gives me an opportunity to see a patient in a home environment, which provides insights I don’t get with an office visit.” Dr. Kimball is finding that many of her older patients are familiar with the technology as they connect with children and grandchildren at a distance. She’s looking forward to being able to use telehealth to stay connected with “snow birds” who winter in warmer climates. Lance Feller, MD, of Northern Light Rheumatology agrees, “I think perhaps the best part is flexibility. We’re able to address patient needs more readily without having them travel to the office. Particularly during this pandemic, it allows me to communicate with and continue to manage patients who would be at a high risk for becoming quite ill if they caught COVID-19, and we would prefer not to have them come to the office if we can avoid it.” Dr. Feller adds that about a third of the practice’s visits are happening through telehealth right now and he anticipates that percentage can grow as more patients become accustomed to the technology. It’s Not Just for Kids In the Portland area, Northern Light Home Care & Hospice and Northern Light Mercy Hospital have found a very different way to leverage the power of telehealth. In April, the team there conducted its first telehealth visit in a homeless shelter. The patient was being monitored for COVID-19 exposure, but the nurse noticed he was having trouble walking. “I asked if I could look at his feet and found he had very significant ulcerations and swelling,” remembers visiting nurse Leann Thayer, RN. “I got the patient registered for services and a primary care doctor saw him via video on my iPhone!” The patient was prescribed some medicine and several days later was doing much better. There are about 200 people without a home each night in Portland and it’s a population that presents many barriers to providing healthcare. Their circumstances change rapidly, they move around a lot, and they don’t have a lot of trust. Providing the service in a place that is familiar to them takes down some of those barriers. “What was keeping me up at night was how we would manage our homeless population, particularly those with underlying conditions,” says Kristen Dow, the director of Health and Human Services for the City of Portland. “Our shelter staff is not medically trained.” Northern Light Health stepped up in a big way, says Dow. Nurses are conducting clinics in four of the city’s shelters, monitoring guests with suspected COVID-19 exposure, and taking care of other health concerns at the same time. “As a primary care physician, I was a bit resistant to the idea of telehealth,” remembers George Stockwell, MD, primary care provider at Northern Light Mercy Hospital. “But we are all realizing there’s actually a lot we can do with it. I have found most patients really like it and some patient visits are actually more productive and focused using telehealth. There will always be a need for face-to-face assessments, but in the case of this patient, it worked very well. We saved him a trip to the emergency department and prevented potentially permanent damage and a need for surgery.” A Tool for Public Health

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