Ardmore hospital to utilize telemedicine for COVID-19 treatment

Michael D. Smith

Hospitals across the world have been on edge as a coronavirus pandemic stretches resources thin, and Oklahoma hospitals are not immune to the pressure. As public and private health care systems learn to cope with a pandemic through the winter holidays, Mercy Hospital Ardmore has started caring for COVID-19 patients in a new way.

Rather than hospitalizing patients so doctors can closely monitor COVID-19, a new initiative by the Mercy hospital system is providing care remotely while a person recovers at home. The telemedicine model is nothing new for the nationwide network of hospitals and other health care facilities that includes a dedicated telemedicine campus near St. Louis.

Health care providers within the Mercy hospital network are already being encouraged to roll suspected COVID-19 patients into the program, according to Dr. Carter Fenton, medical director of the Mercy Virtual vAcute service. By minimizing the amount of time potentially infectious people spend within hospitals, patients and health care workers alike can benefit.

“We’re trying to provide access for patient care that is not as risky, it’s not financially as burdensome and just physically as burdensome. Because these patients are sick, but maybe not to the level of hospitalization,” he said by phone on Thursday.

A primary goal of the program is to open up bed capacity at facilities like Mercy Hospital Ardmore, according to a Wednesday statement. Mercy Virtual president Dr. Gavin Helton said his facility’s five years of experience with telemedicine is being translated for COVID-19 care within a patient’s home.

“We hope by caring for certain COVID-19 patients in their homes, it will make them more comfortable and still connected to care, while lightening the load on hospital caregivers and in-patient resources,” Helton said.

Patients who are even suspected of having COVID-19 are evaluated before being considered for the service. Once a patient is approved, they are sent home and receive daily text messages for at least 14 days that ask about things like blood-oxygen levels or respiratory function. 

Fenton said those daily updates may escalate to phone or video calls so physicians can get a better understanding of their patient’s condition. About 38,000 patients have already been considered for home care, about 6,000 felt the need to reach out for further care.

“That’s 6,000 patients that theoretically could have sought in-person care at a time where access to care is a premium,” he said. “A lot of times you just don’t need that higher level.”

Of those 6,000 that followed up with telemedicine doctors for further care, about 300 were later admitted to the hospital for further care, according to Fenton. A hospital spokesperson on Thursday said at least one local COVID-19 patient was referred to in-home care this week.

The telemedicine care is carried out by the Missouri-based doctors, but Fenton said that a patient's local primary care physician also receives notes and updates on their patients. While Mercy Virtual doctors have been providing specialized health care to patients across the hospital system since 2015, they have also been consulting with colleagues across the country.

“They’ve learned and had an evolution with COVID knowledge through the duration of this pandemic just like everybody else has, but they’re bringing that same level of expertise into the virtual setting,” he said.

Local physicians already have some experience working with Mercy Virtual. Fenton said his facility is responsible for providing services for Mercy Hospital Ardmore virtual ICU patients, a service that has been available for over a decade. 

“This COVID platform is very similar to some of the other platforms we have which are text based,” he said. “It’s a means to create a large outreach, and those that need us grab us. Those that don’t are like ‘I’m fine today.’”

Fenton said along with medical conditions, a patient’s domestic situation is also considered by physicians. If a patient is unable to contact doctors, cannot provide reliable health information, or would otherwise be unsafe recovering from the disease at home, they will not be considered for in-home care.

Months after the onset of the pandemic, health care providers have learned more about treating COVID-19. According to Wednesday’s announcement of the at-home care program, Mercy also worked with New York’s largest health care providers, Northwell Health, to learn about a similar and successful program set up during the virus’s first surge in the spring.

Fenton indicated that the new approach at managing the pandemic may last if hospital beds continue to be occupied by a growing number of COVID-19 patients. 

“When we first started, we had a volume close to this. And then as COVID kind of died down over the summer, in regards to the number of cases, we saw a reflection of that. But we’ve had a severe uptick over the past few weeks,” he said.