The coronavirus pandemic took an enormous financial toll on health care providers, especially those mainly provide elective care.
Now those businesses are using new technology to make patients feel safe as they come back to doctors’ offices.
Darren Harris, CEO of the Bone and Joint Institute of Tennessee, said that during the first few weeks of the pandemic patient volumes dropped by 80% at the clinic based in Williamson Medical Center.
Some patients still came in with broken bones, but the Bone and Joint Institute mainly provides elective procedures like hip or knee replacement. Gov. Bill Lee suspended all non-essential procedures in March, and health care providers couldn’t start them again until May.
Doctors at the Bone and Joint Institute started using video and phone calls to talk with patients during March and April. However, the nature of the Bone and Joint Institute’s work often requires doctors to touch patients, testing their range of motion or probing painful areas.
That meant that the clinic needed to make patients feel safe enough to come back to a physical office and see a doctor in a small exam room.
Initially, the clinic kept patients out of the waiting room entirely by careful scheduling appointments. Staff all wear masks, and the institute asks patients to do the same. Harris said the group is diligently monitoring software that tracks how long patients are waiting during each part of the appointment to make sure there are no bottlenecks.
Now, some patients are allowed in the waiting room, but the institute is careful to make sure the number is small. Doctors are using telemedicine less frequently than they were in the spring.
The measures to make patients feel safe appear to be working. Over the last several weeks, patients have started to come back. Harris said the number of patients coming to the clinic is now almost back to where it was preceding the pandemic.
“We got patients back very quickly so they had the ability to have social distancing because we didn't have them sitting in a lobby,” Harris said. “Because of that we've come back very quickly. Patients feel very safe in our environment.”
The coronavirus hurt the bottom line, but Harris said he expects the experience of getting through the virus outbreak to make the company stronger. He said the clinic will continue to use telemedicine for some appointment, which could make it easier to attract patients who live far from Williamson County.
“Where you might travel two and a half, three hours for a surgery. You're probably not going to do that for a post-op visit or a routine check up,” Harris said. “By forcing us to move into telemedicine faster than we would have naturally selected, we are becoming a more regional destination for patients that are coming from other areas.”
Like orthopedic clinics, imaging centers, which provide X-ray or MRI scans, found themselves in a difficult situation. Much of their work was suspended because of the coronavirus, and telemedicine wasn’t an option.
Outpatient Imaging Affiliates has a corporate headquarters in Franklin and about 50 locations across the Eastern U.S. The company saw an enormous drop in its business during the start of the pandemic, but demand has bounced back quickly since then.
Director of IT Applications Adam Ray said that’s because the company has turned to new technology to make sure patients feel safe. Patients can now fill out any paperwork needed for their appointment on their phones while they wait in a car outside the building.
“We could capture everything we needed while they were sitting in our car, so that when it was time for their visit we could just send them a text,” Ray said.
The company also used text messaging to reschedule big blocks of patients who had appointments last spring. Ray said that communication effort is a big reason that patient numbers have rebounded.
Even after the pandemic subsides, Ray said the company won’t go back to using clipboards and waiting rooms. Instead, the company is now trying to fully integrate the new technology into all of their systems.
“Next year, our business is going to be so much better,” Ray said. “A lot of the things we've talked about doing … but maybe not the time to do, were forced on us. This was a catalyst.”
The Franklin-based health technology company Relatient started selling that kind of software long before the new coronavirus had ever infected a human.
“We're in the business of providing a digital front door for health care. Before COVID, we were working with people that were innovative,” CEO Michele Perry said. “Post-COVID, these capabilities are no longer an option. They are a requirement for organizations to have. You've got to have contactless capabilities.”
The company sells software that allows patients to fill out paperwork on a phone, chat with doctors electronically and schedule their own appointments. Perry said the phone has been ringing off the hook with inquiries about those products, especially software to provide contactless check ins.
“This was never a use case we dreamt about when we came out with that product,” Perry said.
Much of the company’s existing software could easily be adapted to help doctors’ offices operate during an infectious disease outbreak. Relatient also started modifying its software to work better for telemedicine, as doctors started using that technology more than ever.
Perry said she thinks many of these new technologies are here to stay, mostly because patients will demand them.
“Even if providers would rather go back to 100% in the office, patients are not going to do that. The doctor's office is going to look different,” she said. “Everyone is going to say goodbye to the traditional waiting room … Out go the magazines, out go the pamphlets.”
With the number of deaths and COVID-19 cases in Tennessee expected to increase through the summer, Harris said the lessons learned last spring will prove useful going forward.
"I think this will happen again. We are going to put systems in place that allow us to still safely treat our patients. I think it will have a financial impact on us,” Harris said. “But I think we have more knowledge now and we'll be be able to manage it better without having to shut down everything.”