When social distancing and sheltering in place took effect in March, a group of Novant Health OB-GYNs in Winston-Salem, North Carolina, figured it needed to implement virtual visits. And the doctors already had an in-house authority.
Dr. A.J. Lewis had been talking up virtual visits for several years – ever since he returned from a medical conference at the University of Utah where he heard about the concept. In snowy, mountainous Utah, there are times the roads aren’t passable. So, medical practices there rely on video visits. Even though most of North Carolina’s climate and terrain are unlike Utah’s, Lewis thought this innovative approach could be a time-saver for patients. Not every visit during a pregnancy – especially those with no complications – really needs to be an in-person visit.
But the concept never took off.
Then a pandemic hit, and Lewis’s colleagues started asking him, “Remember that idea of yours?”
“Novant Health already had the information technology in place for video visits,” said Lewis, of the Novant Health Valaoras & Lewis OB/GYN clinic in Winston-Salem. “Suddenly, it exploded in other practice areas. We formed a working group of physicians to look at how we could apply it to obstetrics and gynecology and released the guidelines to all Novant Health OB-GYNs. From the outset, we let patients know this is just an option. Anyone who wants to come for an in-person visit can do that.” Since March 2020, there have been more than 150,000 video visits with Novant Health providers.
“The idea is to alternate in-person visits with video visits – particularly in the second trimester and early third trimester,” he said. “We never want to go too long without seeing a patient in person.” Overall, the move to video visits for a typical pregnancy is reducing in-office visits from around 13 to about eight.
Video visits are very similar to regular, in-person visits. If the patient has a scale and blood pressure cuff at home, a nurse will ask her to check both before the doctor enters the room – via Zoom teleconference on their phone, tablet or laptop.
Physicians can troubleshoot over video as easily as they can in the office. “If a patient tells me over Zoom she’s not feeling the baby moving as much,” Lewis said, “we’re going to get her in right away.” And when patients do come to the office, they should know that Novant Health is constantly updating procedures and practices to ensure social distancing and keep hospitals and offices clean and safe.
Today, Lewis’ practice has 35 to 40 video visits each week. Across the Novant Health network, physicians are doing 5,000 video visits a day. “Patients appreciate the convenience,” Lewis said. “If they have other children, they don’t have to worry about finding a sitter. If they work, they don’t have to take time off.”
During a time when lots of couples find themselves both working from home, virtual visits allow dads to easily be part of the appointment. Lewis had a video visit with one patient whose husband, two kids, dog, cat and pet bird all joined in.
A convenience for patients
Kim Ray, one of Lewis’ patients, was quick to get onboard. She not only uses the technology as a patient – but also as a provider. She’s a physician assistant with Gastroenterology Associates of the Piedmont and conducts video visits with her own patients. “We have a number of elderly patients, and this idea has gone over really well with them,” she said. “Some of them have mobility issues, and some live out of town. Video visits allow them easy access to care.”
Ray is 34 weeks pregnant and already knew her OB well, so the transition to video visits for every other checkup was easy. “You can actually assess a lot over the phone or video,” she said. “I had been having acute abdominal pain before one visit, and Dr. Lewis arranged for me to have labs done right away. He also assured me the pain wasn’t related to my baby, which had been my biggest worry.”
The high-tech visits don’t feel impersonal, she said. “It’s funny that it actually feels like a house call,” she said. She’s fully accustomed to using technology for her own prenatal care. She and her husband even logged on to Novant Health’s website for an online breastfeeding class.
‘Dramatic change for the good’
Video visits are an idea whose time has come, Lewis said. It took a global pandemic to push medicine in this direction, but he doesn’t see video visits going away once the COVID-19 pandemic subsides. “This has been a dramatic change for the good,” he said. “We’re using technology for the benefit of patients, and it’s working for everyone. There is no decrease in the level of care we’re able to provide.”
Novant Health is here for expectant moms every step of the way.
Novant Health now allows one healthy adult support person to accompany expectant mothers to obstetrical ultrasound appointments. Details here.
Caption for top photo: Kim Ray, above, says scheduling a video visit from an office at work allows her to save time. Instead of taking more than an hour off work to drive to her appointment, she can go online and take care of it in about 15 minutes. If she needs to see her physician in person, however, the option is always there.