JOINT BASE SAN ANTONIO-LACKLAND, Texas —
While San Antonio is under a “Stay Home, Work Safe” order, members of the 59th Medical Wing at Joint Base San Antonio-Lackland have found new ways to continue providing high-reliability care through virtual appointments while keeping patients and staff safe.
Beginning in early March, 59th MDW providers began going through their scheduled patient appointments to determine which could be conducted vi telephone, particularly appointments for elderly patients more at risk for contracting COVID-19.
“We had the ability to do telephone consults, but we wanted to take that a step further,” said Maj. Christopher McMillian, 59th Medical Support Squadron information systems flight commander.
The wing quickly put together a team to evaluate how to convert traditional in-person visits to telehealth appointments. The team developed user guides and telework plans for providers and technicians, pushed technical updates to desktop computers for home use, issuing laptops and more.
“At this stage, 95-98 percent of our appointments in both primary and specialty care have been converted to telehealth appointments,” said Lt. Col. Sarah Whitson, 59th Medical Operations Group senior group practice manager. “Anecdotally, our patients and providers appreciate it. In addition to staying safe, it is also saving patients’ time – they don’t have to drive to their appointment or wait in the waiting room.”
This also allows providers and technicians required to work from home during this time to continue providing patient care, thus augmenting urgent or emergent care clinics.
“Almost a quarter of our regular users are able to do their jobs without having to come to work at Wilford Hall Ambulatory Surgical Center, which is minimizing the physical footprint of the workers and minimizing our exposure to one another,” McMillian said. “The work of the medical wing is able to go on, irrespective of where the workers or the patients are.”
With the additional help of the Army Virtual Medical Center at Brooke Army Medical Center, the team also developed an audiovisual appointment capability for those appointments that need face-to-face interaction.
“It’s often important for the provider to actually see the patient,” said Maj. Juilene Durisma, 59th Medical Specialist Squadron allergy and immunizations flight commander and virtual health champion. “When we are being isolated, this can be incredibly valuable for people who need that connection. Additionally, the provider can see the patient’s cues and non-verbals to best treat them.”
“Losing that face-to-face interaction with the people they trust with their health can be a real challenge,” said Capt. (Dr.) Shane Riggs, 59th Medical Operations Squadron psychiatrist. “The technology we’re using allows a close approximation to that. It’s a step closer than just a voice over the telephone.”
Appointments are scheduled as they always have been, by calling the Consult Appointment Management Office at 210-916-9900. At the time of the appointment, a provider calls or sends the patient a link to the audiovisual platform being used for the visit. The link can be accessed on a patient’s home or work computer, cell phone or tablet, without creating an account.
“Having to stand up this capability so rapidly and during a pandemic outbreak has helped launch us forward into an area we were heading toward anyway,” Riggs said. “Telehealth is not going to end when this pandemic ends. I don’t think it will ever be able to completely replace face-to-face visits, but it is something we can add to our practice that will benefit our patients’ mental and physical health.”
With that in mind, the virtual health team has already begun formulating plans for using telehealth to improve patient care in the 59th MDW during and after the pandemic, improving access to specialty care, decreasing appointment wait times and more.
“I truly believe this will change our operations for the future,” said Col. (Dr.) Karen Bowman, 59th Medical Operations Group primary care department chairman. “We are going to continue to capitalize on this innovation.”
“If something like this happens again, in a time of pandemic or a time of war, we will already have this system in place. We won’t be reacting and we’ll do an even better job of responding to it,” Riggs said.