We started hearing about and using the verbiage COVID-19 back at the end of February. By Mid-March, our practice was preparing a contingency plan should we need to shut our doors for “elective in-person” device checks. The COVID-19 pandemic arrived, and that contingency plan went into effect on March 18th, 2020.
Background
Our clinic has built a reputation for efficiency, staff satisfaction, and patient satisfaction (Press-Ganey score 94.2). All along leveraging remote monitoring to achieve this status. Our patient utilization of remote monitoring is 98%. We adapted to the use of remote monitoring from the onset. We understood the way to service our clients was to get information needed from the device to the hands of our providers quickly. Remote monitoring became an integral part of our care.
Challenges
A challenge with remote monitoring is the management of the alerts and routine transmissions. CVRS established guidelines regarding staffing needs and customer expectations. We also have invested in the quality of our services, such as staff certification, experience, and education. We do not schedule more work than can be done in a day based on staff availability.
When the mandate for social distancing meant we had to stop seeing patients in person, we were able to call those patients that were due for an in-person and opt for a remote follow up instead. This allowed us to push out their in-person visit for three months. So, all patients have been evaluated. Only those with urgent needs were seen in-person minimizing risk to both patient and staff. Our guidelines for urgent visits are based on HRS recommendations: “Guidance for Cardiac Electrophysiology During the Coronavirus (COVID-19) Pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association.”
Remote Work
We have maintained a full patient load, remotely. COVID-19 has had minimal impact on the care of our patients, and the staff have been able to continue to work primarily from home. We have used Microsoft Teams Meetings for our daily huddles, Jabber, and e-mail to stay connected.
Our only challenge has been those patients with a newly implanted device that need education, their site check, and device evaluation. We decided to schedule a remote transmission one-week post-implant. We also call the patient to educate and inquire about their implant site. If there are any issues, we will see them or have them send in a photo of their implant site. Our plan is to replace this workflow with virtual telehealth visits in the next few days.
A consequence of COVID-19 restrictions is that we have more time to follow up on patients that are lost to follow up and non-compliant. We can manage these populations using our Paceart Optima System. It is nice to be able to devote time to get these concerns addressed.
Consider Us
If you are a clinic that found yourself unprepared for the COVID-19 and the changes it demanded, you may need to consider how you care for your patients in the future and encourage your patients to use remote monitoring. If you are a clinic drowning in remote monitoring transmissions and do not have the staff to manage your population, consider consulting CV Remote Solutions to help you until you can get your staff in place and volumes managed.
A partnership with CV Remote Solutions can be an excellent solution for many clinics. CV Remote Solutions specializes in providing a high level of technical support for device clinics. CV Remote Solutions uses only IBHRE certified RNs for technical device support. They are flexible to allow quick integration into your current workflow. They do so using your current device database and integrating with your EMR. This flexibility will enable them to provide the solution that you need for your clinic quickly while allowing you to retain control over your device clinic patients and resume follow-up yourself when your staffing issues are resolved. CVRS also provides device clinic consultative services that can allow for assistance with training your device clinic staff and establishing workflows and protocols that will allow you to realize the highest level of care that you desire for your patients. Now may be a good time to consider CV Remote Solutions for your device clinic’s needs.
Laura Van Heel RN, BSN, CCDS is the Supervisor of Clinic Cardiology at Centracare Heart & Vascular Center (CCHVC) in St. Cloud Minnesota. She supervises the Pacemaker/ICD Clinic, the CCHVC Heart Failure clinic, CCHVC Electrophysiology, and Atrial fibrillation clinic scheduling. Van Heel has been a Cardiac Implanted electronic device nurse for 28 years.