One of the most significant downstream effects of the COVID-19 pandemic on pediatric medicine is the accelerated adoption of telehealth. Research shows that following an initial spike in the spring of 2020—when safety and distancing protocols forced most non-emergency medical visits to be conducted virtually—telehealth utilization is now stabilizing at levels 38 times higher than before COVID-19.
The pandemic-fueled spike in telehealth use at Children’s Hospital Los Angeles (CHLA) exceeds the national average. The hospital averaged 39 telehealth visits per month prior to COVID-19; today, those numbers run in the thousands, sometimes topping 6,000 visits per month.
The rapid growth and staying power of telehealth prompted the hospital’s leaders to invest in a new program devoted solely to virtual patient rooming.
“We realized virtual health is key to the future of health care, so it was our responsibility to make sure we were mimicking the key principles of satisfaction in a virtual setting,” says LaNice Berry, director of patient care services at CHLA. “This process allows us to do that.”
How it works
CHLA launched its virtual rooming program—the first of its kind in the U.S., according to the hospital—with a dedicated team of five remotely based virtual medical assistants (MAs) in March 2022. About 10 to 15 minutes before a scheduled telehealth visit, an MA reaches out to the patient’s family to initiate the rooming process.
The MA checks the audio and video connections, confirms that everyone is present, and asks the family if they have any questions for the provider. If necessary, the MA brings an interpreter into the video conference and then places the family into a virtual waiting room until the provider joins the call.
The MA relays any pertinent information or questions to the provider via a secure Microsoft Teams message and checks back with the family in the event of any delays. “That was a big gap we identified prior to doing this project—if the provider was running behind, parents were just sitting there waiting without any resolution,” Berry says.
“The MA team has done a phenomenal job at closing that communication gap and letting our patients and families know we're still engaged even though we're not sitting with them face to face.”
While the current role of the MA largely involves technical support and basic medical questions, CHLA plans to expand the program in its next phase. Eventually the virtual rooming process will mirror in-person rooming to include gathering full medication history and allergies, as well as any other initiatives or screenings the hospital is performing at that time.
Promoting health equity among many benefits
In addition to creating a better telehealth experience for CHLA’s patients, Berry says the virtual rooming program provides a host of other benefits:
- Efficiency. Solving technical issues before the telehealth visit ensures providers maximize their time with the patient.
- Telehealth expansion. CHLA is seeing higher patient satisfaction scores on telehealth visits; they expect that to lead to families using the program again and recommending it to others.
- Retention. Berry says some of the current MA team members were long-term employees considering leaving health care in the wake of COVID-19. The newly created work-from-home program enabled them to remain with CHLA and created another career path for others.
One of the most important benefits, according to one of the program’s architects, is how virtual rooming can help disadvantaged patient populations.
“From a health equity perspective, this program really helps bridge important gaps,” says Omkar Kulkarni, chief digital transformation officer and chief innovation officer at CHLA. “It helps ensure that all patients—regardless of their digital proficiency or access—have the ability to engage with their provider.”