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June 27, 2020 01:00 AM

'Virtual' waiting rooms help keep patients 6 feet apart

Jessica Kim Cohen
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    Southwestern Vermont Medical Center lets patients wait in their car instead of a waiting  room. They get a text when a clinician is ready to see them.

    Southwestern Vermont Medical Center lets patients wait in their car instead of a waiting room. They get a text when a clinician is ready to see them.

    To ease the risk of COVID-19 exposure in crowded waiting rooms, hospitals reopening for non-emergent care are taking a page from the restaurant industry.

    Executives at Southwestern Vermont Medical Center needed to find a way to support social distancing and cut down on patients’ time spent inside. The Bennington-based organization had ceased non-urgent patient encounters and elective procedures due to the pandemic in mid-March but re-opened for those practices in May.

    They created a way to let patients wait outside the building before an appointment, as part of a so-called “virtual waiting room.”

    Rather than walking into a facility and visiting a registration desk, patients have the option to call a designated phone number when they arrive. After sharing check-in information like name, date of birth and who they’re scheduled to see, the patient is OK’d to wait in their car until they receive a text message or phone call saying their clinician is ready.

    “The expectation is that they’re going to be brought directly back to the exam room,” said Gail Balch, director of information systems and clinical informatics at the medical center. “There’s no initial waiting that occurs when they arrive.” 

    It’s similar to how a customer who goes to a busy restaurant might sign up to get a text when a table is ready rather than waiting by the front door, said Dr. Trey Dobson, chief medical officer at the medical center.

    “We’ve seen (these concepts) before,” Dobson said.

    To use the virtual waiting room, a patient needs to have a cellphone and a vehicle to wait in. There’s not a lot of space to stand around outside, according to Balch, so patients who arrive another way—walking, public transportation or taxi—are asked to wait inside.

    To protect those patients, the center has spaced out furniture, revamped conference rooms to serve as additional waiting space and ensured there’s hand sanitizer available. All patients and visitors are required to undergo a COVID-19 symptom screening and wear facial coverings.

    Southwestern Vermont Medical Center has made the virtual waiting room application available to all of its sites since the start of June, but only some are using it.

    As of mid-June, about half of the organization’s roughly two dozen sites opted to offer the capability to patients. Leadership at other sites decided they had adequate waiting space, according to Balch.

    About 28% of patients who had in-person primary-care appointments used the virtual waiting room the first week the option was offered, Balch said.

    It’s becoming increasingly common to see hospitals implementing virtual waiting room programs, partially as a way to ensure social distancing and partially as a way to ease stress patients might be feeling about visiting a healthcare facility during the pandemic, said Aloha McBride, global health advisory leader at consulting firm Ernst & Young.

    “First and foremost, they’re trying to establish trust with their customers, with their patients,” McBride said.

    She said some hospitals are going beyond the virtual waiting room, adding remote check-in and payment options, too. The goal is to get to a point where patients walk into the building for their appointment and then leave, without having to spend time on other tasks.

    An application developer at Southwestern Vermont Medical Center built the organization’s virtual waiting room program, which involves a web-based interface where staff enter a patient’s demographic information, phone number and assigned exam room.

    The application took three or four days to develop, said Charles Wells, the app developer. He’s planning to continue building on it, adding ways for patients to request an update on their wait time or to enroll in the program by texting a phone number, rather than calling.

    Ohio Valley Surgical Hospital is using a virtual waiting room tool from patient engagement company Jellyfish Health. Ohio Valley had planned to add the company’s virtual waiting room service by the end of 2020, but that plan got pushed forward amid COVID-19.

    In February, the Springfield, Ohio, hospital began using a set of other tools from the company, including ones to send appointment reminders and after-visit surveys via text message. 

    Jellyfish prices its services using a tiered structure based on customers’ annual visit volumes, said Dave Dyell, the company’s CEO.

    So far it has launched the virtual waiting room feature at its imaging center and breast center. It plans to roll out the tool to its other specialties in the following months, and not just as a program for COVID-19. Leadership plans to keep the option to wait outside available even after the pandemic subsides.

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