SHM Converge Scientific Abstract ePoster Gallery-Implementing and Sustaining a Perioperative Medicine Telehealth Program During the Covid-19 Pandemic

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This document describes how a preoperative medicine clinic at OHSU implemented and sustained telehealth during the COVID-19 pandemic. Telehealth was already being planned before the pandemic for geographically remote and disadvantaged patients in Oregon, but COVID-19 rapidly accelerated adoption and greatly expanded visit volume. OHSU’s existing telemedicine infrastructure made this expansion possible.<br /><br />The clinic developed a multipronged strategy to maintain care quality and support staff. Key elements included adapting clinical workflows for telehealth, emphasizing history and review of systems when physical exams were limited, using video-based exam techniques when possible, coordinating labs and EKGs with other on-campus visits, and improving EHR interoperability. The team also introduced new frailty and cognitive screening tools, refined patient triage based on medical complexity, geography, mobility, technology access, and psychosocial support, and built trust with internal and external stakeholders. Medical assistant workflows were redesigned so nurse practitioners and physicians could work at the top of their licenses.<br /><br />Telehealth use became substantial: during the early pandemic, 90–95% of NP/MD visits were virtual. As surgical services resumed in summer 2020, telehealth stabilized at about 70% of visits, and by summer 2021 in-person visits had risen to about 50%.<br /><br />The document also outlines visit triage guidance: telehealth is best for patients who are not local or have transportation barriers, while in-person visits are needed for patients with communication barriers, hearing difficulties, certain testing needs, or when they are already on campus. The authors note that telehealth improved access and saved travel time, but disparities remained, especially for older adults, non-English speakers, and Black patients, who were more likely to use phone than video visits.

Asset Subtitle

Avital Y. O'Glasser

Meta Tag

Author List Avital Y. O'Glasser, Elizabeth Hays, Katie Schenning, Kristen Ash, Kristen Lund, Lizi Sukowatey

Category Innovations

Concept COVID-19 Pandemic

Concept Telehealth

Concept Preoperative Medicine Clinic

Concept Telehealth Implementation

Concept Patient triage

Distinguished Non-Finalist

Presenter Organization Oregon Health & Science University

Presenting Author Avital Y. O'Glasser

Track Perioperative

Keywords

telehealth

preoperative medicine

COVID-19

OHSU

virtual visits

patient triage

EHR interoperability

frailty screening

cognitive screening

health disparities

COVID-19 Pandemic

Telehealth

Preoperative Medicine Clinic

Telehealth Implementation

Patient triage