Working in telemedicine during the age of COVID-19

Smriti Shah

COVID has impacted us all. Working remotely has been a challenge. This is set of conversations with implementation, engineering and management to gain some insights into their work during these challenging times.

2020 has led to many changes— transitioning to remote work being one of them. Many of us are still getting used to our new reality of telecommuting with about half of employed adults currently working from home. Telecommuting has been on the rise over the last several years and has accelerated exponentially since the pandemic first began. Drawing a direct parallel to this, the field of telemedicine has had a similar claim to fame. Put these two together and working on telemedicine programs for a health system in the midst of a pandemic can be a whole other ball game. I sat down with some integral members of the Way to Health Team to talk about the COVID-19 pandemic and just how it impacted their work here.

Neda Khan, Senior Applications Specialist

Has your work become more meaningful in any way?

My focus has been more research so it’s always been impactful work with the goal of improving patient behaviors to in turn, improve health. Working on COVID focused projects allows us to see how we are impacting patients directly while trying to help make clinicians’ lives easier. It is definitely much more rewarding and meaningful to see the direct impact our work is having on patients and providers. We’ve also been getting patient feedback once programs have completed to see if the program is effective and helpful.

Have you identified any areas in your work that have been fast-tracked or accelerated with quicker input/output time compared to pre-pandemic structure?

We’ve adopted a much quicker output time — we’re now building programs, testing and launching them in a matter of days. Before, we launched programs over a span of weeks or months and now we’re iterating much more quickly than we’ve ever done before. We have a high number of patient enrollments, providers and clinicians constantly looking at data so our user and patient experience is happening at a quicker pace, and consequently we are learning a lot from the huge volume of data.

What makes the service Way to Health provides unique?

Way to Health is really set apart from our competition due to a couple factors. We have seamless integration with EPIC that makes it easy for providers to enroll patients into different programs. Since we’ve been around for so long, we have a ton of experience with what works and what patients respond to in texting and remote monitoring programs. We have the ability to integrate with connected care devices — this makes a huge impact, and we have the data and metrics to show just how successful it can be.

Kyle McGrogan, Software Developer

Have you identified any areas in your work that have been fast-tracked or accelerated with quicker input/output time compared to pre-pandemic structure?

From a developer point of view, we’ve created a whole new ticket type for fast tracking work. Our normal flow puts us through a test environment, but now we usually go straight to production. This felt odd at first and took some getting used to.

What is one silver lining you have noticed amongst all the uncertainty and unrest?

One silver lining I’ve noticed is that a lot of red tape got cut away. People are focusing on what we need to do to get care to the people who need it most. I think everyone realized there was a need and started asking, “How can we actually do this?” For instance, integrating with Lancaster General Hospital usually would’ve taken 1-2 months to get approval up the chain whereas now, it happened in a week. Everyone’s coming together to recognize that need for care and how we can get things done quickly.

Michael Kopinsky, Engineering Lead

Shifting to remote work - how has the operational response and needs of HUP & other clients impacted your work? What does your “new normal” look like?

Since we already had occasional remote work we had the tools in place in terms of Slack and Zoom and knowing how to communicate with each other. Our COVID Watch program would normally have taken a few months of working with stakeholders, clinical partners, implementation, and product development, but it took 2.5 weeks instead. In the past we’ve had to scramble to get things done, but now the order of magnitude speeds up the process. For example, decisions we would have agonized over, now due to time constraints we go forward with what works. And we find solutions that don’t put our other projects at risk.

Has your work become more meaningful in any way?

We have always done a combination of research and clinical work. With COVID Watch, we are much closer to patients and patient-specific needs. Normally we’re looking for an elegant solution that meets lots of people’s needs, or we stop to consider heavily what clinicians and patients want. Now it’s more like, “Here’s the specific problem these people are having, and how do we solve it?” In the past we haven’t really been involved in running programs. We just support the program and help it launch. With COVID Watch, we’re intimately involved with tracking data daily and closely monitoring what our patients are doing. We can say they’re our patients when in the past they’ve been likened to our “customers.” It’s definitely more meaningful.

Mohan Balachandran, COO

If the economy takes a serious hit, how does it impact our customers?

The economy has already taken a serious hit. Way to Health is part of Penn Medicine so anything that impacts Penn Med will impact us as well. Budgets are constrained across the board. Health care is an essential service. It’s not like you can put off chemotherapy infusions or CABG surgeries indefinetely. So we can now see gradual recovery as patient volumes come back up to pre-COVID levels.

We have two sets of customers - researchers and health care organizations. Research has definitely been impacted with studies paused but are now restarting. Clinical projects have accelerated quite a bit as remote monitoring and telemedicine have taken off. Both were severely impacted over the past few months but they seem to be recovering slowly but surely.

What big opportunities exist for W2H born out of this situation?

As I mentioned earlier, COVID has accelerated the need and support for telemedicine and remote monitoring efforts. We have been working on ways to automate results reporting, especially negatives to reduce the burden on nursing staff. With the University reopening, we expect the volumes to jump dramatically. All of our existing projects are ramping up faster and we have a large set of incoming projects.

Given those changes, we expect that we will be more closely linked to the electronic health record. The intent here is for us to be working in the background so that clinicians don’t have to worry about logging into one more system. We are also increasingly working closer with clinical and research teams on program design given the vast amount of experience we have with the variety of programs we work with.