McLean Embraces Telemedicine
When in-person treatment wasn’t possible, the hospital founds ways to continue much-needed care
July 14, 2021
In the chaotic early days of the pandemic, when federal and state regulators lifted a variety of legal barriers to telemedicine services, McLean Hospital programs raced to provide telemedicine to all levels of care
Within two weeks, McLean pivoted to telemedicine, with 100% of outpatient and partial treatment moving online, and inpatient services changing in fundamental ways.
What seemed to happen overnight took countless hours to achieve, with McLean Chief Information Officer Kara Backman’s team working with hundreds of McLean clinicians and the MGB Virtual Care team to ensure a smooth transition from in-person care to telehealth for McLean providers. In addition to establishing online capabilities, this also meant providing leadership in the development of system-wide policies and procedures related to the privacy and security of telehealth services.
“We’re fortunate that we’re part of a larger enterprise with Mass General Brigham, and we had tools readily available,” Backman said. “Our team had to figure out how to make these tools work for McLean and our workflows, especially where group therapy was involved.”
Although Backman and McLean Chief Medical Information Officer Alisa Busch, MD, MS, spearheaded the effort, they were quick to recognize other key players who were instrumental in setting up telehealth so rapidly at McLean. “We just could not have done what we did without our colleagues Maya Gotova, Lisa Horvitz, and Patty McGeary,” said Busch.
“It was awesome to watch clinical teams thinking not just how they could take what they normally do in person and move it onto a virtual platform, but also how they could use the tools available to help them in their work with patients,” explained Busch. Such changes included using breakout rooms for smaller discussions and sharing screens to distribute handouts.
Mona Potter, MD, a child psychiatrist at McLean, said her team has learned to innovate with the changes brought on by the pandemic. “It’s been fun to watch our team bond over creative ways to engage kids and teens virtually,” said Potter.
While telemedicine has been a game changer for outpatient and partial hospital (day program) treatment, it has also been important inside the inpatient and residential programs. Through the use of iPads, patients who need to be hospitalized can join group therapy from separate areas to remain physically distant, and providers who are not feeling well can still conduct therapy remotely. Such flexibility has helped maintain therapy continuity and staffing conditions, according to Busch.
Rachel B. Weiss, PhD, staff psychologist in the Behavioral Health Partial Hospital Program for adults, said that before the emergence of COVID-19, “my colleagues and I would have asserted that our partial hospital program could simply not be conducted via telemedicine.”
“Nine months later, I am amazed at what we were able to accomplish when we had no choice,” she added. “Through a collaborative process, we developed a virtual workspace that streamlines the technological experience for both clinicians and patients. In turn, we are able to stay focused on compassionate clinical care and to stay fully present with patients, even through a computer screen.”
The Future of Telemedicine
Will McLean continue with telemedicine once the pandemic is over? Busch said the decision will depend in part on whether federal and interstate barriers remain lifted once the emergency has passed. Another aspect involves a hotly debated health policy conversation on how telemedicine can best help people get the care they need.
“There are some things to be worked out,” she said. “But from a health policy perspective, our hope is that we can continue to do this.” Busch added that it is clear that telemedicine is useful for providing care to certain patients. “We hope that, post-pandemic, telemedicine will continue to be a tool in our toolbox so that we can continue to provide these services to patients when it is clinically appropriate.
Transitions are challenging for people with autism spectrum disorders, including those attending Pathways Academy, a school for individuals 6-22 years of age on McLean’s Arlington campus.
“Throughout the program’s history, we have been proud of our close relationship with students’ families—it is one of collaboration, communication, and trust,” said Roya Ostovar, PhD, director of Pathways Academy. “It was no different last March, when we were making the difficult decision of moving to remote learning and delivery of clinical services.”
Pathways began communicating with the families of their students, informing them of the decision-making process every step of the way. Likewise, staff kept working with the students, supporting them through the difficult transition. Many were glad that if they had to attend school, they could do so remotely.
“We have many students with significant anxiety—not wanting to leave the house and feeling much more comfortable learning from home,” said Educational Administrator Laura D. Mead, MSEd.