McLean Shifts to Telemedicine to Maintain Patient Care

In just a few short weeks in March, McLean transformed itself from a hospital that depends on face-to-face encounters and shoulder-to-shoulder group interactions to one that can deliver treatment via patients’ computer screens.

“Pre-pandemic, I would estimate that less than 5% of our care involved telehealth,” said Chief Information Officer Kara Backman. “Today, we’re depending on telehealth at all levels of care and for every illness we treat. Because of this rapid and effective shift, programs across the hospital have been able to continue and, in some cases, extend care during the pandemic.”

While McLean’s inpatient care and certain residential programs are still operating in person—at reduced capacity to allow for physical distancing—more patients now receive their treatment, both one-on-one therapy as well as groups, via Zoom.

“Our technology team provided the tools and training, and it was amazing to watch the clinical teams take it all and run with it,” said Chief Medical Information Officer Alisa Busch, MD, MS. “Our goal is not to have the technology just approximate what we used to do, but to enhance it whenever possible.”

Admittedly, there have been challenges. How do you ensure that very ill patients stay organized and follow a schedule of online groups? Can a therapeutic environment—with all the spontaneous, healing interactions that occur outside of structured programming—still exist when people aren’t physically together?

Creativity has become the name of the game, perhaps none more evident than in the hospital’s child and adolescent programs. “Kids might watch a movie together on Zoom, then have a conversation about it,” said Michael Macht-Greenberg, PhD, MPH, senior director of the Simches Division of Child and Adolescent Psychiatry. “We’ve done lots of other things like online Simon Says, CBT trivia games, and show-and-tell—maybe you show off your pet or a piece of artwork—to keep people connected.”

With the challenges have come unexpected wins. “Telehealth has provided us with opportunities to have more robust partnerships with parents, who are critically important as we work together to manage our youngest patients’ engagement in treatment,” said Macht-Greenberg.

Additionally, no-show rates are down, and the teleconferencing platform has provided an unexpected benefit for trainees: in-the-moment supervision. They can do online therapy with patients as their supervisors observe—with patient consent—then receive guidance from mentors in a “breakout” room, if needed.

Once the pandemic subsides and programs can return to some semblance of normal, telehealth will likely play an ongoing role in some areas of the hospital. “It’s certainly not going away,” said Busch.