CONTENTS OF THIS ISSUE
Summer/Fall 2020 Issue |
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EVMS Free Clinic Update
Can You See or Hear Me Now?
A Perspective on Quickly Transitioning a Student-Run Free Clinic to Telepsychiatry
By Aaliyah Joseph, BA and Stephanie Peglow, DO, MPH
HOPES (Health Outreach Partnership of EVMS Students) is the only free, student-run clinic in the state of Virginia and is dedicated to providing sustainable healthcare services to the underserved in Hampton Roads. COVID-19 abruptly halted the normal way of life, and the HOPES clinic closed its doors in order to protect the safety of the patients, students, and providers.
As the clinic coordinator, I understood that the unpredictable nature of the virus and the increased rate of unemployment would induce anxiety and depression among some and potentially exacerbate existing mental illnesses. As a result, I wanted to move the HOPES Mental Health clinic to remote operation as soon as possible to avoid disrupting the continuity of care for our patients who already face tremendous barriers to receiving healthcare. The process of creating the virtual clinic took a total of two weeks and involved brainstorming ways to satisfy the following requirements:
- find a platform that was HIPAA compliant
- offer video calls
- enable the healthcare professional to know the physical location of the patient
- provide a virtual space where our mental health team could discuss patient cases privately
- and enable student clinicians to add an attending to the call if they encountered a suicidal patient
Through innovation, I organized our telemedicine system which involves Bluejeans as a “virtual conference room” to discuss cases, and two doxy.me accounts where student clinicians, residents, and attendings can conduct video calls with our patients.
This virtual system has proven to be quite efficient, and we’ve observed an increase in appointment attendance since moving to telemedicine. Virtual appointments eliminated the barrier for patients who may not be financially or physically able to travel to the physical HOPES clinic. Consequently, we’ve been able to reach more individuals who are in need of our free mental health services. With transportation no longer an issue, we can further extend the scope of our services to more patients in the Hampton Roads area. In addition to the increased healthcare access, our virtual clinic platform has allowed us to maintain the unique learning environment that HOPES provides to EVMS students. Third- and fourth-year students still have the opportunity to volunteer as Senior Clinicians, where they strengthen their patient assessment skills and learn more about the field of Psychiatry. In addition to that, residents are able to practice creating treatment plans for the patients. Both groups are exposed to telemedicine and able to observe how medicine is practiced in an unconventional setting.
In contrast to the many positives telemedicine has created, we’ve faced some challenges as well. The primary obstacle we face with telemedicine is bringing free mental health treatment to the homeless population in Hampton Roads. Many of these individuals don’t have a personal phone, and as a result it’s difficult to schedule them for appointments, conduct appointments virtually, and assist with medication management. We hope to combat this issue by partnering with another EVMS student-run free clinic, Street Health, which serves this population specifically. Student volunteers at Street Health provide the patients with laptops so they can connect to our teleclinic. In addition, our clinic will help staff Street Health’s pop-up clinics with Psychiatric attendings and residents to conduct mental health evaluations and improve access to psychiatric care for this group. Through collaboration with Street Health, we’ll be able to meet this patient population where they are, and increase mental health treatment access to one of the patient populations that need it the most.
Telemedicine enables our clinic to provide continued support and healthcare services to the HOPES patient population during this unprecedented time. I look forward to utilizing this platform in the future to reach more at-risk groups that face tremendous barriers to accessing mental health treatment, and whose voices often go unheard.
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