In an interview with Patricia Slusser, RN, we discussed the differences between the RN’s role in a traditional, face-to-face doctor’s appointment and what her day is like as a caregiver and digital telehealth facilitator.
Patricia Slusser, RN, starts her day as many other nurses. She listens to messages, checks the schedule to see which patients are coming in that day, and sets up the exam rooms. But as a facilitator care coordinator for the Optimized Care Network (OCN), a hybrid digital telehealth practice, the rest of Slusser’s day looks very different than most RNs currently working in primary care offices across the United States.
OCN’s digital exam room is called Optimized CareSpace. By combining the right technologies with a specially trained nurse guided by the health provider to perform the health assessment of the patient, Optimized CareSpace offers digital telehealth that remains uniquely human.
I spoke with Slusser about the role of nurses at the forefront of this changing healthcare landscape.
EHRs bring instant gratification
Slusser, a seasoned registered nurse who has worked on oncology units, surgery, and labor and delivery, began her career in the age of paper records. I asked her how she felt about the transition to electronic health records (EHRs).
I was used to a paper chart. The EHR was a game changer. It is a huge entity with intricacies to learn… Once you learn it and own it as your tool, it is fantastic and I don’t know how we survived without it… It’s like having information at your fingertips, that back in the old days I had to go to books, or the pharmacist to get. Looking back now it seems quite archaic… We’re used to instant gratification now and the EHR provides that really well.
Technology as a tool for engagement
Slusser and I discussed the differences between the RN’s role in a traditional, face-to-face doctor’s appointment and what her day is like as a caregiver and digital telehealth facilitator. OCN exam rooms are equipped with a large screen, which, via a two-way video, provides a three-dimensional image of the physician for the patient in the exam room.
She mentioned—more than once—that there’s a certain wow-factor that occurs the first time a patient walks into the OCN exam room.
When the patient comes for the first time they are pretty wowed by the technology…. Basically it’s a traditional space, other than that there’s PresenceCare in the room… That PresenceCare screen sits there empty basically when I’m talking to them. Then, through the patient's conversation with the provider, that technology all falls away. I feel so lucky to witness this with every patient, that the encounter becomes the conversation and the technology is just the tool.
When I inquired about OCN’s patient satisfaction scores, Slusser didn’t have the information in front of her. But, given the amount of time she spends with OCN’s patients in front of her, she told me, anecdotally:
Our patients love it. You know, you wouldn’t think that the elderly would take to this, but they really like the attention they receive. It’s funny, after the doctor leaves, especially with elderly patients, they’ll look at me and say, ‘Hey, can you help me figure this out? I’m not sure what he meant…’ Also, we can send a HIPAA compliant link to a family member who might want to be part of the exam.
Building trusting relationships despite—perhaps because of—technology
OCN’s platform—this type of nurse-facilitated digital telehealth consultation—seems to transcend technology and help patients build trusting relationships with their physicians. This, according to Slusser, is a key differentiator for the company.
In the exam, Slusser (or another RN) acts as a scribe, recording answers to the offsite physician’s questions and performing the physical exam in the tele-presence of the doctor. The physician, who appears in 3D in the exam room, is able to make eye contact with the patient. Unlike a chat using FaceTime or Skype, in which participants struggle to look at the image on their computer as well as the stationary camera on their device, the physician and patient are able to have eye contact.
Photo courtesy of: Optimized Care Network
During our telephone conversations, Slusser indicated that
the relationship between doctor and patient is key to success in healthcare – and to build that relationship you need eye contact.
Many RNs spend their days on the phone and in front of computer screens. The majority of patient interactions are either with a medical assistant or the physician. Slusser feels as though her work facilitating care at OCN is a return to the core of nursing. In her own words, digital telehealth at OCN “brings the RN back to the bedside… I feel like we do our best care there.”