When COVID-19 and virtual care collided
During our time providing patient care in 2020, our nurses and care coordinators were able to service 83% of our COVID-19-related chats with telemedicine or at-home self-care – keeping patients safely at home and reducing burdens on brick and mortar healthcare facilities.
When the pandemic began, Pager was – and remains – a key service to patients in need of support. In service of our clients, our command center nursing and care coordination staff saw huge surges in the number of chats they were receiving, both about COVID-19 and other health needs. To support this influx, Pager’s care coordinators and nurses worked around the clock to deliver care and triage patients, then connect them with telemedicine, in-person visits, COVID-19 testing site information, and CDC guidance.
Following this, our team dove into a subset of COVID-19-related data to understand where virtual care was having the greatest impact on combating the pandemic.
We examined COVID-related chats that occurred between April 1 and December 31, 2020 to understand patients’ needs as they related to COVID-19 health concerns – and to understand how virtual care can play a role in reducing the spread of the coronavirus.
Why patients turned to Pager
The most common COVID-related reason patients turned to Pager was to ask a general question about the virus. Forty-one (41) percent of chats came from individuals who may not have had a specific health risk or exhibited symptoms, but had a health concern. Pager’s care coordinators and nurses were able to serve as a resource for those who may not have been comfortable going to see a doctor in person, or for those who simply needed more information in order to make the best choices for their health.
When COVID-19 started spreading, there was a lot of confusion, and patients really just wanted information. Many weren’t sure how to protect themselves, or how to discern flu or allergy symptoms from COVID-19 symptoms. Our nurses were able to help patients stay at home by providing information on symptoms and whether it was really necessary to head to an urgent care or ER.
- Elizabeth Nieves, Nurse Supervisor
Thirty-nine (39) percent of chats regarding COVID-19 were from patients who had symptoms. These patients turned to Pager’s care coordinators and nurses to discuss what their symptoms may mean, and to understand how and where they could access care safely and within their health plan network.
The most common symptom reported by these patients was cough (42%), followed by fever (28%). Most patients who reported symptoms had only one symptom (46%), and few (11%) reported four or more symptoms.
In addition, 20% of patients initiated a chat because they were exposed to COVID-19, most often via a person who was confirmed to have COVID-19. For these people, our clinical experts provided a safe, easy way to guide patients to the best next step to take once receiving new information that they were potentially at risk for contracting the virus.
Thirty-four (34) percent of people were classified as being at heightened risk for severe illness from COVID-19. The most common risk factor was being over the age of 50, followed by lung disease and being otherwise immuno-compromised. For these people, who are at increased risk and may be wary of going to a doctor’s office in person, Pager’s services were able to provide support and direct them to the best type of care for them.
At least 74% of people were directed to testing sites and 77% were provided with COVID-19 guidance information from the CDC. With a very fragmented COVID-19 testing environment, in which many people didn’t know where to go to get tested, what it would cost, whether they need an appointment or how long they will have to wait, our care coordinators and nurses served as a direct link to information and support.
“Everyone I spoke to was nice, caring, and very helpful. With the pandemic especially, it is so nice to be able to get in touch with real people to help you when you aren’t feeling well so you don’t have to go out!”
- Patient feedback
Despite fragmentation making it difficult for anyone to predict wait times or appointments, our Command Center was able to provide patients with a list of testing sites in their state, and if a person was experiencing symptoms, a care coordinator could transfer him or her to a nurse to determine the best next step. The peace of mind our Command Center agents are able to provide to patients – via reassurance they can stay at home, care provided by a nurse, or connection to telemedicine or testing in their area – is a major benefit to those who were experiencing heightened stress or anxiety surrounding the unknowns of the COVID-19 pandemic.
This gives me peace of mind, being able to see a doctor when I’m scared to go to a doctors’ office because of COVID.
- Patient feedback
Even in situations where telemedicine wasn’t appropriate or necessary, Pager’s Command Center coordinators and nurses provided value by helping with the logistics of accessing care or information, providing triage and a first line of care for those experiencing symptoms, and offering emotional support by being a trusted professional with whom they could connect.
Results from patient COVID-19 chats
We also examined each chat to see what next steps the nurse recommended for the patient: to stay at home, connect to a telemedicine provider, or see an in-person doctor. Most commonly, patients who initiated COVID-19 related chats were connected to a doctor in a telemedicine visit (44%). This indicates that these people may have needed care from a doctor, but not so urgently that they needed to go to the emergency room (ER) or urgent care center. With telemedicine, individuals were able to stay at home and get the care they needed, rather than going to see a doctor in person and risk infection, or risk infecting others.
I was avoiding a walk-in as to not expose myself to any unwanted COVID-19 encounters. The nurse and doctor here were amazing! They are top notch providers with a caring and friendly disposition. Most of all they were easy to talk to and really listened.
- Patient feedback
The next most common care disposition was the patients who were encouraged to stay home (39%). These patients may have been asked to stay home because they were unlikely to have COVID-19, or because they were instructed to quarantine given their symptoms or the likelihood they could have the virus. In either scenario, Pager’s Command Center was able to provide advice on when the best option was to simply stay home and social distance, rather than risking infections or placing a burden on already-crowded medical facilities like urgent care centers and ERs.
Seventeen (17) percent of people were sent to in-person doctors, which includes primary care physicians (PCPs), specialists, the ER, or urgent care centers. Importantly, only 10% of patients were instructed to go to the emergency room or an urgent care center. This means that Pager nurses were able to triage patients in a way where only the most at-risk or in-need patients visited healthcare facilities reducing a large burden of COVID-19 care on facilities. This helped to minimize the chance that patients further strain the resources in the ER and at urgent care centers, allowed those with more dire needs to access care quicker, and reduced costs for patients and payers.
Why virtual, continuous triage can improve COVID-19 care
At a time where many patients are unsure about the best way to safely access necessary care or guidance related to COVID-19, Pager’s care coordinators and nurses were able to provide support and appropriate triage for patients quickly and virtually, without requiring them to leave home. Eighty-three (83) percent of COVID-19 chats examined during this time period either connected patients to a doctor via telemedicine or instructed them to stay home.
In all our care conversations – both related and unrelated to COVID-19 – typically only about 33% of patients initiating chats require in-person care from a doctor. This is particularly noteworthy, as it is critical to reduce the number of people visiting in-person healthcare facilities at a time when doctors' offices and hospitals are overcrowded and crowding could cause further spread of the virus.
The whole process was easy to follow and relatively fast. I’m very thankful to have such great health insurance with nurses and doctors representing them that are even better! Thank you! Plus, being able to avoid going into the urgent care center, especially during the COVID pandemic, is so appreciated.
- Patient feedback
We are grateful for our care coordinators and nurses – and all healthcare professionals on the front lines of care – who are able to help keep patients safe and healthy and provide the care they need as we continue to fight the COVID-19 pandemic.
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