Months before the coronavirus outbreak became international news, nurse practitioner Jennifer Allaire, G ‘12, and nursing graduate student Erin Leighton, Doctor of Nursing Practice ’20, began developing a telemedicine protocol for patients of Appletree Bay Primary Care in Burlington. Their trial project aimed to serve patients who miss in-clinic appointments due to mobility and transportation challenges, and to limit visits by patients who don’t need to be seen in person.
Now, with social distancing and stay-at-home orders in place around the world to curb COVID-19, primary care by video chat is everyone’s new normal.
Appletree Bay Primary Care, part of the College of Nursing and Health Sciences, is an outpatient clinic that serves as a teaching site for undergraduate and graduate students. The students work side-by-side with nurse practitioners and nurses who are UVM faculty. The Appletree Bay telehealth trial, began in 2018, was Leighton’s graduate project for the Doctor of Nursing Practice (DNP) program, which provides opportunities for students to identify and apply evidence related to issues of importance to nursing.
With a telemedicine system ready when the COVID-19 pandemic began unfolding, Appletree Bay quickly converted to clinic-wide remote primary care. This helps prevent potentially sick patients from spreading coronavirus, and keeps medical professionals healthy so that they can continue to do their jobs.
“It was an amazing mobilization. Having the technology and systems in place allowed Appletree Bay Primary Care to nimbly move to telehealth during a quickly evolving pandemic,” Allaire says. “Students witnessed the clinic transition to video visits and participate in virtual patient care.”
Almost all Appletree Bay patient visits now take place by phone or Zoom, an internet videoconferencing platform. NPs and nurses evaluate, diagnose and treat patients, answer questions about symptoms and medications and provide triage for patients unsure of what to do or where to go for help.
For routine blood tests that must be performed in person, such as blood clotting tests for patients taking blood-thinners, medical assistants wearing masks and gloves meet patients in the parking lot to do finger pricks, as patients remain in their cars.
“We have hardly any patients coming into the clinic for any reason,” says Ellen Watson, a nursing instructor and family nurse practitioner. “The technology is very manageable, and it feels like all staff and our patients are working together to make a difficult and potentially very stressful situation as good as it can be.”