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A Pivot to Telemedicine 

COPA, Bend Vet clinics among those moving care online

Adaptability in the age of COVID-19 is coming in the way of telemedicine.

Over the past several weeks, Oregon leaders have announced numerous, increasingly stringent orders around social distancing to help prevent the spread of COVID-19. Earlier this month, Gov. Kate Brown banned groups over 250. She narrowed that this week, banning groups of over 25. Hospitals and nursing care facilities have banned visitors all together.

click to enlarge A box sits ready for donations Friday in the gym/cafeteria of Ensworth Elementary in Bend. Drop locations are located at grab-and-go lunch sites around Central Oregon. - NICOLE VULCAN
  • Nicole Vulcan
  • A box sits ready for donations Friday in the gym/cafeteria of Ensworth Elementary in Bend. Drop locations are located at grab-and-go lunch sites around Central Oregon.

Meanwhile a shortage of personal protective equipment, or PPE, had St. Charles Medical Center putting out a call Thursday for locals to donate gloves, masks, gowns and other supplies. On Wednesday, Brown asked health care providers, including dentists, orthodontists, veterinarians and those at private clinics, to cease non-emergency visits in the interest of preserving PPE. Further, Brown asked providers to donate supplies to facilities treating COVID-19.

Enter a lot more telemedicine.

Pediatric telemedicine

In short order, clinics including Central Oregon Pediatric Associates are pivoting to seeing many more patients via Zoom—the video conferencing app that seemingly everyone with home internet downloaded this week.
In the interest of maximized social distancing, COPA, the largest pediatric provider in the Central Oregon region, began offering expanded telemedicine for many of its patients as of Tuesday. Patients (or their caregivers) call the clinics' main line to get started.

click to enlarge Dr. Carolyn Guttman, pediatrician at COPA, at her Zoom station. - COURTESY COPA
  • Courtesy COPA
  • Dr. Carolyn Guttman, pediatrician at COPA, at her Zoom station.
"We now have the capacity to see a wide range of pediatric visits over video, which allows us to continue our relationships with patients and provide great care while keeping the community safe," wrote Dr. Logan Clausen, COPA's chief medical officer, in an email to the Source. "Well before the suggestion by the Governor, we were already working on schedules that ensured patients needing essential visits were being seen in person."

The clinic will continue to provide in-person visits for newborns and for well-child checks for kids two and a half and under—visits that often include immunizations and monitoring developmental milestones that providers must do in person, COPA stated Friday.  (Updated 3/21, 5:30pm: the original version of this story stated providers "can't" do those visits; that was inaccurate.)

Like other health care providers faced with supply chain disruptions, preserving PPEs is definitely a thing.

"COPA is conserving all our PPE supplies using multiple methods to ensure that our current supplies last as long as possible," Clausen wrote.

COPA continues to be open regular hours at its east Bend, Northwest Crossing and Redmond locations.

Vets adapt to social distancing

Dr. Byron Maas of Bend Veterinary Clinic was seeing a goat when I called to chat on Thursday.
Following the governor's announcement, Maas said his clinic has moved much of its care to telemedicine, but that he's still working on emergency cases in the clinic.

"The Oregon Veterinary Medical Examining Board issued a statement saying that says we can provide telemedicine to our patients," Maas said. "We are taking it seriously. We have already, for the last two weeks, have been anticipating a need for PPE, and conserving and recycling and reusing whenever possible—autoclaving it when we can, so we don't burn through one per patient. Because of that, we can still be open and still do the care we need for our patients."

Maas said his supplies of PPE are adequate for his team, but that they don't have a stockpile.

"I've responded to the emergency task force—for things like anaesthesia, we will have that available for them in a time of need," he said. 
click to enlarge Dr. Byron Maas of Bend Veterinary Clinic, with Spike during our 2018 Best Of issue. - DANIEL ROBBINS
  • Daniel Robbins
  • Dr. Byron Maas of Bend Veterinary Clinic, with Spike during our 2018 Best Of issue.

Maas also said the shortage of PPEs worldwide has had his team going "old school."

"Before this throwaway society, we used to have cloth masks. We have a couple employees now doing that, who have seamstress skills."

The next frontier

Telemedicine—defined in the Oxford dictionary as "the remote diagnosis and treatment of patients by means of telecommunications technology"—is seen as the next frontier for health care, especially in rural areas. In veterinary medicine, the OVMA just adopted new standards last month, in February 2020. Under the new standards, Oregon vets can conduct telemedicine visits with patients, provided the patient has been seen in the past year and doesn't need to be seen again to conduct the visit.

"While telemedicine is still very much in its infancy, these new health care platforms have the potential to solve some of the most persistent problems faced by rural inhabitants," the Oregon Health Sciences University's Oregon Office of Rural Health detailed on its web page. Part of the office's purview is Project ECHO, which focuses not only on expanding telemedicine, but on using it to help health care providers in rural areas get the continuing education credits they need to maintain or advance their careers. "There are certainly limitations as to what telemedicine can accomplish, but for populations with limited access to health care, a little has the potential to go a long way." 

Check out all our coverage at our COVID-19 HQ

About The Author

Nicole Vulcan

Nicole Vulcan has been editor of the Source since 2016. (Blame her for everything since then.) Favorite car: A Trek commuter bike. Favorite cat: An adopted dog who looks like a Jedi master. Favorite things, besides responding to your comments: Downton Abbey re-runs, Aretha Franklin albums, and pink wine.
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