The Pandemic’s Effects
The introduction of telehealth – and the expanded opportunities for insurance reimbursement the pandemic has afforded – has been a game changer for the populations Glacier Pediatrics serves.
“Before the pandemic, working with the insurance [companies] when it came to telemedicine was definitely somewhat of a barrier,” says Dr. Dressel. “We’d already had some of the conversations, but it happened kind of overnight and it was trial by fire a little bit, like everybody else.”
Prior to the pandemic, the practice had experimented with offering behavioral health services in cooperation with a provider in Anchorage; patients would come to Glacier Pediatrics and then conduct appointments virtually. Now, patients are able to download an app and sign up for the telehealth service on the practice’s website. Telehealth appointments are available for providers with Glacier Pediatrics as well as with certain specialists in Seattle, which has been key to getting children seen by a physician more quickly.
“The wait list went down severely,” says Dr. Dressel. “Instead of months wait list, [specialists were able to say] ‘we’ll get you at the end of this week.’” I think that was one nice thing that came out [of the pandemic.]”
Prescribing medications also became easier. For families in outlying communities up the Alaska Marine Highway, it could be challenging to travel to refill a prescription in-person. Changes brought about by the pandemic has allowed Glacier Pediatrics to electronically send scheduled prescriptions to a pharmacy in a patient’s community. “Rather than making people come in to get their prescriptions on a regular basis,” says Dr. Dressel.
And on weekends, when a staff member is on call, telehealth has improved access to healthcare. For certain conditions that can be triaged with a video consult as opposed to a phone call – like pink eye, for example – a patient can receive a diagnosis and prescription without leaving home, avoiding the ferry ride they may otherwise be facing.
The team is optimistic that the changes to telehealth payment will outlast the pandemic.
“I believe it’s here to stay. I think it’s a very valuable option,” says Gardner. “We hope we’ll still get reimbursed, that insurance companies will see it the same way.”
Even as telehealth improves patient care, the practice continues to deal with pandemic-related challenges. Supply chains have been disrupted worldwide; in Alaska, that issue is magnified.
“It’s hard down south, but imagine your deliveries only being able to be flown here or barged here,” says Gardner. “And we have limited access – there is a limit to who will actually deliver or ship to Alaska. Some of that is very hard, [along with] the costs to have those items shipped to Alaska. It can be astronomical and quite difficult.”
Glacier Pediatrics has adapted as best they can, in part by providing services that they know the community needs. With CARES Act funding, they were able to purchase equipment to offer in-house testing for COVID-19 as well as certain common viruses.
“For a lot of our testing we would swab here, and then have to send them to the hospital at various hours to get the tests run,” says Gardner. “[Families] had to be their own courier so to speak. It’s nice to test for COVID, flu, RSV, and strep right here rapidly, and be able to give them an answer and treat on the spot rather than wait.”
Glacier Pediatrics is also seeing more patients for behavioral or developmental issues that were missed during the early days of the pandemic, or managed in a family’s home, says Gardner. The goal now is to diagnose and set them up with what they need.
“Let’s get some evaluations going and actual diagnostics, so they can get some services,” she says.
They’ve been adjusting to a new schedule as well, one that doesn’t seem to have the same ebb and flow as in previous years. For example, August and September has generally been a time that Glacier Pediatrics is focused largely on physicals and well visits, as families get ready for the return to school. That hasn’t been the case this year, as the practice has had to balance that late summer workflow with COVID-19 testing along with an uptick in patients coming in for treatment of illnesses, including a surge in COVID-19 cases thanks to the rise of the Delta variant.
“Previously, you would know which would be our busy days and which would be our slow days, and I feel like during this last year and a half I can’t predict,” says Dr. Dressel.