Sara Horst, MD, on How I Practice Now, Take 2: Telehealth in Gastroenterology

In this video, Dr Horst, from Vanderbilt University, discusses how telehealth has functioned in the practice of gastroenterology during the COVID-19 pandemic.

Sara Horst, MD, is an associate professor of medicine at Vanderbilt University.

Dr. Sara Horst: I'm Sara Horst, a gastroenterologist at Vanderbilt University in Nashville, Tennessee. Today, I'm going to talk a little bit more about telehealth. It's been about 6 months since we forayed into the world of telehealth, as I'm sure many of you have.

I just wanted to give an update and talk through some of the challenges and successes that we've had and the directions that I'm sure many of us are thinking about as telehealth continues to hopefully be part of our practice patterns in the next few years.

In my state, thankfully, where we had been restricted quite significantly for the ability to do that, insurance companies have continued to cover telehealth in the pandemic. We've gotten some word that this is going to continue into the future for us.

We, as a practice—and I'm in a tertiary care IBD center—we've really worked hard to figure out how we can continue to make this an option for patients but also keep it productive for our practice.

The way we've done this — I'm sure people will have many different opinions about this and how they'll continue this in the future — we have built telehealth slots into all of our provider's schedules at this point. It's about 30% currently. Because we're still in an area where in COVID infections are prevalent, we also offer this option for really any return patient.

We send out a blast message for the upcoming month for patients. We have dedicated telehealth slots, but we also have the option to turn a regular visit into a telehealth slot if the patient chooses. With that, we are still doing about 50% to 60% percent of our return patients. We're seeing them back in telehealth. It's been working relatively well.

I think the best way to move forward with this is to really have those dedicated slots because my experience is bumping back and forth between a telehealth slot and a regular clinic slot can get a little tricky, and sometimes I get behind. Our patients really have embraced it. We have a large catchment area, so we see patients who travel typically 2 to 3 hours to see us.

The ability to do this has been has been really great, and they're excited about it. We've had immense improvement in our platform, so the ability to get patients on, whether it's Zoom, FaceTime, or anything like that, the institution has learned a lot about that. It's running much more smoothly than we had 6 months ago.

Some of the areas where we still need to improve is we do have a multidisciplinary care center. Some of the things that we've had to work on is figuring out how those team members can still stay a part of the experience for the patients. We've had to get creative with that.

Some patients are able to do those visits telehealth beforehand, but some patients who really need to see our dietitians in person or some of our support staff for mental health really are coming back and seeing us in clinic at this point. There's some opportunities for us to improve that.

Some of our colorectal surgeons have started to do telehealth as well, which has been really great. Bringing in multidisciplinary care back in the telehealth form is something that we're continuing to work on. I think the idea of the team care in telehealth is something that, in the future, we're going to really need to think about going forward. Thanks for your time.