5 minute read

BHC perspective, Portland, OR

When our CFHA blog editor reached out to ask for posts on the rapid conversion to telemedicine due to COVID my first thought was, “oh yes, I would like to read those!”.  Then I realized that as one of your bloggers it is my job to try to narrate my own experience in the clinic as a BHC.  I am not yet ready to write something that seems definitive or even a little bit like advice. Too many changes for that.  So I went with a daily log format that intends to be more lyrical than sensible. That is the best I have to offer in these chaotic times. I am sending warmth and energy to all of you who are out there too, putting your skills to the best use possible in this chaotic time.

Wednesday, March 11, 2020

The United States seems to be taking notice of the COVID threat (finally!).

We are a Washington-California sandwich over here.

Where do we start?

Thursday, March 12, 2020

 Schools are closed starting tomorrow.

This is definitely serious.

    Where do we start?

 Changed 9-year old daughter’s birthday party to Face Time. Weird. Sorry buddy.

Friday, March 13, 2020

Calling all patients over 60 or otherwise vulnerable to change scheduled BH appt to phone.

  “Social distancing” enters lexicon.

  Appointment conversion workflow and scripting for schedulers.

 Will the company be appropriately compensated for phone care?

Everyone knows the phone visit codes pay like crap.

Crap!

Some people say we are overreacting.

Sunday, March 15, 2020

 Administration has worked around the clock since Friday.

 Consolidating 15 open clinics into 3 open clinics starting Tuesday.

Every behavioral health visit will be changed to a phone visit by Tuesday.

Will the company be appropriately compensated for phone care?

Decided to use health and behavior CPTs for phone visits for now. Risky?

 Nobody knows.

 Are these COVID symptoms or anxiety?

Monday, March 16, 2020

Amazing teamwork.

Patient outreach to inform of phone-based care for next 2 weeks (optimists).

We have a COVID command center now.

Chaos reigns.

Tuesday, March 17 2020

Patients and staff stressed and uncertain.

Workflow to convert medical providers to phone visits begins.

 Will the company be appropriately compensated for phone care?

Everything is new. This is exciting!?

Wednesday, March 18 2020

  STOP!!!!!!!

 Change to VIDEO visits out of concern for appropriate compensation.

 10 emergency meetings to figure it out.

 Communication under pressure is difficult.

My afternoon Snicker bar habit begins.

#covid19(lbs)

Thursday, March 19 2020

 Test the technology.

 Fail.

 Test the technology.

 Fail.

 Test the technology.

 Success!

 Test the technology.

 Fail.

 25% success rate will have to be good enough for now.

Friday, March 20 2020

 Video visit trials with live patients.

 I can see you but I can’t hear you.

 I can hear you but I can’t see you.

 I will just call you.

 How many times can a workflow be changed in 24 hours?

 This is anxiety and not COVID.

 What is my crisis self-care routine again?

Nobody is saying we are overreacting anymore

Sunday, March 22, 2020

Change the video visit scheduling workflow again.

Fix technical glitches.

Try to get everyone working from home by Tuesday unless essential to come onsite.

BHC’s and most patients strongly prefer phone to video so far. Too bad?

Monday, March 23, 2020

Led all 140 clinicians plus upper admin in brief guided meditation and talk (via gotomeeting)

Fire alarm went off in building during my talk, who needs humor when you have irony?

Doximity is a bit glitchy, *67 it is.

More failed video visits. Crap. We default back to phone for now pending more information.

Prep for many more people to move to working from home.

Gifted bag of bite-sized snickers, getting reputation.

Change fatigue is setting in among providers and staff. BHCs providing support.

I miss my gym.                       

Tuesday, March 24, 2020

BHCs settle into working from home.

Phone transfers from medical providers for warm handoffs—works ok!

Patients are starting to talk about feeling cooped up and restless.

More confusion as to if phone can be compensated like video. Everyone wants answers.

How long will this last? How long will this last? How bad will it get? How bad will it get?

Silence.

Wednesday, March 26, 2020

Really meaningful clinical day.

So many needs.

Job losses. Depression. Worry. Panic. Uncertainty.

Providers and staff reaching out for support.

There aren’t enough masks to protect them.

Stay centered, stay centered, stay centered.

Behavioral health is essential.

Thursday, March 26, 2020

As of tomorrow behavioral health fully set up for telemedicine (video).

For those that cannot manage video we do phone.

No idea if phone compensation will be fair and equal to the amount of intervention.

Best purchase of the year is a $10 desktop tripod.

Provider exposure in hospital.

There aren’t enough masks to protect them.

Invisible enemies are the hardest to fight.

Keep going.