Thread by @TheLizArmy

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson WARNING: This might be a long response.
When it comes to all things, including the adoption of various technologies, each health system prioritizes different things in different orders.
It's not that some things are BETTER than others, they just can't do everything at once.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson Before #COVID19--like, years before--some health systems made telemedicine a key priority (e.g., KP Nor Cal). h/t to @RobertPearlMD & @davisliumd
I am no longer a KP Nor Cal pt, but I imagine they were ready to go w/telemedicine, and pts could make appts through the portal.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd Also before #COVID19, health systems may have been piloting various telehealth platforms--some native to the health system platform w/their own docs, and some using 3rd parties like @teledoc.
I had a televisit in Dec. 2018 and my health system used a 3rd party platform.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc My experience w/the 3rd party platform was interesting because they were not linked into my record at my health system. The doc didn't know anything about me or my pre-existing conditions.
I did have a good visit, but the visit was never captured in my health system's record.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc BUT NOW, with #COVID19 happening, pretty much every health system that was piloting OR thinking about telemedicine is rushing to go live w/their telehealth solutions.
They are having to on-board real fast:
- getting technology in place
- educating docs
- educating pts

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc Some organizations were ready for this, mobilized fast, and are doing a great job.
Case study: @UCSDHealth:

https://twitter.com/UCSDHealth/status/1245175301593804801

h/t @marlene_mmm @brianclaymd @calonghurst
They even wrote a paper about it already. 👏 #overachievers

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc @UCSDHealth @marlene_mmm @brianclaymd @calonghurst That said, not all organizations are doing the same things--which makes it all a bit confusing for patients who are hearing about telemedicine in the news or on social media, but can't find out HOW to make a televisit appointment.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc @UCSDHealth @marlene_mmm @brianclaymd @calonghurst ALSO confusing is if you are used to using a patient portal to book an appointment, but the televisit option isn't available, you're like, "What gives?"

And if you are a patient at 2 health systems, w/2 logins, that both use the same EHR, you get different options.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc @UCSDHealth @marlene_mmm @brianclaymd @calonghurst THAT SAID, our healthcare leaders are going as fast as they can, and are doing an amazing job. 🙌

I've been so impressed by the leaders who are helping people at competing organizations by offering tools, resources, and know-how. Because they all share patients, and they ❤️ us.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc @UCSDHealth @marlene_mmm @brianclaymd @calonghurst In summary:
- All health systems have different tools
- We're watching a digital revolution in real time
- Health care will be forever changed
- Massive amounts of pts are signing up for pt portal access for the 1st time just to use telemedicine
- Let's be patient (pun intended)

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc @UCSDHealth @marlene_mmm @brianclaymd @calonghurst AND, those with access to their clinical notes (aka #opennotes) will be better prepared to navigate their care if they end up interfacing with a doc who does not have access to their records during a televist.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc Shoot--wrong Twitter account.
@teledoc should have been @Teladoc.

@BraveBosom @drdonsdizon @ePatientDave @VinceKuraitis @MightyCasey @draparente @AndreaCoravos @HealthPrivacy @emilykg1 @eperakslis @nickdawson @RobertPearlMD @davisliumd @Teledoc @UCSDHealth @marlene_mmm @brianclaymd @calonghurst Update: @MichaelDFratkin et al. published these recommendations in @JPSMjournal on #telemedicine in the time of #Coronavirus.

I'm not a clinician, but I pay attention to whatever @MichaelDFratkin says, especially when it comes to telehealth.

https://twitter.com/MichaelDFratkin/status/1245471182586908672