Blue Water Woman--Summer 2020--Interactive

PROTECTING
patients
BY DALE HEMMILA
Christine Robinet is a doer.
A nurse practitioner at Physician HealthCare Network’s Macomb
Family Practice, Robinet recently took on two new healthcare initiatives
as a result of the COVID-19 pandemic to assist patients and facility
operations.
Prior to the pandemic, Robinet’s routine involved working with Pietro
Cavataio, M.D., seeing patients for preventative visits, physicals, sick visits
and follow-up exams. That changed when Michigan Governor Gretchen
Whitmer issued stay at home orders in March. Even though visits to
healthcare offices were allowed, an uncertain and cautious public began to
avoid clinic visits.
“All of sudden, we went from a very busy office to essentially seeing
no patients,” Robinet said. “No one wanted to come in, even if they
were sick, they didn’t want to come in. A lot of
people were scared and confused about what they
needed to do to keep themselves safe.”
At that point, it seemed obvious there would
need to be a different approach to patient care
with a nod to technology.
“So pretty quickly, Dr. Cavataio and I started
dabbling in telehealth,” she said. “I’m pretty
good with a computer, so I can fix most issues
and I kind of took it on that I was going to start
trying it.”
They found a web-based platform that was
secure and HIPAA compliant. As patients continued to phone in with
health care questions, they encouraged them to communicate through the
telehealth website.
As patients continued to be reluctant to visit the office, it became
obvious that all the family care and urgent care providers would have to
become comfortable using the telehealth program.
“It took me a little bit of time to understand the platform,” Robinet
said “Because without understanding it well, you’re not going to give
good instructions to the patient, the staff’s not going to know, so once I
was kind of familiar of how the site worked, I wrote up some guidelines
and an instruction sheet for the providers on how to use it, for front desk
staff on how to explain this to patients, and some basic troubleshooting
things.”
While there was a learning curve, Robinet said they feel comfortable
with the system even though they only began using it in March. The
patients also have adapted to it very well.
“They have been extremely pleased with telehealth,” she said, “and
just really appreciative that we were willing to do it. Overall it has been
an extremely positive response. Even continuing now, patients who are
elderly or have mobility issues, it’s much easier for them if they have a
smartphone or computer just to log in.”
And Dr. Cavataio was impressed with Robinet’s work. “Christine was
instrumental in establishing our telehealth care program,” he said. “Her
expertise in the latest technology helped our staff and patients navigate
through technical difficulties that arose especially within our elderly
population.”
While telehealth addressed patient and provider concerns related to inperson
visits, the overriding healthcare concern remained the Coronavirus
pandemic.
Of major concern was the lack of testing available. This made diagnosis
and treatment difficult for healthcare providers and patients.
“Immediately when the stay at home order went into place, we were
getting calls about people who were sick,” Robinet said. “They needed
to be tested and it was extremely difficult to figure out how we were
supposed to be doing this.
“A lot of people in healthcare felt like we needed to do more to help the
community and our patients; Dr. Cavataio and I thought coordinating
testing was one way we could really make a difference.”
Fortunately, their office manager found a Grand Rapids lab that could
provide the supplies for testing. That, however,
was just a starting point.
“It’s a lot more complicated than just having the
swabs,” Robinet noted. “You have to know how
to obtain a sample because it is a nasopharyngeal
swab, so it’s supposed to go to the back of the
nose.”
Issues related to patient safety, staff safety and
other logistics also needed to be addressed.
“After we got the testing supplies in the office,
they sat around for a few days,” she said. “It just
seemed to me there was a need for someone
to step up and be accountable for the process. So I read through all of
the policies and procedures and wrote a policy of how I thought testing
could work in our office. I bought some bins and made some logs so we
could track things and figured out where all the supplies could go, where
the patients would come from, and where our staff would keep PPE.
I educated all the staff, including some of the providers who had never
obtained a nasopharyngeal swab before, on how to do it. We got it up and
running quickly and we’ve been testing since the last week in April.”
They have seen quite a few patients test positive.
“When we get a positive result, that patient gets a call and we
recommend they schedule a follow-up so that we can see how they are
doing,” Robinet said. “We’re just trying to follow-up with everyone as
consistently as we can so that everyone comes through this okay,” she
said. “When it comes to helping your patients and the community, you’re
never quite done with that job, but I think that we have done a great job
in educating our patients about the coronavirus.”
Similar to the telehealth program, Dr. Cavataio noted Robinet’s
involvement.
“As the pandemic intensified, the lack of available testing became a
source of great frustration for our patients and providers alike,” he said.
“We wanted to be on the forefront of accessible testing in our area and
again, Christine rose to the occasion to make that a reality.
“Her confidence and competence in implementing both of these
projects has provided much needed guidance and assurance to each of our
staff members in these uncertain times which is ultimately passed along to
our patients.”
SUMMER 2020 BLUEWATERWOMAN.COM 13