New Platform Makes Telemedicine Easier for Johns Hopkins Patients

Published in Dome - Dome July/August 2020

(Photo of  pediatrician Helen Hughes by Keith Weller. Hughes is assistant medical director in the Office of Telemedicine, and medical director of pediatric telemedicine for the Johns Hopkins Children's Center.)

A new telemedicine platform gives Johns Hopkins ambulatory patients one-click access to their virtual appointments, without having to download an app.

Johns Hopkins Community Physicians (JHCP) and the school of medicine’s Division of General Internal Medicine moved to Cisco Webex on July 29 for video visits with internal medicine, primary care, pediatric and family practice patients.

The switch, representing approximately one-third of Johns Hopkins Medicine’s outpatient telemedicine volume, will roll out to the remaining outpatient providers starting Aug. 25.

The move follows a spike in telemedicine visits spurred by COVID-19.

Before the pandemic, Johns Hopkins providers conducted about 50 to 100 telemedicine appointments per month, says Brian Hasselfeld, medical director for digital health and telemedicine in the Office of Johns Hopkins Physicians.

Starting in mid-March, when outpatient clinics closed for all but the most urgent cases, the number surged past 5,000 per day. It has since steadied at about 3,000 per day, or about 20% of ambulatory appointments, as outpatient offices reopen, he says.

Though telemedicine appointments are often a safe and convenient alternative to in-person visits, providers found that some patients struggled to download the required app.

“Any type of download obviously represents a technology barrier,” says Hasselfeld. “You need internet speed and access in order to download. You need to know how to operate in a new app. All that adds cost, time and complexity for the patient.”

The new system, by contrast, uses a browser, so patients and providers merely click a link to join the video appointment with each other. It requires no download and is compatible with most major internet browsers, including Safari, Firefox and Chrome, though not Internet Explorer. It can be used on a computer or a smartphone.

Patients access appointments through MyChart and click “Join Video Visit.” Instead of downloading an app, the link simply launches in a browser.

“There are no other changes,” says Hasselfeld, who uses the system with his internal medicine and pediatric patients. “How I document and bill remains the same.”

Patients can check in and fill out insurance or other forms before the session begins. The session is not recorded, and all health data is encrypted for privacy, he says.

Danny Lee, an internal medicine doctor with JHCP Odenton, says the new system is easier for both patients and providers.

“Installing something on your computer or smartphone is not intuitive to most people,” says Lee, who is also chief medical informatics officer for JHCP. “The burden of helping patients get set up was too time-consuming. Browsers, on the other hand, are extremely intuitive.”

The browser-based version of their popular Webex platform is new for Cisco, Lee says, so the company is receptive to ideas from Hopkins providers about how to fine-tune it. One innovation that came out of that collaboration, says Lee, is the ability to “pin” speakers so viewers can see who is talking — a feature that is useful when a visit includes several people, such as family members and specialists.

Training sessions for providers and resources for patients are online. But the system is so intuitive, they may not be necessary, Hasselfeld says. “The best thing is when, without education and training, someone figures out it’s as easy as point and click. Our focus was to make things easier for patients, and this clearly is a winner.”

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