NHPCO NewsLine Summer 2020 - 15
person lives in, where they
consider themselves the person
they are, not the disease that
they have. When we can enter
that space and become present,
without invading that space, we
can become invited into their
home and evaluate what their
needs are, without intimidating.
In that environment, on that level
playing field, the ability to
establish intimacy within the
framework of this technological
boundary, it's actually much
better than real life even though
there are some real losses on the
ability to put my arms around
and hug a patient, the ability to
walk into a room and scan the
environment of their living room,
to learn a lot of enriched
intangible information. Those are
things that can be worked
around, but they are a real loss,
as a home visit is a kind of unique
environment. But there is a
telemedicine visit, a virtual visit
using video conferencing.
visits. To help mitigate COVID-19
and to protect our personal
protective equipment supply, our
practice stopped all non-essential
face-to-face visits. We adapted to
virtual visits literally overnight
using the telephonic and video
visits. Our network's
administrative team adopted the
electronic health record for us to
include telephone and video visit
templates so that we were
capturing all required elements for
billing.
Nancy Fickert, DNP, FNPBC, PMHNP-BC, ACHPN
Nancy Fickert is a home-based
Palliative Care Nurse Practitioner
with the Lehigh Valley Health
Network.
As a home-base nurse practitioner
located in Allentown, Pennsylvania,
I work on a base team with six
other nurse practitioners, a social
worker, two RNs, and a medical
assistant. I am also supported by
an inclusive hospital network with
a shared electronic health record.
Prior to March 16, 2020, I was
doing 100% face-to-face home
Virtual visits have to be easy for the
patient and we had to find the right
modality, and this takes a lot of
consideration.
You need to risk stratify patients
based on acuity or level of risk,
such as low, moderate, or high.
And many things go into this:
Their symptom burden, their
stage of disease, their functional
status, their access to resources,
and what kind of family and
caregiver support they have. This
determines how often our
patients need to be contacted by
our team.
Virtual visits have to be easy for
the patient and we had to find
the right modality, and this takes
a lot of consideration. For
instance, does the patient have
hearing loss? Do they have visual
impairments? What kind of
cognitive issues or language
barriers might be present? When
is the right time to conduct a
virtual visit based on whether
they need a caregiver to be
present for support? Do they have
the right access? Is there an
internet connection? Do they have
a smartphone? What other kind
of technology might they
currently have in the home?
Newsline / Summer 2020
15
NHPCO NewsLine Summer 2020
Table of Contents for the Digital Edition of NHPCO NewsLine Summer 2020
NHPCO NewsLine Summer 2020 - intro
NHPCO NewsLine Summer 2020 - 1
NHPCO NewsLine Summer 2020 - 2
NHPCO NewsLine Summer 2020 - 3
NHPCO NewsLine Summer 2020 - 4
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