How Rosedale Medical Practice is Pivoting to a New Modus Operandi with HotDoc Telehealth
The building used by Rosedale Medical Practice might look familiar to some. It was home to Molly Jones from ‘A Country Practice’, the multi-Logie award-winning Australian television soap opera, which aired from 1981 to 1994.
In the show, Molly Jones—an unconventional farmer, environmentalist, and fashion designer—was one of the series’ most popular characters, and her death episode became the most watched episode in the history of television soap opera.
Dr. Jas Saini, Principal GP and Co-Director at Rosedale Medical Practice, explains, “In a scene that would break many Australian hearts, Molly would die of leukemia lying on a couch in the garden watching her husband playing with their daughter. Perhaps now etched somewhere in our distant history, many of the values—love, life, resilience—live on. Ask our team, and many of our patients, and they’ll say that there is something magical about serving our fellow humans from the house that Molly once called her home.”
Before COVID-19
Rosedale Medical Practice is composed of 1 Practice Manager, 4 GPs, 2 Practice Nurses and 4 Reception Staff. “The team is made up of people who genuinely care about others, and love what they do,” Dr. Saini says.
Prior to COVID-19, Dr. Saini and his team happened to already be on a journey to innovate Rosedale. Why? Because 8 months earlier, Dr. Jas Saini and his wife Gurleen Saini had taken over ownership of the practice as Co-Directors—Gurleen Saini as Practice Manager and Dr. Jas Saini as Prinicpal GP.
Since then the clinic has taken some big steps to improve the practice. “Within 8 months we’ve made steady progress towards becoming a paperless, faxless practice with online appointments, as well as recalls and reminders all running through HotDoc,” Dr. Saini says.
Things were going well. No one predicted that a pandemic was on its way.
The Pandemic Hits—How Rosedale Medical Practice is Surviving COVID-19
In the following Q&A interview, Dr. Jas Saini (Principal GP), and his wife Gurleen Saini (Practice Manager) share what they’re doing in response to COVID-19 using HotDoc Telehealth.
What are the biggest challenges your clinic has experienced during COVID-19? How are you overcoming these challenges?
“We took over the ownership of Rosedale Medical Practice in July 2019. I don’t think we could ever have imagined that we would be leading our team through an international crisis, certainly not this early on into the piece. I think we were fortunate in that we recognised the need for the digital transformation of the practice early on and we had the full support of our existing team.
“Eight months ago, we made a deliberate choice to transition from a hybrid into a paperless practice, which had adopted an online appointment booking, recall and reminders system (HotDoc), and implemented a shared-care management and remote patient monitoring tool (CareMonitor). This meant that we were well placed technologically to pivot from full face-to-face to telehealth within a matter of days.
“The challenges? Much like other practices, we had to come up with new policies, procedures and processes in record time, and walk our team and patients through an entirely new way of delivering health care.
“Communication has been key, and has included listening very carefully to feedback from our patients and our team, making informed decisions fast, and being careful to explain the ‘why’ throughout the process. It’s important at a time like this to be able to tap into the expertise of our entire team. Meetings are useful but not always possible, and when things move so fast, many decisions need to be made on the go.
“This is also a time when more delicate matters need to be addressed and brought to the fore.
“We recognise that this is a time of great anxiety and concern for our team and have prioritised transparency above all else.”
“This is a time of great uncertainty. We all fear for our own health as well as the safety and well-being of our loved ones. While we have implemented a number of physical measures, we do not have enough PPE to get us through the next few months. Even with our pivot to telehealth, there will still be a number of patients we must see face-to-face.
“This is a serious issue and we will continue to lobby for this to be addressed. COVID-19 threatens our emotional, physical and financial health. It raises questions about job security and business viability. These are all very human challenges and will become increasingly apparent over the next few months. We believe that the right way to address them is through clear, honest and open communication throughout the next few months.”
How are you triaging patients? What is your best COVID-19 triage tip?
“Our triage has evolved over the last few weeks. Initially, we triaged based on the screening criteria for COVID-19. In the wake of increasing community transmission, we now no longer feel that this is adequate. New Zealand Prime Minister Jacinda Ardern expressed it well. She said, ‘If you have any questions and you’re looking for answers, apply a simple rule: act like you have COVID-19’.
“We now assume that all of our patients may carry the virus and ensure that full PPE is available and used appropriately for all face-to-face appointments.”
How are you managing teleconsults?
Rosedale Medical Centre is using HotDoc to triage all online bookings to telehealth appointments.
“We’re managing phone consults very well and the process has been well received by the vast majority of our patients.
“As far as tips. A tip for videos is that Apple FaceTime and WhatsApp Video are useful because most patients already have these tools installed on their phones. They make it easy to shift from a phone call to a video call. Video consults are great for key components of examination, like activity, breathing, colour and hydration for young children, all achievable with the assistance of parents.
“Being able to see each other is comforting for parents and provides extra assurance as a clinician. Most patients are loving the attention we are paying to their safety, health and well-being. History gives us most of the clues, asking the right questions, in the right way, has always been our forte as clinicians.”
“There are a number of helpful resources available around running teleconsults. My favourites are those produced by the RACGP as well as the NZ Telehealth Forum and Resource Centre.”
Did you decide to keep using HotDoc Online Bookings during COVID-19? Why?
“Yes, we have kept [HotDoc] Online Bookings on.
“HotDoc has been the ‘secret sauce’ in our response to COVID-19 and made it so much easier for Rosedale Medical Practice to pivot to an entirely new modus operandi.”
“We’ve appreciated all of the [HotDoc] in-app improvements that have streamlined the booking process throughout the last few weeks as the COVID-19 situation evolves.
“Initially, we continued to offer all appointment types, however, we are now only allowing bookings for telehealth—phone and video. Face-to-face consults are now the exception, rather than the rule, and our patients are asked to call our reception team should they require this.”
If you had one piece of advice for other clinics when dealing with COVID-19 what would it be?
“Take your team with you, and look after yourself. Beyond anything else, we need to get one thing right. That is, to look after each other and to ensure that we make it very clear that safety is first and paramount. The fundamental structure of any business is its people.
“Part of this is also paying attention to your own health and well-being. This is an extraordinarily stressful time and it is easy to pay less attention than usual to your physical and emotional well-being. Put on your own oxygen mask first. Only then are you equipped to deal with what is to come.”