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 in-person 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.”