Staff photo by Clay Schuldt NUMC Director Toby Freier demonstrates virtual visit technology. Dr. Emily Bastyr answers his call for a face-to-face conversation through the Allina Health app.

NEW ULM — New Ulm Medical Center (NUMC) has reached a unique milestone this month. Since the start of the COVID-19 pandemic, NUMC has conducted over 10,000 virtual visits with patients.

In the 16 months since the COVID-19 pandemic hit, NUMC has completed around 11,700 virtual visits. They anticipate surpassing 12,000 virtual visits before the end of the month.

People have become accustomed to using video conference technology for everyday meetings and that includes doctor visits. NUMC was already doing virtual visits before the pandemic.

NUMC Director Toby Freier said the technology for virtual visits has been with Allina for over five years. Virtual visits were originally seen as a way to neutralize geography. Freier said in a rural setting that is valuable. There are other circumstances where a virtual visit would be a benefit. Often a loved one will want to take part in a visit, but cannot physically be part of the conversation. In Minnesota, the weather is also a reason patients might prefer a virtual visit. Teens going away to college for the first time also want to maintain a relationship with the family doctor.

Freier said there was always a reason to offer virtual visits, but it was not until the pandemic virtual visits were offered on this scale. He said before the pandemic there were around 10 virtual visits a week. During the height of the pandemic, there were hundreds in a week.

As regulations are lifted on the pandemic and in-person visits become safer, the number of virtual visits is still around 100 a week. NUMC physician Dr. Emily Bastyr said she averages between 18 and 20 patient visits a day and between two and six are virtual visits.

Before COVID, virtual visits were limited to family medicine, but after COVID medical providers are learning the technology can be used for all specialties including psychiatry, oncology and even surgical consultations.

Bastyr said it was a huge pivot for the medical center. In March 2020, NUMC was closed to all but essential visits.

“Pretty quickly we realized people were going to continues to have needs regardless of the pandemic,” Bastyr said. “We’re always trying to meet patients where they are medical to help with shared decision making, but this was a huge step in being available.”

The move to virtual visits was done out of necessity, but physicians found there are many conditions and diseases that doctors can help patients manage without a clinic visit.

During the pandemic, there were only a few situations where physicians would require a person to come in for in-person visits. Bastyr said if in a virtual visit, a patient was experiencing shortness of breath, chest pain or belly pain that patient would be asked to come to the clinic. Bastyr estimated less than 10% of her virtual visits required a follow-up in-person visit.

The majority of cases could be handled through a virtual visit. The patient could ask and answer questions. Since the visit had a video component, physicians can make visual examinations.

For those with chronic conditions, the clinic has a program for patients to obtain certain diagnostic equipment, like blood pressure cuffs. Certain medical measurements that were previously done at the clinic can be done from home.

“It is such a great model for providing better access for patients,” Bastyr said.

For some patients, there was a concern that virtual visits were inferior care to an in-person visit. Bastyr said that was not true. Virtual visits are mostly the same as in-person visits. A physician will spend the same amount of time on a virtual visit as an in-person visit.

Virtual visits do create greater efficiency. The patients are not taking up physical space in the building and scheduling is easier. It also allows flexibility with patients. The appointments are easier to schedule around work.

Bastyr said originally the virtual visits were mostly from younger patients, but now the majority of virtual visits are from working people, the elderly and those with mobility issues.

“I think they really like the option of not coming into the clinic if they don’t need lab work done,” Bastyr said.

Nursing homes and assisted living facilities have also expanded the technology to make virtual visits with residents easier than ever before. Bastyr said medication adjustments for nursing home and assisted living residents are simpler now.

Freier and Bastyr gave a demonstration of how a virtual visit worked. The first step has the patient create an Allina Health Account and schedule a virtual visit through the Allina health app or website. With the Allina Health app, patients can conduct a virtual visit over the phone. Through the technology, a patient and physician can have a face-to-face conversation. On the physician’s end, the doctor has access to the patient’s medical record on a split-screen for a full patient profile.

A patient without a smartphone can still have a virtual visit if they have access to the internet through a computer or iPad. A virtual visit link can be sent through email.

Once the visit is over, the patient’s medical information is immediately updated and shared with the patient.

As the number of COVID cases decrease, the immediate need for virtual visits also decreased. Bastyr said most patients want a return to in-person visits after over a year without it, but she suspects many will be open to future virtual visits.

Freier said according to patient feedback many were impressed with the efficient and seamless way virtual visits were conducted. He believes there will be more virtual and digital options in the future. Freier believed some companies will directly market virtual visit technologies.

“I don’t see it replacing in-person visits,” Freir said. “I see it complimenting it. There will always be a place for coming into the clinic and sitting down with your surgeon or primary caregiver. This is an addition, not a replacement.”