The arrival of COVID-19 drastically affected Arlington Free Clinic’s model of delivering safe, effective healthcare as we had done for over 26 years – onsite and with a team of over 450 volunteers.
Unlike in most private practices, AFC patients face numerous barriers to successful telehealth utilization including language/literacy challenges, lack of a computer or smartphone, and inadequate internet connections. At the same time, our volunteer providers and the volunteer scribes and interpreters who support them have varying levels of comfort with telehealth technology, not to mention a wide range of at-home computer and internet set-ups.
Despite the challenges, the AFC team quickly got a basic telehealth system up and running the first week into the shutdown, and they’ve been busy refining and expanding care delivery under our new normal ever since.
Since the beginning of the shutdown (through August), we’ve trained about 73 staff and volunteers on our telehealth system and provided 1,792 visits (1,486 of which were virtual) to 456 individual patients. Throughout the crisis, we continued providing emergency dental care (251 visits) so patients in pain wouldn’t have to visit the emergency department. This is a particularly incredible accomplishment, given the risks of providing dental care in the age of COVID-19. We also provided mental healthcare and a whopping 1,142 virtual appointments with our Social Services Case Manager – which speaks to the great increase in need for services “beyond the exam room” like food, rental assistance, and transportation.
As AFC begins its measured return to ”normal” care, we will shift to a combination of face-to-face care and telehealth and plan to grow or shrink onsite services based on the virus’ spread within our community. We will continue to develop new roles for volunteers that provide both onsite and remote opportunities, allowing us to prioritize their health and safety as patients return to the Clinic.
We are learning a lot about telehealth and realize that many aspects of it are here to stay. Telehealth appointments, when used wisely, can supplement the management of certain health conditions and can eliminate the need for patients to take time away from hourly jobs and forego precious wages. Our integrated model of onsite care and telehealth will give us increased flexibility to meet patient needs in a timely, convenient manner — while also making it easier for our volunteers to stay involved — including those who leave the DC Metro area and want to remain connected to AFC and its patients.
As we move forward, AFC will continue to provide a top-quality healthcare home where our patients, volunteers, and staff all feel safe — and where we can meet the health needs of those we serve.
— Joan Bowes Ritter, MD