Virtual prenatal visits, combined with remote monitoring, have the potential to not only make life easier for the patient but give them the holistic support they need during this significant time in their lives.
One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?
In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Jane van Dis.
Jane van Dis, MD is a board certified obstetrician/gynecologist and works as an OB Hospitalist in La Cañada, CA. Dr. van Dis was an early adopter of virtual care, starting in 2012, and joined Maven when the company launched their tele-health network in 2016. Today, Dr. van Dis serves as medical director for Maven, which has grown to be the world’s largest virtual clinic for women’s and family medicine. She is co-founder of TIMES UP Healthcare and Equity Quotient, as well as Ob Best Practice/OBG Project, an online resource for ObGyns. Dr. van Dis completed her residency in ObGyn at UCLA. She is a single mom to twins, Brooklyn and Miles.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
I started in tele-health in 2012 on the HealthTap platform and then as soon as I found out about Maven Clinic in 2016, I jumped at the opportunity to work on a platform dedicated to women’s health. From the beginning I knew this team was going to provide an incredible and necessary service for women and families.
Can you share the most interesting story that happened to you since you began your career?
I am not one for splashy stories. I think the most interesting thing I have done in my career is provide women a safe place to share their stories and their hopes and fears. Healthcare is a technical and scientific field, but, assuming the technical aspects are evidence-based, what matters most in healthcare is how we connect with one another.
Do you have a favorite life lesson quote? Can you share how that was relevant to you in your life?
“When there are nine.” Ruth Bader Ginsberg
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
My father. He always believed in me from day one, and the confidence he shared whenever I felt defeated or overwhelmed has stayed with me throughout my life.
The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?
As an ObGyn there are components of an evaluation that require a physical examination to be sure. Having said that, it’s a misconception that you can’t connect as well with patients via tele-health. It’s all in how you approach the encounter. In an exam room, I’m often not looking at the patient for 100% of the visit because I am required to enter information into the electronic medical record, thus taking my focus off the patient. In tele-health, the patient’s face is always right in front of me. There are aspects to tele-health which are, in my opinion, even more intimate than an in person visit. Luckily patients and doctors have both!
Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)
- Prepare for the tele-health visit ahead of time, read as much about the patient, their chief complaint and medical history.
- Practice patient-centered care, making sure to repeat back to the patient what you understand is their reason for making a tele-health appointment.
- Ask the patient if they need more time or if they have additional problems or information that would be helpful for you to understand their condition.
- Provide the patient with your diagnosis and clear next steps that one or both of you are going to take.
- Provide the patient resources that they can read on their own as well as clear and concise “next steps” or follow-up.
Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?
Telehealth can play a key role in expanding access to care. For example, 50% of US counties do not have an ObGyn. Through a platform like Maven, women and families in these counties — and the many more counties that don’t have specialists like reproductive endocrinologists, pediatric speech therapists, and much more — can access the care they need.
Telehealth can also be a great complement to in-person care, and at Maven, we’ve seen firsthand the way tele-health can help drive positive behaviors, whether it’s breastfeeding longer after meeting with a lactation consultant on our platform or better managing anxiety and depression after meeting with mental health providers. In healthcare we know that adherence is critical, and tele-health has the potential to be a powerful lever to achieving that.
Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?
At home blood-pressure cuffs and fetal dopplers have been incredibly helpful for performing obstetric tele-health visits.
If you could design the perfect Telehealth feature or system to help your patients, what would it be?
The perfect system to me is one where tele-health is core to the prenatal care model. Women have so many needs — mental and physical — that arise during this period of time and those needs often cannot be met by a quick appointment (9–12 minutes on average) with an ObGyn. They also lead busy lives, and spending 40+ hours attending 9–12 in-person prenatal visits may not be realistic or necessary if they have a low-risk pregnancy. Virtual prenatal visits, combined with remote monitoring, have the potential to not only make life easier for the patient but give them the holistic support they need during this significant time in their lives.
One other specific feature that I would be excited about is the seamless integration between the tele-health EMR and the in-person EMR. Continuity of care is so critical.
Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?
I actually think patients have adapted incredibly well to the telehealth environment. At Maven Clinic we’ve always been a telehealth platform, so we are constantly thinking about how to improve our product and our connection with our members.
The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?
What excites me is providing our current technology to more members. There is a digital divide in this country, and rather than obsession with the next “new” thing, it’s also important to remember those who are frequently left behind by new technologies. For example, we know that only 18% of households with annual incomes <$30,000 have access to a smartphone, computer, broadband internet or a tablet. Addressing these barriers requires partnership at all levels, investment in community resources, training and recruiting diverse providers to meet the needs of these populations, and much more. I would much rather provide care to a greater percentage of women, than spend resources on technologies only available to a few.
Is there a part of this future vision that concerns you? Can you explain?
Again, I think we need to raise all women in their journey if and when they desire to start a family. Leaving no family behind is my biggest concern.
If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be?
Our country is struggling with inequity, whether of income, wealth or access to healthcare. I think the “movement’’ we need is to lift all women and support them in their health — whether to start a family, support the family they have, or pursue their individual dreams.
How can our readers further follow your work online?
Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.