Integrating telemedicine into the Mayo Clinic Urology practice to expand options for patients

Sept. 15, 2020

Mayo Clinic met COVID-19 challenges with telemedicine solutions to interact with patients in meaningful ways. The benefits have continued after in-person visits resumed. Matthew (Matt) J. Ziegelmann, M.D., with the adult Urology practice in Rochester, Minnesota, and Candace F. Granberg, M.D., with the pediatric Urology practice in Rochester, shared their perspectives.

How did the emergence of COVID-19 affect the adult Urology practice?

Dr. Ziegelmann: At the institutional level, with the spike across the country, we first paused for safety and to make arrangements to keep patients, staff and the community safe. Because we were encouraging patients to hold off on trips to Rochester at that time, it opened opportunities to fast-track ways to see patients by other means, such as video visits and telephone consults. The opportunity to use technology really pushed us as a department to explore how to get that first interaction with patients going, and to make it very meaningful.

Were there aspects unique to pediatric Urology?

Dr. Granberg: Before the COVID-19 pandemic, parents had to set up a patient portal on-site here in Rochester. Our team with the Center for Connected Care was amazing at creating a quick, new process for parents to set up an account for their child by phone, through which we could conduct video and telephone visits. Also, with schools closed, we could see kids right at home at convenient times for families, without them missing school to travel to see us.

What was telemedicine like, as a physician accustomed to in-person care?

Dr. Ziegelmann: It was invigorating. We could continue to interact with patients, provide them with our expertise and help guide their decision-making. Across the board, people were very happy to be able to visit with us about their condition. Though we weren't seeing them in person, the ability to say, "We hear you, and we're here for you" has been embraced by patients. I think most people really enjoyed it and spoke highly of it. People continue to request video and telephone visits.

How did pediatric Urology approach telemedicine consults?

Dr. Granberg: We deal with sensitive topics and areas of the body, and with video and telephone visits, we were unable to adequately examine those areas. So we rely on the patient's local doctor's office or the parents to take photos and upload them to the patient portal. We had the photos uploaded into their child's online portal prior to the telemedicine consult, and could then appropriately counsel families. This was also the case with radiology images such as kidney ultrasounds, CT scans and X-rays. We could "share our screen" with families and go over scans in detail to discuss their child's condition, and together develop the best plan of care.

What was it like to return to in-person care?

Dr. Ziegelmann: We're now providing the exact same level of care as before the pandemic, but with additional levels of precaution. These include screening for symptoms and COVID-19 contact before entering Mayo Clinic buildings, universal masking and additional changes to our consult rooms that promote social distancing. We feel it's extremely safe for our patients, our staff and ourselves to offer all the same procedures we offered before. The patient experience and quality of care is as good as it ever was, if not better.

Are you integrating telemedicine with the resumption of pediatric in-person visits?

Dr. Granberg: Absolutely! Particularly for those who travel from a distance, telemedicine has really improved the flow of care and minimized trips to Rochester. We can obtain a patient's outside records and images and then conduct a telemedicine visit to discuss the surgical plan and expected recovery, so the family can plan time off work, child care for siblings, and more. They only have to make one trip — they see us in clinic one day and have surgery the next-day. This streamlined process is appreciated by parents and referring providers, as it helps families better prepare for a visit, saving the family time and costs incurred for travel and lodging with a single trip as opposed to multiple trips.

How will adult Urology apply telemedicine learnings and new capabilities?

Dr. Ziegelmann: The way we practice medicine as a department and institution, and the practice of medicine in general, will change beyond the pandemic because of our increased capabilities. Telemedicine doesn't replace in-person interaction; it enhances it. Our department is at full capacity in the clinic and the operating room — and we're doing telephone consults and video visits as well. Even if I'm not in the clinic, if I'm in the hospital, I can still see a patient on an operating room day. I just need a phone or a computer. We will continue to refine that balance and think outside the box.