Laura Kimble & Her Telemedicine Experience

Tell the reader a little about yourself and your practice. I am a board certified nurse practitioner who is using telemedicine to provide additional provider hours for a community clinic, Connections Health and Wellness Advocacy in Cleveland, Ohio. Since I live about 1 ½ hours away from the clinic, it accommodates me as well as the client since I do not have to drive to and from the clinic.

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What is your background? Specialty? How long have you been practicing? Where is your primary location? I am a master prepared registered nurse with a master in nursing education and a board certified nurse practitioner in both Adult/Gero medical surgical and Psychiatric. I have been working in psychiatry since graduating with the NP in December 2012, however I have been in nursing since 1970. I am a contracted CRNP-BC PMHNP-BC and therefore I use Doxy.me from my home office about 75 miles from the clinic.

How long have you been practicing telemedicine? I have been doing the telemedicine about a year now.

What motivated you to start practicing telemedicine? It is much more convenient for me due to the distance from home and due to the need for more provider hours.

How has telemedicine changed your practice? I have been able to provide more hours of care and therefore see more patients without the stress of driving 3 – 5 hours a day.
alt Telemedicine & Physician Burnout: Do you have any stories with burnout of a traditional setting and adding telemedicine has helped you balance your workload? As a very active and busy CRNP I work 6 days a week, the 4 days for Connections and 2 days covering a psychiatrist at 2 in hospital units. The extra time spent in preparation and completion of my work, rather than driving time, has been extremely helpful in keeping me balanced and providing the client with options for more frequent office visits as needed.

How do your patients like meeting with you by telemedicine? For the most part, the clients do not seem to mind the telemedicine experience. Some are excited to do a new thing. I still try to maintain one office day so that if necessary, the client who does not do well with the telemedicine experience still has the option of a face to face, in person, visit.

alt Do you have any insightful, interesting, funny, or notable experiences using telemedicine? For the most part my visits run smoothly, but once in awhile, the nurse is tied up with another client, and I am waiting for someone to bring the client into the office. I use the cell phone number of the nurse so that I can call them, and they know that I need to talk with them, or that I am ready for the next client. They do not always answer. I let it ring about 3 times and then hang up and wait for them to come into the office and talk to me through the computer, or they answer or call me back.

What challenges have you experienced practicing telemedicine? How did you overcome them? As noted in the previous question, the wait time has been an issues at times, but using the phone, the email, and just calling to the person outside the room will usually illicit their response.

Occasionally the computer access will be interrupted and I will have to call someone to come in and fix the connection. It has not caused us a lot of issues. The firewall can sometimes prevent us from the full connection and we will have to reboot or reset the page. I have the direct line to the IT department!

What advice would you give to other healthcare providers interested in starting telemedicine? Find out what you need in the way of equipment. For me it has just been my pc, camera, and internet access. I use the electronic documentation on one pc and use the doxy.me on the other. But you do not need to have 2 computers. It is helpful to have 2 monitors, however.

Please connect with Linda Kimble on twitter.

Courtney Larson

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