Katherine Berger, MS is a Transition Care Manager/Admissions Liaison at Cornerstone VNA. Berger was trained as a counseling therapist and worked for 15 years in education. I had the pleasure of chatting with her about her role and her experiences introducing telehealth to patients before hospital discharge.
GC: How long have you been a Transition Care Manager and Admissions Liaison at Cornerstone VNA?
KB: I have been at Cornerstone VNA for two years. I help patients understand how telehealth can complement their care.
GC: How do you determine which patients receive telehealth?
KB: At Cornerstone VNA, if a patient has both CHF and COPD, they are automatically introduced to telehealth. If they have just one of these two conditions, I will ask our telehealth coordinator if we can place them on telehealth. I especially like to learn about patients and if I see that a patient lives in a remote area, then I really encourage that they be placed on telehealth.
GC: Why do you encourage teleheath for remote patients?
KB: Being discharged from the hospital puts a lot of anxiety for patients who have chronic disease. Especially those that live alone. When I become aware that the patient lives alone and lives remotely, I know they can really benefit from telehealth’s ability to have clinicians monitor their health and to be able to communicate with their clinician.
GC: How do you approach patients at the hospital?
KB: I do my research. I start introducing myself 3-5 days before discharge and form a relationship with the patient. On the first few visits, I do not bring the telehealth equipment; I talk about telehealth and what it can do for them.
GC: Have you ever had a patient refuse telehealth?
KB: Surprisingly, no. I have never had someone say, “oh no this is too complicated.” I take the telehealth unit into the hospital and show patients how easy it is. In large part the response is, “this is so cool.”
GC: Sounds like there are no objections which is great, but what are some concerns that patients typically bring up?
KB: Most of the time they ask who will pay for it. I reassure them that at Cornerstone VNA, this is a complimentary service.
They are also concerned about losing network connection if they live in remote areas. I tell patients that we chose our telehealth provider because of good network coverage. I also like to share with them a story that happened last year.
Last winter, we had a very bad snow storm, and one of our nurses just could not drive to get to a patient’s home. The nurse used wound imaging and video conferencing to walk the patient through dressing a wound and the patient was able to do it.
Especially in the winter, I tell patients that telehealth is important because even though you may never need wound imaging or video conferencing, it is available to them. That is so comforting for patients.
GC: Wow, that’s a great story! Have you ever felt that a patient will not adhere to telehealth?
KB: No, I study patients before I put them on the program. There was only one case I can think of. But, I still had a conversation with the patient even though I thought telehealth would not be the best fit. I like to emphasize to patients how this tool is made to complement their care; it is ok if it is not a fit.
With this patient, I introduced the idea of telehealth while focusing on fit. During one of my visits, the patient told me that she had talked about telehealth with nurses in the unit and they had encouraged her to use it. I also spoke to her caretaker about it and she was onboard. After our conversations, when she was discharged, the patient was open to the idea and eventually benefitted from telehealth.
GC: What advice would you give to nurses who are introducing telehealth for the first time?
KB: Talk to the patient first before bringing in the technology. Something that I think is also important is to be familiar with telehealth yourself. I took a unit home and practiced with it for days. You want to be confident and comfortable when presenting it to patients. Also, emphasize that you and the organization will be there to always support them throughout the process.
Thank you, Katherine, for chatting with HRS about your work as a liaison!
