Doctors engage with patients virtually during COVID-19

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Screeners greet patients at the doors of Sanford Clinic in Jamestown as seen Thursday, April 9, 2020 at the Second Avenue facility. John M. Steiner / The Sun

Visiting the doctor from a living room couch is becoming a routine for some in the Jamestown community.

North Dakota health care providers Essentia Health and Sanford Health have continued to serve the Jamestown and surrounding area populations in the midst of the coronavirus pandemic. The first positive case of COVID-19 in North Dakota was on March 11 and in efforts to minimize the spread of the virus, Essentia Health Chief Medical Officer Dr. Richard Vetter said doctors are taking time to see as many patients technologically.

"The first thing we are doing is we're trying to get the word out to all of our communities and patients about if they have a concern that they try and access (Essentia) through an electronic way first," Vetter said. "Ninety percent of diagnoses can be based off of history, the other 10 percent are either a physical exam or laboratory X-ray testing to confirm your diagnosis but your diagnosis, for the most part, is based off of history."

Vetter said the virtual visits have the added benefit of being able to see patients - looking at rashes, swelling or other symptoms patients may be having. While the technology is available Vetter said patients are still utilizing the in-person appointments from time to time. All patients are asked to go through the COIVD-19 screening process. Free screening technology is available online.

"We still are seeing patients who need to be seen with acute illness whether it is an injury or some other undiagnosed symptom that we feel we need to see them face-to-face," Vetter said. "We are encouraging everybody to first try and reach out and try to manage those with virtual visits."


Jamestown Sanford Health Clinic is doing much the same as Essentia both on and off of the web. Clinic Director Jon Lillejord said there have been preventative practices put into place when a patient arrives for his or her appointment.

"We have screeners at the door at both the Second Avenue and Fifth Avenue clinics and they are there all day long," Lillejord said. "We are screening every patient that comes in. We have separate waiting rooms for people with respiratory issues and (those) with more routine visits. We have a separate check-in desk at the Second Avenue clinic for people with respiratory issues."

Lillejord added the Sanford Health staff is working to get all patients into the exam rooms as fast as possible whether the patient is suffering from an acute injury or from potential COVID-19 symptoms. While speed and efficiency are the name of the game inside the clinic, at home diagnoses are quickly becoming a way to serve the Jamestown community. Lillejord said virtual visits allow accurate and timely diagnoses while practicing the social distancing guidelines set forth by the Centers for Disease Control and Prevention.

"We've done virtual visits for quite some time," Lillejord said. "It's just with the COVID issues going on we've certainly expanded the scope of virtual visits."

Vetter said Essentia was planning to implement the e-visit technology this week but added the rapid outbreak of the coronavirus accelerated the process. There have been 278 positive cases and six deaths in North Dakota, the North Dakota Joint Information Center reported Friday, April 10.

"This is certainly unprecedented in just the public health nature," Vetter said. "I remember being in college when the HIV epidemic hit and then, of course, we have had H1N1, we've had Ebola, we've had SARS (Severe Acute Respiratory Syndrome), but nothing as far as global and community impact of course that COVID-19 has had."

Sanford has seen a decline in preventative care visits but is still accepting patients - particularly children in need of immunizations. Sanford Health's staff will reach out to families before arriving at the clinic in efforts to protect the health of patients. The screening protocol applies to all patients regardless of symptoms or reasoning for visit. Lillejord said if the matter is not pressing a number of patients have been opting to postpone routine checkups or engage in a virtual visit. Sanford still will accept an in-person visit if the patient requests one.

"I think people just need to stay home as much as possible," Lillejord said. "Social distancing is extremely important, the less interaction people have with those outside of their homes the safer they are."


If the screening warrants the COVID-19 testing, Essentia patients are directed to a mobile testing site. Vetter said if results come back positive for COVID-19 the practitioner will set up an electronic visit. Vetter reiterated that the majority of positive COVID-19 cases can be cared for at home and do not require hospitalization.

The first positive COVID-19 case in Stutsman County was reported Wednesday. Cass County is the case leader with 88 positive cases while Burleigh is the second leading county in the state with 48 as of Friday, April 10, according to the North Dakota Joint Information Center. There have been 29 counties with at least one case of COVID-19 as of April 9. Lillejord said there is no reasonable explanation for the lack of cases in Stutsman County. Vetter and Lillejord said eating balanced meals, reducing stress management and traveling less will likely help slow the spread of the virus.

"I think we often overlook those things we can do to keep all of ourselves healthy - not just from this but also from other respiratory illness," Vetter said. "If you smoke, don't smoke. Try to get enough rest, eat healthy, exercise ... we know that all of those things will help keep people's immune systems more healthy and will help lessen the effects of COVID-19."

Gerber is a sports writer for the Jamestown Sun.
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