Macon County veterans are still getting the medical care they need at the Franklin Community-Based Outpatient Clinic, but the process has changed since the COVID-19 pandemic hit.
The clinic’s COVID approach is a slower, more regimented process that results in more social distancing and less face-to-face time.
“We are open back up to 50 percent of what we were pre-COVID, so we’re seeing about 50 percent of the face-to face visits of what we were before,” said Angie Stone, the clinic’s interim director. “It’ll be missed, but at the same time it’s not worth risking even one veteran.”
The clinic has implemented a new mobile check-in program called VEText to limit exposure to both veterans and VA staff members.
Once they park, veterans are asked to text “here” to 53079 and wait in their vehicles for a text from the clinic with further instruction. Veterans who do not receive text instructions within 15 minutes of their scheduled appointment are asked to call 828-369-1781.
“We have someone who is dedicated to screening all the time. They go out to the patient and ask those COVID questions,” Stone said. “Then they check in using their ID card, which pulls up their information.
“That allows us to be able to control the flow of how many patients are in here at a given time,” she said. “When they’re ready to approach the door, we have a room for them to go into so they’re not lingering in the waiting room.”
One obvious change is the number of people that can be accommodated in the waiting room.
“With distancing, we can have 10 people in the waiting room at one time,” Stone said. “We would usually 25-30 people here standing, sitting. Our families are used to bringing their families with them. We’re having to limit that right now.
“The closed space, obviously, is more concerning than the outside space,” she said. “We were pretty much taking care of everyone outside. We were actually doing labs outside, swabbing outside, triaging people outside. We have been able to move that inside. That allows us to be able to control the flow of how many patients are in here at a given time.”
Stone stressed that the clinic never stopped seeing patients during the pandemic.
“We’ve chosen different modalities, using video and phone,” she said. “All along we’ve been seeing them face to face. Our biggest concern was just the amount of people being in one space, breathing the same air.”
Masks are mandatory for both patients and staff. The new procedures were developed with a regional VA committee.
Adapting to new technology
For the most part, veterans have taken to the new process pretty well.
“I’ve been surprised by the amount of people who use the technology and have been able to adapt or change to a different modality. They’ve been very receptive.”
Processes are different inside the clinic as well.
“Each room where our providers are has a workstation with video capability and a microphone,” Stone said. “During the screening determining what their needs are, they are asked if they have a computer or a smart phone, access to a camera and microphone.”
The clinic has an iPad so they can work with veterans who don’t have access to the technology.
“So if someone shows up here and wants to do video with a provider, nurses will take the iPad out into the parking lot and help them work with that. It still allows a physical distance and safety to be in place.”
She said vets are taking to the new system, “sometimes more than the staff.”
“Prior to COVID people could walk in for labs, but are labs are now by appointment only,” she said. “Currently, anyone who has symptoms and wants or needs to swabbed, we’re doing that outside to prevent them from coming into the clinic.”
Patients can still walk in to get a flu shot with an appointment, after being screened outside.
The clinic is testing for both COVID-19 and the seasonal flu. Telling the two illnesses apart is difficult based on symptoms alone.
“It’s been very difficult, very challenging,” she said. “We do have the capability to test for flu right here, so we can rule that out fairly quickly. You can also have both.”
The COVID testing situation has improved considerably since the onset of the pandemic,” she said.
“We are still sending our COVID swabs to Durham, and it’s taking about two or three days to get results,” Stone said. “We were waiting 14 days initially.”
Vietnam veteran Calvin Rogers the system works well, though he misses some of the face-to-face interaction.
“It’s been OK,” he said. “It’s not as good as going in person and talking to them, but if you’ve got any problems, they’re going to take care of you.”
Stone has been at the clinic since it opened 12 years ago. Starting as a PAC nurse, then a certified nurse assistant, assistant nurse manager, nurse manager and now interim clinic director.
The bureaucratic process to make her the permanent director is underway.