While the COVID-19 pandemic has people staying indoors, Mayo Clinic is finding new ways to serve their patients in nursing homes.
In March, Mayo distributed iPads to 17 nursing homes across Minnesota, including Central Health Care in Le Center, Ridgeview Le Sueur Long Term Care and Rehabilitation Center, Benedictine Living Community in St. Peter, Mala Strana Care and Rehab Center in New Prague, and Lakeshore Inn in Waseca.
At a time when the spread of infectious disease has made it unsafe for nursing residents to see their doctors, this technology is giving thousands of patients the health care they need through a practice known as telehealth. Simply through using the iPads’ teleconferencing features, patients can be face-to-face with Mayo Clinic staff from the comfort of home.
“As residents are being seen through telehealth on a weekly basis, Mayo Clinic staff can see us, we can see them,” said Dori Mutch, a LNHA consultant with Central Health Care. “The video can also be used so that the physician can see the extremity or the anatomy of a resident and find out what’s going on. Say for example, an eye infection we can show the physician what that looks like.”
For people like Jerome Determan, having access to this technology has been essential. The 88-year old was diagnosed with multiple myeloma in 2009 and was told he may only live for another three years. Today, he feels just fine, but Determan has yet to enter remission and must still receive treatment for his cancer. While he still needs on-site infusion treatments at Mayo Clinic Health System and Mayo Clinic campuses, some of his appointments can be handled remotely through video visits.
“We have very much appreciated our patients’ willingness to try the technology so we can continue to provide them with quality care in their homes,” said Amrit Singh, M.B.B.S., Mayo Clinic Health System in New Prague oncologist in a press release from the Mayo Clinic. “We’ve been so pleased with how smoothly the process has gone and how many patients we’ve been able to serve so far. We want to encourage many more patients to schedule these visits for any health care needs that don’t require a physical exam during this period when it’s safer to shelter in place.”
Telehealth has been used for years at Mayo Clinic and throughout the health system, including on rural medical campuses to connect patients with specialists in Rochester, among other locations. But the novel coronavirus required a hastening of widespread use, meaning thousands of patients like Determan are experiencing it for the first time this spring. It’s taken some effort to get used to, but Lakeshore Inn Director of Nursing Marlene Robran said patients are figuring it out just fine.
“It’s a little different for most people in that generation,” said Robran. “So at first they are questioning it or looking at it kind of funny, but once they realize where the voice is coming from they’re enjoying it.”
When a doctor’s visit on the computer first came up, Determan thought, “Well, I’m computer illiterate.” But thankfully his wife, Donna, is not. She has a computer and an iPad, and she got her husband all set up for his first video visit. The visits only require a device and an internet connection. No software needs to be downloaded.
“I’ve used Skype, and it’s very similar,” said Donna in a press release from Mayo Clinic. “I got it on the computer, and everything went fine. (The Connected Care person) walks you right through it. It went really smooth.”
Determan agreed and was so impressed with how the visit went that he hoped they would continue using it after the COVID-19 pandemic. He and Donna have made trips to Rochester for check-ups that don’t involve a physical exam, and he thought video visits would be a big time-saver.
“In this day and age, if there’s new technology that will make things better for you and me, then let’s do it,” Determan said in a press release. “If we all kept using the same stuff we were born with, we’d all be driving horses and buggies. Let’s progress with the world.”
To take advantage of these online visits, patients need to have a Patient Online Services account. They can inquire about setting up an account when calling to make an appointment, which are required for video visits. Patients are asked to log into their account 15 minutes before their appointment. Their provider will log in at the scheduled visit time and the session will begin. Those who have trouble with the program can receive guidance from Mayo.
“Our concern at first was acquainting patients with the technology. In Oncology, we work in large part with an older population and not all of them have access to computers,” said Tracy Culbertson, Oncology nurse manager with Mayo Clinic Health System in New Prague in a press release. “But a lot of people have had family members who can help. Or, if they have a computer and can log into their Patient Online Services account and click the link that says, ‘Click here to start visit,’ then a member of the Mayo Clinic Connected Care team appears on the screen and walks the patient through the process of ensuring the sound and video are working properly. They make it very simple.”
Mutch was grateful to have the technology at Central Health Care’s disposal. She said it keeps residents up to date with their healthcare while keeping them safe.
“It’s made a significant impact in that we have a transparent way of communicating through the use of technology with our physician nurse practitioner and the resident and the nursing staff, said Mutch. “It keeps our facility residents safe with COVID-19 restricting the movements of our practitioners and family and friends to the building so it decreases the ability for the virulent to get into the building so it keeps our residents safe and it keeps our practitioners safe.”
As a graduate of Montgomery-Lonsdale with a more than 30-year career in education, Tri-City United Montgomery Pre-K-8 Principal Deb Dwyer has long been a pillar of the TCU school district. The 2019-20 school year marks Dwyer’s final year with the district before her retirement, but the outgoing principal won’t be forgotten by her students, teachers and colleagues.
Before she was a principal, Dwyer graduated from Montgomery-Lonsdale as a student. Her father and uncles were educators, as well as her role models at school, so it was only natural that Dwyer would pursue a similar career.
“It kind of came full circle,” said Dwyer. “I just had great role models for teachers and obviously my father and my uncles many of whom were educators themselves. I was inspired by how they loved what they did and the teachers that I had were awesome and I wanted to follow in their footsteps and make an impression on kids’ lives.”
Dwyer had the opportunity to teach in Denver, Colorado, but she couldn’t shake her love of small town Minnesota and would return to teach in the same area she grew up. With a teaching career spanning more than 20 years, Dwyer was a mainstay in Le Center classrooms before becoming an administrator.
In 2012, the Le Center and Montgomery-Lonsdale school districts consolidated into what is now the Tri-City United School District. In her new role as the TCU Montgomery principal, Dwyer had the opportunity to lead the school into a new era and she considered it one of the proudest moments in her career.
“My main goal is to enable all students to have opportunities and to learn at high levels, and I really feel that we’ve been able to do that,” said Dwyer. “Part of the consolidation was to bring in opportunities from a little bit larger district into a little bit smaller district. To give students opportunities and to see them grow in various areas was a wonderful goal that I think was accomplished with the consolidation.”
As a principal, Dwyer sought to foster a nurturing environment and to build relationships between students and faculty. She was known for starting each school day greeting students with a wave and visiting with them on their way to the cafeteria or the classroom.
“One of her favorite sayings is ‘Make it a great day,’ and she’ll give you a smile and kind of a fist in the air,” said TCU Montgomery fourth grade teacher Nyla Newton. “The kids hear it and the staff hears it and it’s always a positive message from her.”
Newton has worked across many different buildings in her teaching career, but she said that Dwyer was the best principal she’s ever worked with.
“Deb is the kind of principal that every teacher wants to have,” said Newton. “She truly cares about the staff and the students. She promotes a positive culture within our building and she’s definitely knowledgeable about our curriculum standards. If you have a question, she’s right there and easy to go to. I just love how I feel like I can go to her with a new idea and she truly listens and she will let you know one way or another.”
Dwyer has also earned praise for her commitment to students. Superintendent Teri Preisler said Dwyer would go all in on everything, whether it was highlighting students and their accomplishments on Twitter or having fun on Halloween.
“I meet with all of our principals and directors each month, and Deb would always go ‘I can’t wait to show you the data on the student’s growth here,’” said Preisler. “She would pull out the spreadsheets and she would have bar graphs, and you knew those were things that weren’t just important to her for academics, they were important to her and to the students, because it represented their growth and her belief in them.”
After so many years of educating, Dwyer will be able to enjoy a well-deserved retirement. But she said leaving the kids will be hard, especially with COVID-19 shutting school doors for the forseeable future.
“I’m going to miss seeing the kids’ faces and their enthusiasm and seeing their smiles” said Dwyer. “It’s bittersweet. I never thought my career would end so abruptly, and I don’t know if I’ll have the opportunity again to give them hugs and that type of thing. So I definitely will miss their energy, their smiles and their enthusiasm for learning.”
“If I knew March 13 would be the last time I would be face-to-face with the kiddos, I would have given them each a big hug,” she continued. “They’re awesome.”
The coronavirus pandemic continues to make itself known in the area, though some numbers are certainly more encouraging than others.
In Nicollet County, there has only been seven confirmed cases, but two deaths have stemmed from those cases. On the flip side, Le Sueur County has had a high number of confirmed cases for south central Minnesota region at 22, but Public Health leaders say 21 of those cases are recovered, while the 22nd was just recently reported.
Regardless of the known cases and deaths, public health officials across the state continue to note that the virus is likely more widespread than confirmed cases indicate, as testing lags and many are asymptomatic. The latter is why the stay-at-home order, currently in place until May 4, is important, according to the state leaders who issued it and those supporting it. Many residents may contract the coronavirus and never show significant symptoms from COVID-19, but they are still able to pass the virus on to others, including those who may be more vulnerable.
In an April 17 social media update, Nicollet County Public Health said, “Unfortunately, we have been notified of a second death related to the coronavirus in Nicollet County. Our hearts go out to the family and loved ones of this individual.”
The post continued, “As warmer weather is approaching, we ask you to remember the importance of safety maintaining distance between yourself and other active community members. Pay attention to closures, restrictions, and the number of people likely to be in outside spaces, making sure that you can keep at least 6 feet away from others.”
Le Sueur County leaders are offering similar advice. In a letter signed by every mayor in the county, plus Public Health and local medical facility leaders, continued social distancing was recommended.
“We understand that making these temporary sacrifices is difficult. However, doing so can mean the difference between life and death for the people of our community, particularly those at highest risk,” the letter stated.
It further said, “We are asking all of you to self-quarantine if you have any COVID-19 symptoms (fever, cough or shortness of breath) or have been exposed to the virus. For everyone else, please distance yourself from others in the following ways: avoid public places and go out only for essential work, get essential supplies or for exercise outdoors. Avoid family or public gatherings and stay 6 feet away from anyone with whom you do not live. The Centers for Disease Prevention & Control (CDC) is now recommending that everyone wear a cloth (homemade) face cover when going out in public to get essential supplies i.e. groceries. The purpose is to protect other people in case you are infected but not showing any symptoms. A couple important reminders: Do not use medical grade facemasks intended for healthcare workers as they are in short supply and remember that the face cover is not a substitute for social distancing.”
Residents can go to the Minnesota Department of Health website for the most accurate information about COVID-19 — www.health.state.mn.us/diseases/coronavirus/index.html — or to the CDC website — www.cdc.gov/coronavirus/2019-ncov/index.html. For information on what to do if you develop symptoms of COVID-19, call your local health care provider or visit their website.