August 24, 2025 • 29 mins
CAROLINA Focus with Sharon Thorsland, Jim Szoke and Ed Billick – Sunday Aug 24, 2025
Guest - Dr. Lyn Nuse, Sr Medical Director for Atrium Health Levine Children’s discussing virtual primary care that Levine now offers. Excellent tool for parents as we head back to school. The details and advantages of this new way to see your physician with Sharon/Ed
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Well, good morning, Carolinas. You're listening to Carolina Focus SO
News Talk eleven ten ninety nine three WBT Mixed one
oh seven nine and Sports Radio ninety two to seven WFNZ.
Carolina Focus is our public affairs show along with Sharon Fordesland,
I'm ed Billick. All Right, folks, kids going back to school,
germs that are passed between kids, they come home, they
(00:21):
have the sickness, they get the flu. You know, we're
getting into that time of year. What appropriate topic. Sharon
in studio with us, let's talk about it.
Speaker 2 (00:30):
We have doctor Lynn News.
Speaker 3 (00:31):
She is senior medical director at Levigne Children's and going
to talk about their virtual primary care medical program that
they have there. Doctor News, thanks so much for joining
us today.
Speaker 2 (00:42):
Thanks for having me.
Speaker 3 (00:44):
Now, I know that people often probably equate you know,
telehealth or you know the virtual care where you get
on the computer. Oh, I've got a sore throat. Help
me out what can I do? And I know that
that is something that you guys do, but you do
so much more so, can you tell us a little
bit about just a sort of an overview of the
virtual care program that you have at Livings.
Speaker 4 (01:06):
Absolutely so, virtual primary care actually started, oh gosh, about
two years ago with our adult counterparts, and a little
over a year ago we had the request to consider
developing a children's virtual primary care practice as well. And
you never bring a request to a competitive group of
(01:29):
people without expecting a yes answer, So we said, yes,
we're in, and we've been able to really design it
thoughtfully from the ground up since that time. A lot
of conversations with fellow pediatricians with parents, really trying to
understand how we can meet our parents and children where
they are and best serve our families with another option
(01:52):
for care, and we realize one size does not fit all,
and wanted to really come to people with an alternative
for their busy lifestyles. So virtual primary care for pediatrics
really has been designed to function in several different ways. One,
(02:12):
if you are a parent with the lifestyle that you
choose to have the majority of your child's care done virtually,
you can have your own pediatrician virtually through our practice,
and you can have continuity with them over time, choose
to see the same pediatrician each visit, and function very
(02:34):
much like a primary care pediatrician in a brick and
mortar office and with the relationship beyond that. I know
growing up, when I would go to see my favorite pediatrician,
sometimes he wasn't there for whatever reason, and so I
had a second favorite pediatrician. One of his partners was
the person that I always chose to see, and virtual
(02:55):
primary care can be that virtual partner as well for
our brick and mortar primary care pediatricians offering the convenience
to families to be able to receive that care at
home with extended hours something that younique to our practices.
We are open eight am to eight pm, seven days
(03:16):
a week and can offer a wide range of services.
Most of the things that you can get done in
your primary care office can also be done virtually. So
that's a high level overview of where we are and
glad to share.
Speaker 1 (03:36):
More doctor news. Is this like a zoom call or
a Microsoft team's call with a face on audio? Is
that how it works?
Speaker 4 (03:43):
It's very similar to a zoom call. So you can
log on and schedule an appointment through any of our
online applications through the Myatrum Health portal. We also you
can go through the website for Pediatrics Virtual and find
an appointment with an available pediatrician. You can even go
(04:06):
old school and call into our call center and they
can help you to get an appointment with that and
then you log on through the my Atrium Health app
and have a direct connection face to face with a pediatrician.
Speaker 3 (04:20):
So you said that this started about a year ago
for the children, in about two years ago for adult
Is this something that sort of grew out of COVID,
because I know during COVID a lot of people started saying, oh,
you know, we don't want to come to the doctor's office,
we want to, you know, just do it over the
computer or something like that. Is that sort of where
the genesis for both programs came from or how did
it start?
Speaker 4 (04:39):
So? I think COVID gave us a platform to explore
virtual and to really start to understand how we can
expand access and care to patients. You know, here in Charlotte,
it's pretty easy to access healthcare, but it's not true
(04:59):
across our state or even across our country. And so
as we have gotten more and more experience with virtual,
we really as a healthcare system sought to figure out
how can we provide more access and more options to
our families out there? You know, So we have continued
(05:22):
to develop and expand our virtual capabilities. You know, Hospital
at Home is a pretty well known program here in
our area. That's another example of a virtual program. We
have school based virtual clinics in I think we're in
over two hundred and thirty schools at this point across
(05:43):
multiple counties. And so it just seems natural that the
next iteration would be how can we expand upon this
sick access that we have built over time and actually
start to provide primary care virtually?
Speaker 2 (05:58):
So how does it?
Speaker 4 (06:00):
Like?
Speaker 3 (06:00):
Just starting out with the sick access, Like you said,
if your child is sick and you dial in, how
do they tell if you're sick? I mean, how does
it actually work? Because it sounds like how does that?
How can they tell if they have a fever when
they're at home? I guess lobby to the parent could
do that. So sort of walk through the details of
how it works, starting with the sick fist, and then
we'll go on to everything else you offer.
Speaker 4 (06:18):
Absolutely, so if you think about what happens when you
are in the waiting room waiting on your pediatrician or
you know, nurse to come into the room to talk
to you, what do you spend most of your time
doing you spend most of your time talking with your
healthcare provider. So you know, we spend a lot of
(06:41):
time talking, getting the history, understanding what the symptoms have been.
There's a lot that we as physicians and apps observe
while you're talking to us. Okay, does this patient look sick?
Are they you know, for a child? Are they clinging
(07:02):
to mom and dad? Are they moving around the room?
Speaker 2 (07:05):
Playful? Interactive?
Speaker 4 (07:08):
There's a lot you can tell just by looking and
saying is this child sick or not? Or how sick
are they? All of that can be done virtually. You know.
Speaker 1 (07:17):
It's funny. My sister's a nurse and she was just
visiting us, and she was looking at the two grandkids,
and she made a couple of medical comments. You know,
his eyes don't look as she you know, I see
a little bag as he tired, you know, and I'm
going I don't see that, but they do. And that's
a good point.
Speaker 4 (07:34):
So yes, I mean I remember being a medical student
and having one of my attending say ninety percent of
what we do is really in the history and talking
with our patients and understanding what their symptoms are and
what they're going through and so that translates to virtual
very well. And there are absolutely standards for how to
(07:55):
do a physical exam virtually. Now I can't lay hands
on on the patient and feel what their belly feels
like or that sort of thing. So there are some
things that we cannot do virtually, and we absolutely recognize
the limitations of that, But there is much more that
we can do virtually and that gives a great option
(08:15):
for care. You know, I mentioned remembering my pediatrician when
I was younger. I also remember my parents had to
take vacation to take me to the doctor.
Speaker 3 (08:24):
Wow.
Speaker 4 (08:25):
And you know they only got two to three weeks
of vacation for a year. So you think about all
the visits you make to the pediatrician, especially the younger
your child is, that's a lot of time away from work.
Speaker 2 (08:39):
Even if you don't have to take vacation.
Speaker 4 (08:41):
When your child's older in school, that's a lot of
time away from school for them. So being able to
have that extended care into the evenings and on weekends,
I think is a real winner for our families, you know.
I also my administrative part ner talks about how crazy
(09:02):
it is when she takes her two boys to the
pediatrician and they're climbing on the table, and they're opening
and closing the doors and the drawers and just sometimes
trying to keep them in the exam room challenge in herself.
You know, when you're a parent, being able to be
in your home and let your kids be distracted by
(09:24):
their familiar surroundings where they're comfortable and you can have
this conversation with the pediatrician through the screen can actually
help mitigate some of those challenges that come with having
your children in the exam room.
Speaker 2 (09:41):
Stressed, Yes, absolutely, so. It started out with the sick visits.
Speaker 3 (09:45):
So you treat things like what strep throat, that kind
of things like like I don't want to say easy
medical diagnosis, but I mean things that are like you know,
stomach ache or fever or things like that. Is that
and then they just like write a prescription then or
call it in or so.
Speaker 4 (10:01):
Some of our most common diagnoses include cold, allergies, pink eye.
We can somewhat do sore throat.
Speaker 3 (10:11):
So jem wait that takes a test, doesn't it right?
Speaker 4 (10:15):
So but it's a great example of one of those
limitations and how we can work within our healthcare extended
healthcare system. So if there is a complaint, let's say,
you know, a child comes onto the platform with a
stomach ache is the complaint. And as we're looking at
the child and they look a little sicker than just
(10:37):
you know, having a little bit of a belly ache,
we hear that they've been having a lot of vomiting, diarrhea,
that sort of thing. We're worried about, dehydration, maybe appendicitis.
We can automatically connect with one of our brick and
mortar facilities, be it a primary care office, in urgent care,
or an ED and get that patient smoothly to the
(10:59):
location is going to be able to meet their needs
the best.
Speaker 1 (11:02):
So this may be a way to expediate that appointment.
Speaker 4 (11:05):
Then well, yeah, it would be the same as if
you came to see me in my office and.
Speaker 2 (11:16):
I can't handle this here within this office. I need
you to get to.
Speaker 4 (11:21):
The emergency department and we can help expedite that. Virtual
has the same capability to get patients to the site
of care that they need the most. So if we're
worried about strep throat, we're going to get them, help
get them an appointment within the practice or help get
them that strep test so that we can treat them appropriately.
Speaker 3 (11:42):
Does insurance cover this just like they would a regular visit?
Speaker 2 (11:45):
Yes they do.
Speaker 3 (11:46):
Okay, that's really awesome. Now I know that one of
the new things that you guys are offering are these
well visits. Look you're talking about you know, round up
the kids go in for the annual appointment with the doctor,
and you have a sort of a hybrid version of that.
Speaker 2 (12:00):
Tell us about that.
Speaker 4 (12:01):
So for patients who choose to get the majority of
their care, let's say they're using virtual primary care as
their medical home for their child, we do have the
capability one to meet virtually with a parent and do
what I call the talking parts of a wellness exam.
And then we have here within Charlotte and a couple
(12:23):
other locations some partners who have agreed to help us
with the physical exam portion, the labs, the vaccines, that
sort of thing. For patients who already have a primary
care pediatrician and want to continue their wellness care with
their pediatrician, we want to honor that relationship and we
do not want to disrupt that at all. So in
(12:46):
that case, that parent could still choose to get a
lot of their care through virtual primary care, still see
their same pediatrician of choice virtually, and then still go
to their primary care pediatrician for care as well. So
we're trying to really think about, you know, as the
(13:07):
parent is choosing that primary care pediatrician virtually or in person,
how do we still accomplish care for the family in
a way that's convenient and gives them the access.
Speaker 1 (13:18):
To doctor news A question. Okay, I usually use novaant
or I use another primary institution. Does it really matter?
Speaker 2 (13:27):
It does not matter.
Speaker 1 (13:28):
So I think some people think, oh, I'm just a
novant person or I'm an Atrium person, you know, and
you know, I don't know if I could cross over.
Speaker 4 (13:37):
So absolutely we are happy to see whoever wants to
see us. That is not a problem. The you know,
other advancement in medicine has been the electronic medical record,
and so even if you're with another system, if you
are on like our system is.
Speaker 2 (13:56):
EPIC, you can if you see you have a.
Speaker 4 (14:01):
Doctor, even on the other side of the state, and
you're accessing us virtually for primary care, your doctor, if
they have a connection through EPIC, can still see the.
Speaker 2 (14:11):
Records of what we do.
Speaker 4 (14:14):
So It's not as isolated and siloed in care as
it was even five to ten years ago, which is
really nice because one of the things we treasure as
physicians and apps, anybody in healthcare is that continuity and
being able to have the relationship with the your primary
(14:40):
care provider. But at the same time, we know we're
not there twenty four to seven, three hundred and sixty
five days out of the year. There are going to
be times that you have to have care elsewhere, and
so being able to be a layer of continuity within
the healthcare system through virtual primary care, I think is
a another nice feature of this program.
Speaker 2 (15:03):
Absolutely.
Speaker 3 (15:04):
We're speaking with doctor Lynn Nuse, she is senior medical
director at Lavine Children's You were just mentioning, Oh, if
you're across the state and have to go to a
different doctor, that I would think is just a fabulous
way to be able to keep the relationship with your
your primary care doctor. Say you go on vacation and
you know, your kid wakes up with whatever issue or
they're having or something, to be able to get online
(15:24):
and make an appointment with their doctor instead of having
to go to some random urgent care or something, you know,
down at you know, Charleston. It seems like that's just
a game changer. I would think for parents to be
able to have that, yeah, that's stability and that familiarity
and stuff, to be able to see their doctor instead
of some somebody strange, it's it's.
Speaker 2 (15:42):
A really great point.
Speaker 4 (15:44):
In fact, I was in clinic it's been several weeks
ago and saw a child and I said, well, you know,
things get worse over the weekend.
Speaker 2 (15:54):
We're here, we.
Speaker 4 (15:55):
Have availability, and she said, oh, but we're getting ready
to go on vacation. I said, well, don't forget our
virtual programs. So you can still have access to a
Levine Children's pediatrician either on a first come, first serve basis,
which is our urgent Care virtual visit program that started
during COVID, or through our virtual primary care platform.
Speaker 1 (16:17):
So how do I qualify?
Speaker 2 (16:19):
How do you qualify?
Speaker 4 (16:23):
Basically, you just have to be in one of our
states of service, so our team can see patients who
are physically located in North Carolina, South Carolina, Georgia, Illinois, Wisconsin,
and Alabama. And so you do have to be as
a patient physically in one of those states to be
(16:44):
able to receive care from US, but our team is
licensed across the geography that Advocate health Care, which is
our parent corporation, provides care.
Speaker 1 (16:55):
You know, it's funny because I was just thinking a
lawyers can only practice here and practice there in the
medical field. Not that case. Is it?
Speaker 4 (17:01):
As long as you have a license in a state,
you can practice across state line.
Speaker 1 (17:06):
Which you guys have all those states. That's pretty cool.
Speaker 3 (17:08):
Okay, you were just you just mentioned urgent care, like
you have the first come, first term urgent care? Is
that something like literally I was just three weeks ago
my son got a fish hook in his foot and
we were up in Shelby up there at Moss Lake
and ended up in an Atrium Health urgent care facility.
But is that something that you could like dial in
(17:30):
or do the first come, first serve and say, hey,
is this something Do I need to come in and
be seen for this? Or can I pull this fisher
cup by myself? Or how does it work with urgent care?
Because I wouldn't think, yeah, it was not fun. How
does that work with them? From an urgent care type
of angle?
Speaker 4 (17:46):
So our Urgent Care Virtual does a platform really focuses
on acute illness and acute complaints, and it is as
if you were walking into a virtual waiting room. You
log on, you are put in Q to be able
to see the next available provider. Now, with efficient, they're
(18:07):
probably gonna say you need to go to your local
urgent care and be seen in person. But let's say
maybe your child has a history of swimmer's ear and
they've been swimming a ton while you're on vacation and
they've got a little bit of drainage and their ear hurts.
When that is something that we could handle through either
(18:30):
the virtual urgent care video visits or through our virtual
primary care. For virtual primary care, one of the things
that's different is it is not first come, first serve.
You actually log on and schedule an appointment, just as
if you were being seen in your office.
Speaker 3 (18:46):
So you have the sick visits, you've got the hybrid
wellness visits, and I understand you have a whole host
of other things that you can take care of virtually.
Tell us about some of the other programs you were
talking about with the chronic conditions, a mental health care.
Speaker 1 (19:00):
There are things like that DD that kind of thing.
Speaker 4 (19:02):
Yeah, this is where I think virtual really shines in
a lot of ways, because it does allow us to
give care in a way that kids don't have to
miss school. So you mentioned ADHD well, one of the
things that's really important for children who have ADHD is
to be in school and have that routine and that predictability.
(19:27):
Our platform can do ADHD depression anxiety. One of the
things when we were talking to pediatricians as we were
designing this was really trying to say, if you could
design your practice ideally from scratch and you think about
like what your practice is like day to day, what
(19:49):
would you do differently? And everybody came back with pretty
much the same answer, which is, I would have.
Speaker 2 (19:56):
More time to educate my patients.
Speaker 4 (19:58):
And so this this is a way that you know,
we have a little bit longer appointment time for these
types of complaints. You can you know, log on scheduling
appointment log on. You can see the same physician time
after time, just like you can in brick and mortar.
(20:19):
If it needs to be after soccer practice that ends
at six point thirty seven o'clock at night, we can
do it at that time. If it needs to be
on a Saturday or Sunday, because you know, things are
just crazy during the week, we can do those visits
at that time. We can manage other chronic conditions. You know,
(20:40):
we have asthma. A lot of that can be done
virtually with some tools that we have. As technology continues
to expand, we may even eventually have the capability to
have a device with the family at home where we
could listen to the child, listen to their lungs, listen
(21:01):
to their hearts, look in their ears. So as we
look to the future and how this platform can continue
to evolve, the capability and the possibilities are really limitless.
We have some pediatricians who are part of the practice
who really have an interest in health nutrition, working with
(21:27):
patients who may be struggling with weight gain or pediatric obesity.
That is something that we can do virtually as well,
because a lot of that is counseling, you know, nutrition
helping to talk people through that. And so I think
(21:49):
when we look at all the different things this platform
can offer, we really can do primary care very conveniently.
Speaker 1 (21:58):
You know, I was talking with Sharon before the show
today and we were reminiscing on doctor Campana that used
to come to our house when we were little kids.
What you're trying to do here is replicate that in
a way, because I was just looking at you, you know,
check the ears devices where you can check the heartbeat
all that virtually. I think that's where you're headed. It
sounds like that to.
Speaker 4 (22:18):
Me at least, that that's a really great way of
thinking about it. Is it is kind of like a
virtual house call. It's or the modern edition of house calls,
very moderate. So, you know, technology, the way it has
grown in the last five years is really amazing, and
(22:40):
so our I mentioned our school based virtual program that
actually uses a device where we can listen to heart,
listen to lungs, and look in ears, really looking throats.
Speaker 2 (22:53):
All of that.
Speaker 3 (22:53):
Really and you've already got that seriously, Yes.
Speaker 4 (22:56):
So that's the clinical version of one of the devices
that's out there. And so we're hoping again as technology
continues to evolve and quite frankly gets cheaper for families,
then we'll be able to have similar technology that we
can bring into the whole quest.
Speaker 3 (23:17):
So is this you're talking about with the school thing?
Do they like have like a like a nurse's office
where the kid goes in there and they hook up
with the pediatrician and they can actually use some sort
of a machine that at the school without having to
have a doctor or somebody on hand to school.
Speaker 2 (23:33):
That's amazing. Yeah, pretty much so.
Speaker 4 (23:36):
So if your child is feeling sick and goes to
the school nurse at one of the schools we partner with,
the school nurse can determine if they think it's an
appropriate visit for our school based virtual program. They then
contact our team and we dispatch a telepresenter to the
school with the appropriate equipment. The school nurse can continue
(24:00):
seeing kids who are lined up outside her office when
our telepresenter arrives. They have a dedicated private space that's confidential.
They can contact the parents, well, we always contact the
parents because we get permission for the visit. The parent
can actually come in in a three way connection and
attend the visit if they want to, and our apps
(24:23):
who are working that platform, see the patient and make
the diagnosis, and if the child's well enough to go
back to class, they go back to class, which is fabulous.
And if your child needs a prescription, it can be
waiting for you when you get off work and you
can swing by pick up.
Speaker 1 (24:41):
Sure, and they already get a name for this person
a tele presenter. Yes, yes, that's another type of job.
Speaker 3 (24:47):
Wow, that's really amazing that you have all of these capabilities.
One of the things you're talking about with the chronic
condition management or like asthma or things like that or ADHD.
The mental health has become such a huge thing in
recent years, especially I think coming out of COVID with all.
Speaker 2 (25:04):
These especially in kids.
Speaker 3 (25:05):
You know that had to deal with all of that
stuff going on in high school kids Millskuye, I mean
every and especially college like having this virtual option like that,
is that like particularly great for kids to be able
to be in the comfort of their own home and
not have to like go to the doctor and sit
there and have everybody look at them and think, go,
why are you here at the mental health clinic guy
kind of thing? Is that really does that help with
(25:25):
that as well?
Speaker 2 (25:27):
It does?
Speaker 4 (25:28):
And so you know, as pediatricians, we're managing the medications
that can treat anxiety depression. When patients come to see
me in my office, we sit, we chat, we talk
through it. There's not really a significant physical exam portion
(25:48):
of that that visit, and so you know, we may
want to see the patient in the office for a
visit to you know, make sure everything else is okay.
But in this case, because virtual primary care is actually
connected back to a healthcare system, we can look in
the chart and say, do they have an up to
(26:10):
date exam? Is there a blood pressure? Are there are
vital signs that are in there that we know are
stable over time? And if all of that's there, we
can absolutely handle the mental health concerns virtually. Again, being
able to see the same pediatrician through virtual primary care,
I think is a big win. And having that relationship established,
(26:35):
we also let the I think a big part of
this is giving families choice. So I have been surprised
in seeing patients how many prefer to be in person
for their counseling. So we can get that set up
and if if they want to be seen virtually, we
(26:56):
can set them up with a counselor virtually as well.
Speaker 3 (26:59):
Okay, is that something that like I just sent my
twins off to college this past week, two different directions.
Is that something like especially with the well any of
these and not just not just the mental health or
anxiety or anything like that, but for them to be
able to say if they were seeing a therapist regularly,
you know, for mental health or something like that, to
(27:21):
be able to do it from their dorm at college
and not have to go find a new healthcare provider
down there. They could still keep up that weekly session
or whatever it may be. I mean, this is something
that would work for that as well.
Speaker 4 (27:32):
Absolutely, as long as they are in a state where we,
you know, are providing care. Again, the versatility of the
virtual primary care practice, I think highlights all the different
ways that can be used and you know, we haven't
even really touched on as we look to the future
(27:53):
and what growth we have the potential to bring primary
care into some of our rural communities that may not
have access to a pediatrician or to pediatric care. It
really is exciting to be in this space to see
how we can continue to grow and meet the needs
(28:13):
out there. Growing up in a small rural town, absolutely,
you know, we traveled forty five minutes to get to
the pediatrician, and that.
Speaker 2 (28:22):
Was a long time ago. I'm not going to say
how long. But you know, even it's not like.
Speaker 4 (28:28):
Those conditions have changed here in our present times, there're
still people that struggle to get access to healthcare, and
virtual can also just like it can meet a need
within our cities where we have plenty of pediatricians and
other physicians and apps available to give primary care. Virtual
(28:51):
can meet a need in a whole different type of
community as well.
Speaker 3 (28:56):
I want to talk a little bit more about that
after a break. We're going to take a break here
on a lot of Focus. We've been speaking with doctor
Lynn News, she's senior medical director at Lavigne Children's and
I'm telling them it's all about their virtual primary care
and all the different things you can do with it,
well visited, hybrid care, sick visits, chronic condition management, just
it seems like it's just the endless possibility. So with
(29:18):
what they are able to do and I'm an extended hours,
seven days a week, it's crazy. So we're going to
find out a lot more about the future maybe of
what they can do and some other things of associated
with virtual primary care. Everybody stay with us here on
Carolina Focus.
Well, good morning, Carolinas. You're listening to Carolina Focus SO
News Talk eleven ten ninety nine three WBT Mixed one
oh seven nine and Sports Radio ninety two to seven WFNZ.
Carolina Focus is our public affairs show along with Sharon Fordesland,
I'm ed Billick. All Right, folks, kids going back to school,
germs that are passed between kids, they come home, they
(00:21):
have the sickness, they get the flu. You know, we're
getting into that time of year. What appropriate topic. Sharon
in studio with us, let's talk about it.
Speaker 2 (00:30):
We have doctor Lynn News.
Speaker 3 (00:31):
She is senior medical director at Levigne Children's and going
to talk about their virtual primary care medical program that
they have there. Doctor News, thanks so much for joining
us today.
Speaker 2 (00:42):
Thanks for having me.
Speaker 3 (00:44):
Now, I know that people often probably equate you know,
telehealth or you know the virtual care where you get
on the computer. Oh, I've got a sore throat. Help
me out what can I do? And I know that
that is something that you guys do, but you do
so much more so, can you tell us a little
bit about just a sort of an overview of the
virtual care program that you have at Livings.
Speaker 4 (01:06):
Absolutely so, virtual primary care actually started, oh gosh, about
two years ago with our adult counterparts, and a little
over a year ago we had the request to consider
developing a children's virtual primary care practice as well. And
you never bring a request to a competitive group of
(01:29):
people without expecting a yes answer, So we said, yes,
we're in, and we've been able to really design it
thoughtfully from the ground up since that time. A lot
of conversations with fellow pediatricians with parents, really trying to
understand how we can meet our parents and children where
they are and best serve our families with another option
(01:52):
for care, and we realize one size does not fit all,
and wanted to really come to people with an alternative
for their busy lifestyles. So virtual primary care for pediatrics
really has been designed to function in several different ways. One,
(02:12):
if you are a parent with the lifestyle that you
choose to have the majority of your child's care done virtually,
you can have your own pediatrician virtually through our practice,
and you can have continuity with them over time, choose
to see the same pediatrician each visit, and function very
(02:34):
much like a primary care pediatrician in a brick and
mortar office and with the relationship beyond that. I know
growing up, when I would go to see my favorite pediatrician,
sometimes he wasn't there for whatever reason, and so I
had a second favorite pediatrician. One of his partners was
the person that I always chose to see, and virtual
(02:55):
primary care can be that virtual partner as well for
our brick and mortar primary care pediatricians offering the convenience
to families to be able to receive that care at
home with extended hours something that younique to our practices.
We are open eight am to eight pm, seven days
(03:16):
a week and can offer a wide range of services.
Most of the things that you can get done in
your primary care office can also be done virtually. So
that's a high level overview of where we are and
glad to share.
Speaker 1 (03:36):
More doctor news. Is this like a zoom call or
a Microsoft team's call with a face on audio? Is
that how it works?
Speaker 4 (03:43):
It's very similar to a zoom call. So you can
log on and schedule an appointment through any of our
online applications through the Myatrum Health portal. We also you
can go through the website for Pediatrics Virtual and find
an appointment with an available pediatrician. You can even go
(04:06):
old school and call into our call center and they
can help you to get an appointment with that and
then you log on through the my Atrium Health app
and have a direct connection face to face with a pediatrician.
Speaker 3 (04:20):
So you said that this started about a year ago
for the children, in about two years ago for adult
Is this something that sort of grew out of COVID,
because I know during COVID a lot of people started saying, oh,
you know, we don't want to come to the doctor's office,
we want to, you know, just do it over the
computer or something like that. Is that sort of where
the genesis for both programs came from or how did
it start?
Speaker 4 (04:39):
So? I think COVID gave us a platform to explore
virtual and to really start to understand how we can
expand access and care to patients. You know, here in Charlotte,
it's pretty easy to access healthcare, but it's not true
(04:59):
across our state or even across our country. And so
as we have gotten more and more experience with virtual,
we really as a healthcare system sought to figure out
how can we provide more access and more options to
our families out there? You know, So we have continued
(05:22):
to develop and expand our virtual capabilities. You know, Hospital
at Home is a pretty well known program here in
our area. That's another example of a virtual program. We
have school based virtual clinics in I think we're in
over two hundred and thirty schools at this point across
(05:43):
multiple counties. And so it just seems natural that the
next iteration would be how can we expand upon this
sick access that we have built over time and actually
start to provide primary care virtually?
Speaker 2 (05:58):
So how does it?
Speaker 4 (06:00):
Like?
Speaker 3 (06:00):
Just starting out with the sick access, Like you said,
if your child is sick and you dial in, how
do they tell if you're sick? I mean, how does
it actually work? Because it sounds like how does that?
How can they tell if they have a fever when
they're at home? I guess lobby to the parent could
do that. So sort of walk through the details of
how it works, starting with the sick fist, and then
we'll go on to everything else you offer.
Speaker 4 (06:18):
Absolutely, so if you think about what happens when you
are in the waiting room waiting on your pediatrician or
you know, nurse to come into the room to talk
to you, what do you spend most of your time
doing you spend most of your time talking with your
healthcare provider. So you know, we spend a lot of
(06:41):
time talking, getting the history, understanding what the symptoms have been.
There's a lot that we as physicians and apps observe
while you're talking to us. Okay, does this patient look sick?
Are they you know, for a child? Are they clinging
(07:02):
to mom and dad? Are they moving around the room?
Speaker 2 (07:05):
Playful? Interactive?
Speaker 4 (07:08):
There's a lot you can tell just by looking and
saying is this child sick or not? Or how sick
are they? All of that can be done virtually. You know.
Speaker 1 (07:17):
It's funny. My sister's a nurse and she was just
visiting us, and she was looking at the two grandkids,
and she made a couple of medical comments. You know,
his eyes don't look as she you know, I see
a little bag as he tired, you know, and I'm
going I don't see that, but they do. And that's
a good point.
Speaker 4 (07:34):
So yes, I mean I remember being a medical student
and having one of my attending say ninety percent of
what we do is really in the history and talking
with our patients and understanding what their symptoms are and
what they're going through and so that translates to virtual
very well. And there are absolutely standards for how to
(07:55):
do a physical exam virtually. Now I can't lay hands
on on the patient and feel what their belly feels
like or that sort of thing. So there are some
things that we cannot do virtually, and we absolutely recognize
the limitations of that, But there is much more that
we can do virtually and that gives a great option
(08:15):
for care. You know, I mentioned remembering my pediatrician when
I was younger. I also remember my parents had to
take vacation to take me to the doctor.
Speaker 3 (08:24):
Wow.
Speaker 4 (08:25):
And you know they only got two to three weeks
of vacation for a year. So you think about all
the visits you make to the pediatrician, especially the younger
your child is, that's a lot of time away from work.
Speaker 2 (08:39):
Even if you don't have to take vacation.
Speaker 4 (08:41):
When your child's older in school, that's a lot of
time away from school for them. So being able to
have that extended care into the evenings and on weekends,
I think is a real winner for our families, you know.
I also my administrative part ner talks about how crazy
(09:02):
it is when she takes her two boys to the
pediatrician and they're climbing on the table, and they're opening
and closing the doors and the drawers and just sometimes
trying to keep them in the exam room challenge in herself.
You know, when you're a parent, being able to be
in your home and let your kids be distracted by
(09:24):
their familiar surroundings where they're comfortable and you can have
this conversation with the pediatrician through the screen can actually
help mitigate some of those challenges that come with having
your children in the exam room.
Speaker 2 (09:41):
Stressed, Yes, absolutely, so. It started out with the sick visits.
Speaker 3 (09:45):
So you treat things like what strep throat, that kind
of things like like I don't want to say easy
medical diagnosis, but I mean things that are like you know,
stomach ache or fever or things like that. Is that
and then they just like write a prescription then or
call it in or so.
Speaker 4 (10:01):
Some of our most common diagnoses include cold, allergies, pink eye.
We can somewhat do sore throat.
Speaker 3 (10:11):
So jem wait that takes a test, doesn't it right?
Speaker 4 (10:15):
So but it's a great example of one of those
limitations and how we can work within our healthcare extended
healthcare system. So if there is a complaint, let's say,
you know, a child comes onto the platform with a
stomach ache is the complaint. And as we're looking at
the child and they look a little sicker than just
(10:37):
you know, having a little bit of a belly ache,
we hear that they've been having a lot of vomiting, diarrhea,
that sort of thing. We're worried about, dehydration, maybe appendicitis.
We can automatically connect with one of our brick and
mortar facilities, be it a primary care office, in urgent care,
or an ED and get that patient smoothly to the
(10:59):
location is going to be able to meet their needs
the best.
Speaker 1 (11:02):
So this may be a way to expediate that appointment.
Speaker 4 (11:05):
Then well, yeah, it would be the same as if
you came to see me in my office and.
Speaker 2 (11:16):
I can't handle this here within this office. I need
you to get to.
Speaker 4 (11:21):
The emergency department and we can help expedite that. Virtual
has the same capability to get patients to the site
of care that they need the most. So if we're
worried about strep throat, we're going to get them, help
get them an appointment within the practice or help get
them that strep test so that we can treat them appropriately.
Speaker 3 (11:42):
Does insurance cover this just like they would a regular visit?
Speaker 2 (11:45):
Yes they do.
Speaker 3 (11:46):
Okay, that's really awesome. Now I know that one of
the new things that you guys are offering are these
well visits. Look you're talking about you know, round up
the kids go in for the annual appointment with the doctor,
and you have a sort of a hybrid version of that.
Speaker 2 (12:00):
Tell us about that.
Speaker 4 (12:01):
So for patients who choose to get the majority of
their care, let's say they're using virtual primary care as
their medical home for their child, we do have the
capability one to meet virtually with a parent and do
what I call the talking parts of a wellness exam.
And then we have here within Charlotte and a couple
(12:23):
other locations some partners who have agreed to help us
with the physical exam portion, the labs, the vaccines, that
sort of thing. For patients who already have a primary
care pediatrician and want to continue their wellness care with
their pediatrician, we want to honor that relationship and we
do not want to disrupt that at all. So in
(12:46):
that case, that parent could still choose to get a
lot of their care through virtual primary care, still see
their same pediatrician of choice virtually, and then still go
to their primary care pediatrician for care as well. So
we're trying to really think about, you know, as the
(13:07):
parent is choosing that primary care pediatrician virtually or in person,
how do we still accomplish care for the family in
a way that's convenient and gives them the access.
Speaker 1 (13:18):
To doctor news A question. Okay, I usually use novaant
or I use another primary institution. Does it really matter?
Speaker 2 (13:27):
It does not matter.
Speaker 1 (13:28):
So I think some people think, oh, I'm just a
novant person or I'm an Atrium person, you know, and
you know, I don't know if I could cross over.
Speaker 4 (13:37):
So absolutely we are happy to see whoever wants to
see us. That is not a problem. The you know,
other advancement in medicine has been the electronic medical record,
and so even if you're with another system, if you
are on like our system is.
Speaker 2 (13:56):
EPIC, you can if you see you have a.
Speaker 4 (14:01):
Doctor, even on the other side of the state, and
you're accessing us virtually for primary care, your doctor, if
they have a connection through EPIC, can still see the.
Speaker 2 (14:11):
Records of what we do.
Speaker 4 (14:14):
So It's not as isolated and siloed in care as
it was even five to ten years ago, which is
really nice because one of the things we treasure as
physicians and apps, anybody in healthcare is that continuity and
being able to have the relationship with the your primary
(14:40):
care provider. But at the same time, we know we're
not there twenty four to seven, three hundred and sixty
five days out of the year. There are going to
be times that you have to have care elsewhere, and
so being able to be a layer of continuity within
the healthcare system through virtual primary care, I think is
a another nice feature of this program.
Speaker 2 (15:03):
Absolutely.
Speaker 3 (15:04):
We're speaking with doctor Lynn Nuse, she is senior medical
director at Lavine Children's You were just mentioning, Oh, if
you're across the state and have to go to a
different doctor, that I would think is just a fabulous
way to be able to keep the relationship with your
your primary care doctor. Say you go on vacation and
you know, your kid wakes up with whatever issue or
they're having or something, to be able to get online
(15:24):
and make an appointment with their doctor instead of having
to go to some random urgent care or something, you know,
down at you know, Charleston. It seems like that's just
a game changer. I would think for parents to be
able to have that, yeah, that's stability and that familiarity
and stuff, to be able to see their doctor instead
of some somebody strange, it's it's.
Speaker 2 (15:42):
A really great point.
Speaker 4 (15:44):
In fact, I was in clinic it's been several weeks
ago and saw a child and I said, well, you know,
things get worse over the weekend.
Speaker 2 (15:54):
We're here, we.
Speaker 4 (15:55):
Have availability, and she said, oh, but we're getting ready
to go on vacation. I said, well, don't forget our
virtual programs. So you can still have access to a
Levine Children's pediatrician either on a first come, first serve basis,
which is our urgent Care virtual visit program that started
during COVID, or through our virtual primary care platform.
Speaker 1 (16:17):
So how do I qualify?
Speaker 2 (16:19):
How do you qualify?
Speaker 4 (16:23):
Basically, you just have to be in one of our
states of service, so our team can see patients who
are physically located in North Carolina, South Carolina, Georgia, Illinois, Wisconsin,
and Alabama. And so you do have to be as
a patient physically in one of those states to be
(16:44):
able to receive care from US, but our team is
licensed across the geography that Advocate health Care, which is
our parent corporation, provides care.
Speaker 1 (16:55):
You know, it's funny because I was just thinking a
lawyers can only practice here and practice there in the
medical field. Not that case. Is it?
Speaker 4 (17:01):
As long as you have a license in a state,
you can practice across state line.
Speaker 1 (17:06):
Which you guys have all those states. That's pretty cool.
Speaker 3 (17:08):
Okay, you were just you just mentioned urgent care, like
you have the first come, first term urgent care? Is
that something like literally I was just three weeks ago
my son got a fish hook in his foot and
we were up in Shelby up there at Moss Lake
and ended up in an Atrium Health urgent care facility.
But is that something that you could like dial in
(17:30):
or do the first come, first serve and say, hey,
is this something Do I need to come in and
be seen for this? Or can I pull this fisher
cup by myself? Or how does it work with urgent care?
Because I wouldn't think, yeah, it was not fun. How
does that work with them? From an urgent care type
of angle?
Speaker 4 (17:46):
So our Urgent Care Virtual does a platform really focuses
on acute illness and acute complaints, and it is as
if you were walking into a virtual waiting room. You
log on, you are put in Q to be able
to see the next available provider. Now, with efficient, they're
(18:07):
probably gonna say you need to go to your local
urgent care and be seen in person. But let's say
maybe your child has a history of swimmer's ear and
they've been swimming a ton while you're on vacation and
they've got a little bit of drainage and their ear hurts.
When that is something that we could handle through either
(18:30):
the virtual urgent care video visits or through our virtual
primary care. For virtual primary care, one of the things
that's different is it is not first come, first serve.
You actually log on and schedule an appointment, just as
if you were being seen in your office.
Speaker 3 (18:46):
So you have the sick visits, you've got the hybrid
wellness visits, and I understand you have a whole host
of other things that you can take care of virtually.
Tell us about some of the other programs you were
talking about with the chronic conditions, a mental health care.
Speaker 1 (19:00):
There are things like that DD that kind of thing.
Speaker 4 (19:02):
Yeah, this is where I think virtual really shines in
a lot of ways, because it does allow us to
give care in a way that kids don't have to
miss school. So you mentioned ADHD well, one of the
things that's really important for children who have ADHD is
to be in school and have that routine and that predictability.
(19:27):
Our platform can do ADHD depression anxiety. One of the
things when we were talking to pediatricians as we were
designing this was really trying to say, if you could
design your practice ideally from scratch and you think about
like what your practice is like day to day, what
(19:49):
would you do differently? And everybody came back with pretty
much the same answer, which is, I would have.
Speaker 2 (19:56):
More time to educate my patients.
Speaker 4 (19:58):
And so this this is a way that you know,
we have a little bit longer appointment time for these
types of complaints. You can you know, log on scheduling
appointment log on. You can see the same physician time
after time, just like you can in brick and mortar.
(20:19):
If it needs to be after soccer practice that ends
at six point thirty seven o'clock at night, we can
do it at that time. If it needs to be
on a Saturday or Sunday, because you know, things are
just crazy during the week, we can do those visits
at that time. We can manage other chronic conditions. You know,
(20:40):
we have asthma. A lot of that can be done
virtually with some tools that we have. As technology continues
to expand, we may even eventually have the capability to
have a device with the family at home where we
could listen to the child, listen to their lungs, listen
(21:01):
to their hearts, look in their ears. So as we
look to the future and how this platform can continue
to evolve, the capability and the possibilities are really limitless.
We have some pediatricians who are part of the practice
who really have an interest in health nutrition, working with
(21:27):
patients who may be struggling with weight gain or pediatric obesity.
That is something that we can do virtually as well,
because a lot of that is counseling, you know, nutrition
helping to talk people through that. And so I think
(21:49):
when we look at all the different things this platform
can offer, we really can do primary care very conveniently.
Speaker 1 (21:58):
You know, I was talking with Sharon before the show
today and we were reminiscing on doctor Campana that used
to come to our house when we were little kids.
What you're trying to do here is replicate that in
a way, because I was just looking at you, you know,
check the ears devices where you can check the heartbeat
all that virtually. I think that's where you're headed. It
sounds like that to.
Speaker 4 (22:18):
Me at least, that that's a really great way of
thinking about it. Is it is kind of like a
virtual house call. It's or the modern edition of house calls,
very moderate. So, you know, technology, the way it has
grown in the last five years is really amazing, and
(22:40):
so our I mentioned our school based virtual program that
actually uses a device where we can listen to heart,
listen to lungs, and look in ears, really looking throats.
Speaker 2 (22:53):
All of that.
Speaker 3 (22:53):
Really and you've already got that seriously, Yes.
Speaker 4 (22:56):
So that's the clinical version of one of the devices
that's out there. And so we're hoping again as technology
continues to evolve and quite frankly gets cheaper for families,
then we'll be able to have similar technology that we
can bring into the whole quest.
Speaker 3 (23:17):
So is this you're talking about with the school thing?
Do they like have like a like a nurse's office
where the kid goes in there and they hook up
with the pediatrician and they can actually use some sort
of a machine that at the school without having to
have a doctor or somebody on hand to school.
Speaker 2 (23:33):
That's amazing. Yeah, pretty much so.
Speaker 4 (23:36):
So if your child is feeling sick and goes to
the school nurse at one of the schools we partner with,
the school nurse can determine if they think it's an
appropriate visit for our school based virtual program. They then
contact our team and we dispatch a telepresenter to the
school with the appropriate equipment. The school nurse can continue
(24:00):
seeing kids who are lined up outside her office when
our telepresenter arrives. They have a dedicated private space that's confidential.
They can contact the parents, well, we always contact the
parents because we get permission for the visit. The parent
can actually come in in a three way connection and
attend the visit if they want to, and our apps
(24:23):
who are working that platform, see the patient and make
the diagnosis, and if the child's well enough to go
back to class, they go back to class, which is fabulous.
And if your child needs a prescription, it can be
waiting for you when you get off work and you
can swing by pick up.
Speaker 1 (24:41):
Sure, and they already get a name for this person
a tele presenter. Yes, yes, that's another type of job.
Speaker 3 (24:47):
Wow, that's really amazing that you have all of these capabilities.
One of the things you're talking about with the chronic
condition management or like asthma or things like that or ADHD.
The mental health has become such a huge thing in
recent years, especially I think coming out of COVID with all.
Speaker 2 (25:04):
These especially in kids.
Speaker 3 (25:05):
You know that had to deal with all of that
stuff going on in high school kids Millskuye, I mean
every and especially college like having this virtual option like that,
is that like particularly great for kids to be able
to be in the comfort of their own home and
not have to like go to the doctor and sit
there and have everybody look at them and think, go,
why are you here at the mental health clinic guy
kind of thing? Is that really does that help with
(25:25):
that as well?
Speaker 2 (25:27):
It does?
Speaker 4 (25:28):
And so you know, as pediatricians, we're managing the medications
that can treat anxiety depression. When patients come to see
me in my office, we sit, we chat, we talk
through it. There's not really a significant physical exam portion
(25:48):
of that that visit, and so you know, we may
want to see the patient in the office for a
visit to you know, make sure everything else is okay.
But in this case, because virtual primary care is actually
connected back to a healthcare system, we can look in
the chart and say, do they have an up to
(26:10):
date exam? Is there a blood pressure? Are there are
vital signs that are in there that we know are
stable over time? And if all of that's there, we
can absolutely handle the mental health concerns virtually. Again, being
able to see the same pediatrician through virtual primary care,
I think is a big win. And having that relationship established,
(26:35):
we also let the I think a big part of
this is giving families choice. So I have been surprised
in seeing patients how many prefer to be in person
for their counseling. So we can get that set up
and if if they want to be seen virtually, we
(26:56):
can set them up with a counselor virtually as well.
Speaker 3 (26:59):
Okay, is that something that like I just sent my
twins off to college this past week, two different directions.
Is that something like especially with the well any of
these and not just not just the mental health or
anxiety or anything like that, but for them to be
able to say if they were seeing a therapist regularly,
you know, for mental health or something like that, to
(27:21):
be able to do it from their dorm at college
and not have to go find a new healthcare provider
down there. They could still keep up that weekly session
or whatever it may be. I mean, this is something
that would work for that as well.
Speaker 4 (27:32):
Absolutely, as long as they are in a state where we,
you know, are providing care. Again, the versatility of the
virtual primary care practice, I think highlights all the different
ways that can be used and you know, we haven't
even really touched on as we look to the future
(27:53):
and what growth we have the potential to bring primary
care into some of our rural communities that may not
have access to a pediatrician or to pediatric care. It
really is exciting to be in this space to see
how we can continue to grow and meet the needs
(28:13):
out there. Growing up in a small rural town, absolutely,
you know, we traveled forty five minutes to get to
the pediatrician, and that.
Speaker 2 (28:22):
Was a long time ago. I'm not going to say
how long. But you know, even it's not like.
Speaker 4 (28:28):
Those conditions have changed here in our present times, there're
still people that struggle to get access to healthcare, and
virtual can also just like it can meet a need
within our cities where we have plenty of pediatricians and
other physicians and apps available to give primary care. Virtual
(28:51):
can meet a need in a whole different type of
community as well.
Speaker 3 (28:56):
I want to talk a little bit more about that
after a break. We're going to take a break here
on a lot of Focus. We've been speaking with doctor
Lynn News, she's senior medical director at Lavigne Children's and
I'm telling them it's all about their virtual primary care
and all the different things you can do with it,
well visited, hybrid care, sick visits, chronic condition management, just
it seems like it's just the endless possibility. So with
(29:18):
what they are able to do and I'm an extended hours,
seven days a week, it's crazy. So we're going to
find out a lot more about the future maybe of
what they can do and some other things of associated
with virtual primary care. Everybody stay with us here on
Carolina Focus.
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