Telehealth to the Rescue

For two years, the EVMS Street Health team worked passionately to serve those experiencing homelessness in Hampton Roads. But as the COVID‑19 pandemic forced clinics to close, student volunteers were left searching for new ways to provide for their patients.

The student-led HOPES (Health Outreach Partnership of EVMS Students) Free Clinic was facing a similar problem. As the only free clinic in Norfolk, HOPES provides patient-centered care to hundreds of uninsured residents in Hampton Roads. With clinic doors closed, its patients had nowhere to go.

As both groups are Community-Engaged Learning initiatives and all learning had been moved online, student volunteers weren’t required to keep caring for patients. But the idea of walking away never crossed their minds.

The HOPES team decided to transition to telehealth for their clinics. They began providing primary and mental-health care as early as March 19.

“We had our clinic coordinators reach out to all of our patients to offer phone and video appointments,” says Brianna Kelly, MD Class of 2022, and student Co-director of the clinic. “They were able to recognize any concerns and note those who required prescription refills.”

The solution wasn’t as easy for Street Health. “Our first thought was to try to provide care via telephone or video calls like HOPES,” says Katherine Schaffer, MD Class of 2022. “But we realized that it probably wouldn’t work because of our community’s limited access to phones and computers.”

With that in mind, student leaders decided to set up telehealth clinics at Freemason Baptist Church in downtown Norfolk. HOPES donated four laptops, and Street Health team members set up the computers ahead of the weekly clinics and left before patients arrived. Each week at least two doctors and two students would take calls and address myriad medical concerns from wound care to mental health.

“If someone required additional care, we are able to refer them to HOPES or one of our partners for additional follow-up care,” Ms. Schaffer says.

While the solution helped the team stay connected to their patient community, it also came with a few challenges. “We don’t have any students or physicians there in person, so we have limited ability to complete exams and do labs,” Ms. Schaffer says. “These can really help us make diagnoses and determine the severity of our patients’ conditions.”

Despite the hardships, the transition has exceeded expectations. “The clinic has been wildly successful, and patients have expressed their gratitude for continuing health services in this season,” says Amanda Gibson, MD, Assistant Professor of Family and Community Medicine and HOPES Clinic Director. “Volunteer physicians have cared for patients remotely with various concerns, including depression, muscular injuries, substance use disorders and chest pain.”

In addition to helping with telehealth appointments, Dr. Gibson says Street Health volunteers went above and beyond to serve those in need. Hilde Franklin, MD Class of 2021, felt a responsibility to help and spearheaded a mask-making effort.

“I taught myself how to sew,” Ms. Franklin says, “which was a steep learning curve. But I finally got the hang of it and made around 120 masks." She also collected masks from the COVID‑19 Mask Force, fellow classmates and community groups to distribute to Street Health patients.

Mary Meehan and Andy Abayan, both of the MD Class of 2021, created care packages, which included hand sanitizer, soap, dental hygiene supplies and barrier contraception, to distribute to patients.

“I have been so impressed by the creativity and ingenuity of our students during this unprecedented time,” Dr. Gibson says. “They have been tireless and unstoppable in reaching out to some of Norfolk's most vulnerable and in need.”