Due to the COVID-19 pandemic, how patients are managed has changed dramatically and more change is expected for practicing urologists. Telehealth platforms are rapidly evolving to allow for sharing of diagnostic imaging and interactive education about disease process and treatment options, according to experts who spoke at a session entitled “Re-imagining Our Independent Urology Practices: What’s the New Normal?” at the Large Urology Group Practice Association (LUGPA) 2021 annual meeting.

“Not all follow-up care needs to be done in person. Telepathology has enormous potential for remote testing of urinary and even finger stick blood samples, which can be sent to our labs via commercial parcel companies,” said panelist Thomas Rechtschaffen MD, a urologist with Advanced Urology Centers of New York, a division of Integrated Medical Professionals PLLC, New York, New York.

He added, “I have been advocating in Washington DC on behalf of the AUA for deregulation of telehealth legislation to allow for its expansion and broader access. The regulatory waivers implemented at the start of the pandemic were the proverbial crack in the door we’ve been asking for and has allowed Medicare to reimburse for telehealth services.”

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In addition, clinicians should examine all the options for home testing to diagnose patients, Dr Rechtschaffen said. There are steps urologists can take to reduce the likelihood of emergency department visits or inpatient post-operative stays. Currently, many patients are still fearful of going to the hospital during infectious disease outbreaks.

The urology community has now seen what’s possible because of the pandemic. The new tools and modalities now being adopted, however, need to ensure that they benefit both physicians and patients, Dr Rechtschaffen said. “Challenge your notions about delivery of care and consider all the ways remote care can improve your career satisfaction, your employees’ productivity, your patients’ experience, and the efficiencies of your practices’ functionality,” he said.

“Adaptability, flexibility, and standardization within a practice is more important than ever,” said panelist Kim Ramsey, chief operating officer for Urology of Virginia. “It is an opportune time to change the ‘this is how we’ve always done it mentality.’”

Another panelist, urologist Neal Patel, MD, chief technology officer and Director of Robotic Surgery at the Advanced Urology Institute of Georgia in Atlanta, said for him “the new normal” of urology is 3-fold: further migration of more complex procedures like robotics and laparoscopy to the outpatient surgical setting, making hospitals true tertiary care centers; responding to nationwide staffing shortages with automation of both front and back office positions using robotic process automation (RPA) and new technology; and adopting collaborative platforms to allow instantaneous cross practice and cross position communication.

“Some examples include our outpatient patient urologic robotic program which we established two years ago as the nation’s first non-hospital affiliated true outpatient program in a standalone ASC [ambulatory surgery center]. COVID enabled changes allowed this program to take off which aligned payor, patients and providers,” Dr Patel said.

RPA has allowed his team to develop a reliable automated workforce that allows the practice to have software working 24/7 all year round, mimicking human tasks in the EMR, practice administration, billing, medical records, and insurance portals. “This allows us to be less reliant on workforce staffing and talent acquisition costs and decrease practice overhead,” Dr Patel said.

His office experienced challenges in both indirect clinical and non-clinical staffing as a result of the pandemic, especially in the arena of positions that have a large amount of repetitive and mundane tasks. “COVID has created opportunities more than anything else,” Dr Patel said. “I’m a big believer that quickly and sometimes drastically adapting to major events like COVID results in interesting news processes and innovative technology adoptions.”

This new environment resulted in many providers looking at alternatives ways to run their business in the short-term, but Dr Patel said it also opened urologists’ eyes to the fact that these same changes could protect and optimize their practice long-term. “What worked before will not work in the future,” Dr Patel said. “Reimbursement for services will stay the same or decline while overhead continues to rise. We need to increase our reliance on automation and less on staffing.”