Virtual Medicine

Physician: Gavin Helton, M.D., Medical Director of Ambulatory Medicine, Mercy Virtual Care Center, Chesterfield, Missouri

Undergraduate: St. Louis University

Medical School: University of Alabama School of Medicine, Birmingham

Residency/Internship: Mercy Hospital (formerly St. John’s Mercy Medical Center), Internal Medicine, St. Louis

Gavin Helton, M.D., was born and raised in Mobile, Alabama. Both of his parents were nurses. After serving as the chief medical resident at St. John’s Mercy Medical Center (now Mercy Hospital), Helton remained on the teaching staff there and practiced primary care in the St. Louis area for 17 years.

In November 2014, a steering committee within Mercy identified him and presented him the opportunity to be Mercy Virtual’s medical director of ambulatory medicine. Initially, he turned down the opportunity, saying that he didn’t know what it entailed, had more than full-time work, enjoyed practicing and wasn’t looking for a career change.

Several weeks later, however, a physician from the committee approached him and asked to discuss the potential of virtual care to address the current unmet needs of their patients.

Helton thought of his own complex, chronically ill patients and the gaps in care inherent in the current system. He also saw the need to assist primary care physicians with their often-overwhelming task of caring for these patients and decided to make the move into virtual medicine.

How does virtual medicine work, and how do you like practicing it?

Virtual care allows for identification of the obstacles to care, and we address those in a proactive, preventative manner. This approach prevents unnecessary emergency department utilization and hospital admissions while improving quality of life for the patient.

We have developed the program to be part of each individual patient’s care team. I am careful not to replace anyone. I work very closely with the primary care physician, subspecialists and care management . . . to fill the gaps in care.

The focus is shifted from hospital care to patient-focused care—delivered where and when the patients require it. We deploy peripheral devices, like blood pressure monitors, pulse oximeters and scales into the home. These connect wirelessly to a computer tablet to keep us updated on a patient’s condition.

We’ve also been adding a triage software that allows for interaction between the patient at home and the virtual care team located at Mercy’s Virtual Care Center in Chesterfield, Missouri.

Through centralized monitoring and data analytics, virtual care allows timely and effective therapeutic medical intervention. I document within the electronic health record, which allows all care team members to communicate in real time. The virtual care team, PCP, subspecialists and care management are on the same page.

What is the most challenging aspect of your role?

I certainly miss my former patients; however, I have developed strong relationships with virtual patients, their caregivers and other members of the health care team.

Why did you choose virtual medicine?

I made the difficult decision to leave my practice of more than 5,000 active patients in order to develop a program of helping significantly more patients.

Do you have any advice for physicians who might like to pursue virtual medicine?

The opportunities for a telemedicine physician are limitless, including personalized patient care in any specialty without geographic or time barriers.

My advice to other physicians is to be comfortable challenging the accepted norm. Be willing to think out of the box and have a health care system willing to invest in the infrastructure required to be successful in this environment.

No special training is required and all specialties will benefit, provided they are open to non-traditional solutions. While we visit virtually with our patients, at other times, we can send outpatient education and questions they can view or answer at their convenience.

Simplified, virtual care is the leveraging of technology to allow for a patient care continuum with a combination of traditional care team members working hand in hand with the virtual care team.

What surprised you about virtual medicine?

I have been surprised by how quickly new relationships have developed and how quickly patients of all ages and backgrounds successfully embrace the technology. They become more engaged in their care, and subsequently, patient outcomes and satisfaction improve.

Anything else?

My initial concerns were [about whether I could] develop personal relationships with patients and their caregivers as I had done the previous 17 years. Absolutely!

I have found being in the home and more frequent contact allow for an individualized approach to care. I get to know the patients and caregivers in the comfort of their home environment.

I was also concerned my clinical skills would deteriorate if I [was] not at the physical bedside.

I have found that in focusing on the sickest 5 percent of our chronically ill, I have the opportunity to spend more time focusing on the clinical challenges associated with caring for these complex conditions, and I believe we will develop a new standard of care as we have the ability to medically intervene in a more timely fashion and can follow up on these changes as frequently as the patient’s situation dictates.