I have served for a number of years on the board of the Association of Children’s Residential Centers. Our raison d’être is serving complicated youth and their families, and doing it with heart. These organizations provide typically very “high touch” services to youth going through crises. COVID-19 has been particularly challenging in some unique ways – most of these organizations continue to serve youth, but there are many considerations for doing so safely while making sure we are fully supporting youth and their families during a very critical time in their lives. Late last month, alongside colleagues from other member agencies shared our experiences using telemedicine.

Although I was not doing telemedical services right at the time I moderated this, I have been conducting some select services via telemedicine since then. It is a truly complicated undertaking on many levels, ranging from HIPAA compliance to communicating expectations clearly to patients. On the other hand, many organizations, including the American Psychological Association, have stepped forward to help practitioners figure this out.

For me, personally, I have found this very rewarding, and my patients have been very open and collaborative in dealing with these uncertainties with me. It makes me feel more connected to the people I serve. They are in need, and this is a safe, if imperfect way to do it. Selfishly, and something that I want to spotlight on a different webinar (with a different partner) later this week, it also helps me deal with my own sense of uselessness during this crisis. Much of my engagement has been online – at first, getting people to take this crisis seriously, helping guide people to accurate and scientifically informed data and helping them understand the limitations in what we know. I’ve continued advocating for the disability communities whom I serve online. However, I’m used to being on the front lines – I spent almost the entirety of my training (seven years) in hospitals (and before that, on a different front line, in the manufacturing world), and it’s only been the nine years since then that I have not been on the front lines.

Here are our thoughts, and our encouragement. It is still a good time to think about these issues and consider launching telemedicine services.

 

Edit: I quickly created this post last night, while ensuring panelist permission to publish this, and in the morning, I also saw this great piece from Dr. Rosenthal, a pediatrician at Yale. I don’t usually see infants, but I see many toddlers in my practice, and like her, I find so much rewarding about being connected to my families via telemedicine, and also frustration – it will be a long time before camera technology is adequate to give the kind of in-the room “Witcher sense” we all have, and allow us to notice all the subtle things about our patient’s breathing, subtle changes in their attention and affect, and all the other cues that are so important to doctors like her and myself. 

Edit 2: The next day, Washington Post ran this excellent piece for patients, helping them understand what care might be put off, what care should not be put off, and what care is and is not appropriate for telemedicine. That last point is a critical one, which we touched on briefly in the webinar, too. 

As I noted in other recent blog posts, Mira Krishnan LLC has been using various partnerships to assist with as well as produce webinar content that helps advocate for embracing, supporting, and empowering special populations, all within our longstanding goal of powering up the world through diversity. If you want to work with us, let me know!