Oregon Health & Science University’s virtual immediate care program ballooned beginning with the onset of the COVID-19 pandemic. In March of 2020, the total number of monthly visits nearly quadrupled from the previous month, to almost 800. (OHSU)

Booming growth in Oregon Health & Science University’s virtual immediate care program doesn’t surprise Ira Pollock one bit.

Pollock, a retired electrical engineer from Hillsboro, took advantage of the program on Feb. 3 when he needed immediate care after testing positive for COVID-19. Within a couple of hours, he was connected on a tablet to an OHSU physician assistant who quickly prescribed the antiviral medication Paxlovid.

“The primary benefit was just how quick and timely it was,” he said. “I’m sure if I had to go into the office it would have been at least a day or several days — long enough that it would have been too late to start Paxlovid.”

Pollock, 73, got started on the antiviral quickly enough that he fully recovered and was back in the gym in about a week.

He also appreciated avoiding unnecessary exposure to other patients.

“I certainly didn’t want to expose anybody else, nor did I particularly want to pick up anything worse,” he said.

OHSU and other health care facilities continue to require masking and other measures that minimize the risk of spreading SARS-CoV-2 and other viruses — particularly through the surge in respiratory illnesses Oregon hospitals experienced this winter. At the same time, OHSU program officials say patients report that they like saving a trip to an urgent care clinic or emergency room for an array of conditions that don’t necessarily require a hands-on examination.

Common conditions seen through OHSU’s virtual model include:

• Respiratory illnesses like COVID-19; bladder or urinary tract infections; and pink eye.
• Minor injuries, including cuts, sprain and burns.
• Skin issues such as sunburn, insect bites or rashes.

Ryan Morin, D.N.P., F.N.P.-B.C. (OHSU)

The program, which started in fall 2017 as a way of extending service to people who prefer a virtual visit, ballooned beginning with the onset of the COVID-19 pandemic. In March 2020, the total number of monthly visits nearly quadrupled from the previous month to almost 800.

“When COVID-19 happened, it forced patients to use utilize this type of care and got them familiar with it,” said Ryan Morin, D.N.P., F.N.P.-B.C., an emergency medicine instructor in the OHSU School of Medicine who is licensed to see patients virtually in Oregon and Washington through the program. “Patients’ attitudes and expectations have changed.”

Rise in virtual care

Indeed, virtual immediate care visits have remained steady since the pandemic.

In fact, the pace accelerated by the end of 2022, with almost 1,000 visits for the month of December when hospital capacity across the region was stretched thin. Emergency departments were crowded with a wave of respiratory illnesses, on top of an influx of patients with all medical conditions who had delayed care earlier in the pandemic.

“In December 2022, we hit the highest volume of video virtual visits in the program’s history,” said Lauren Snyder, D.O., the program’s medical director and an assistant professor of emergency medicine in the OHSU School of Medicine.

The program is well-suited for patients like Pollock who don’t necessarily need a hands-on exam, added Stefanie Roland, associate administrator for the OHSU Department of Emergency Medicine.

The program works especially well for older patients getting started on antiviral medications like Paxlovid for treating COVID-19.

“As long as they have a pharmacy nearby, we can save them a trip to the hospital,” she said.

OHSU program leaders say upper respiratory illnesses account for about three-quarters of the visits, with each virtual appointment lasting between 20 and 30 minutes. In about 10% of the cases, an initial virtual assessment requires an in-person visit for matters such as an X-ray or blood draw.

Almost half of the patients return for other virtual visits months or even years later — an endorsement of the service.

The program is staffed with a total of nine clinicians who cover shifts that run from 7 a.m. to 9 p.m. on weekdays and 8 a.m. to 8 p.m. on Saturdays and Sundays. The program is also currently the only facility in Oregon offering the antiviral medication remdesivir, a COVID-19 treatment, in an outpatient treatment setting.

“We’ve learned that if you staff it, they will come,” Roland said. “The same patients are recommending it to their children, friends and family.”