“I Pride Myself on Making Connections”
On the desk in her home office on Florida’s Space Coast, Dr. Elmira Basaly keeps a 2017 letter from the sister of a woman she cared for as an Eagle TeleNocturnist. It reads: “Dr. Basaly was the most professional, caring individual we have ever encountered in a hospital setting. We are so grateful for the compassion she showed us.”
For Dr. Basaly, it’s more than a thank-you note. “It always reminds me that I’m doing it for the patients,” she says. “Knowing that family members remember us for what we did for their loved ones is very gratifying.”
Her desire to be a physician started early on. “I became a doctor because my mom was very ill with atrial fibrillation when I was growing up,” she says. “At age 8 or 9, I wanted to be the one to cure people suffering with this condition. I knew I wanted to help people.”
Years later, prior to becoming a TeleNocturnist with Eagle in 2015—the third TeleHospitalist to come on board after Dr. Jayne Lee, chief medical officer, and Dr. Brian Hunt—Dr. Basaly worked as an Eagle onsite hospitalist in South Carolina after completing her residency, and then became an Eagle locum tenens physician after she had her first child.
More time to build relationships
The onsite experience gives her an understanding of inpatient telemedicine care from both sides of the videoconferencing monitor. Which is better? She believes she builds a stronger connection with patients and their families as a telemedicine physician.
“When you’re working onsite in a hospital, there are so many factors involved that can impede you from building a relationship with patients and staff. With telemedicine, you just have more time to connect,” she says.
She takes pride in the fact that, through telemedicine, she is helping provide access to healthcare for people who might not have it otherwise—often very sick people in dire need of care. “Some of these people are in remote areas and we are all they have, particularly at nighttime,” she says.
Sometimes through the telemedicine “robot,” she’ll show patients photos of her children and engage them in conversations about their families. “You can’t actually hold a patient’s hand in telemedicine, but there are other ways to show empathy through tone of voice, facial expressions and simply pausing to let the patient talk. I pride myself on making these connections.”
Every night is different
Of the 15 hospitals where she has privileges to practice telemedicine, she typically covers five or six of them each night on her 7 p.m. to 7 a.m. shift, with approximately 10 patient encounters during that period.
On a typical night, one hospital might have five admissions for her to handle, and another might not have any admissions, only nursing calls. She might be alerted via Eagle’s secure paging system to attend to a rapid-response situation if a patient’s heart rate or blood pressure is elevated. If the situation requires electrocardioversion, she’ll ask the Emergency Department (ED) physician to work with her to get the patient’s heart rate under control.
On other nights, she might be called to respond to a patient who codes. “In these situations, we have a backup system with rooms set up so we can see cardiac monitors. The ED physician comes up and we work side-by-side until we resuscitate the patient collaboratively with medication or CPR.”
Other times, she’s providing a level of hospice care with the many elderly patients, especially in rural hospitals, who are dying. Many of them, interestingly, come to the hospital at night for admission. Heartier folks might be needing their rest for a lab test or a specialist consultation the following day. “I tell them not to worry. I say, ‘Let me worry for you. I know this is a tough thing to handle. I will just sit with you. You have my time.’”
Eagle’s operations team is critical to success
Dr. Basaly notes that she has strong support from the Eagle operations team. “Eagle has experienced extraordinary growth over the last few years and I am glad to be a part of it. One thing we can never forget is our operations teams. They work with our hospital partners and us to successfully get new programs launched and provide 24/7 support. I know when I call or text in the middle of the night for questions, they are always there. We use an Eagle proprietary software called ETHOS (Eagle Telehealth Operating System). It really makes our lives a lot easier when we are handling multiple hospitals each night.”
Applying higher standards across the board
Something else she appreciates about working with Eagle: Covering a range of hospitals has a way of lifting everyone to a higher standard.
“One hospital might want its pharmacy team rather than the nurses to update the medication reconciliation list,” she says. “Another might want unusually detailed medical and physical histories for patients. Another might have a sepsis or pneumonia quality initiative that requires certain order sets to be tracked in the EMR. What happens is that we typically incorporate one hospital’s standards across our guidelines for all the hospitals we work with. It’s one of the things that sets Eagle telemedicine apart. We really do provide exceptional care.”
Telemedicine allows time to be a mom, too
Most of all, she appreciates the fact that telemedicine enables her to continue to practice medicine and take care of her two boys—ages 4 and almost 2—at home.
“I feel it was my calling to be a parent. It’s a huge responsibility I share with my husband, and even working as a locum tenens physician didn’t give me enough time with my family. Then I learned about telemedicine. Early in my career I was told that I couldn’t be a doctor and a mom at the same time. Today, thanks to telemedicine, I am able to do just that.”