Selected Podcast
Telemedicine: Caring for Our Patients Now and in The Future – UPMC is Here for You
Dr. Robert Nielsen shares how the pandemic has changed patient care and the different ways UPMC Pinnacle is staying connected to their patients.
Featuring:
Dr. Nielsen earned his medical degree from Albany Medical College of Union University in New York, and he completed his residency in family medicine at Penn State Health Milton S. Hershey Medical Center.
Dr. Nielsen founded Annville Family Medicine almost 40 years ago. He has a special interest in population health management and the application of advanced technology, particularly telemedicine, to provide improved patient care. “Health care is all about relationships,” says Nielsen. “The greatest impact is derived when you realize how you can leverage health care concepts to connect high tech and high touch to benefit the patient.”
Dr. Nielsen has been published in numerous journals, and he has served as a medical consultant and co-investigator for research grants. He has presented across the country on topics relating to the Affordable Care Act, payer-provider partnerships, and the transition from fee for service to value-based care.
Robert Nielsen, MD
Robert Nielsen, MD, president, PinnacleHealth Medical Group, part of UPMC Pinnacle, oversees the management of more than 70 primary care and specialty care practices located across 10-counties in central Pa.Dr. Nielsen earned his medical degree from Albany Medical College of Union University in New York, and he completed his residency in family medicine at Penn State Health Milton S. Hershey Medical Center.
Dr. Nielsen founded Annville Family Medicine almost 40 years ago. He has a special interest in population health management and the application of advanced technology, particularly telemedicine, to provide improved patient care. “Health care is all about relationships,” says Nielsen. “The greatest impact is derived when you realize how you can leverage health care concepts to connect high tech and high touch to benefit the patient.”
Dr. Nielsen has been published in numerous journals, and he has served as a medical consultant and co-investigator for research grants. He has presented across the country on topics relating to the Affordable Care Act, payer-provider partnerships, and the transition from fee for service to value-based care.
Transcription:
Bill Klaproth (Host): So, how is UPMC still caring for patients during the Coronavirus health crisis? And how will this care continue for patients now and in the future? Well let’s find out with Dr. Robert Nielsen, President Pinnacle Health Medical Group at UPMC Pinnacle.
This is Healthier YOU, a podcast from UPMC Pinnacle. I’m Bill Klaproth. Dr. Nielsen, thank you so much for your time. We appreciate it. So, how is UPMC still caring for patients during this health crisis?
Robert Nielsen, MD (Guest): Well I think in our ambulatory practices, the important thing is to deliver care to the patients in whatever vehicle we need to do that. It’s about relationships. It’s about managing the person’s individual healthcare needs. It’s the opportunities to talk about things that are meaningful in their lives. We have to realize that this has been a frightening experience for many people including many of us in healthcare. And to try to allay their fears and give them the kind of care that they need. We’ve used a variety of techniques. We’ve used our traditional office visits which obviously, are much less utilized than they were prior to the epidemic and rightfully so. We’ve done a lot of telephone visits, both phone calls where patients have called in and done electronic visits via the telephone or outreach phone calls that we’ve made and then lastly, we’ve learned an awful lot about Telemedicine which is a platform we had been using but we had used probably on the average maybe 40 Telemedicine visits a week before COVID and now we are up above 7,000 a week which gives us a great vehicle to interact with our patients and many have let us know that they may prefer this as a way of interacting in the future.
Host: Wow, 7,000, that is amazing. So, from your perspective, and Telehealth is probably one of the main differences but what is different about the way patients are receiving care in this manner and then what hasn’t changed, what is the same?
Dr. Nielsen: Well I think what hasn’t changed is the interaction, the relationship. Primary care in particular is all relationship driven. And I think the more we can focus on the needs of the patient and meet them where they are at that time, the better off we are. It’s almost like you can see me in exam room one, you can see me in exam room two or you can see me via a telephone or a Telehealth type of visit. Telemedicine has been a tremendous opportunity to reach out to people. It’s fairly efficient once the technology gets down. We’ve been training our providers up in the skills of the “physical exam” via Telemedicine and there’s a lot of interesting best practices within that.
As we start to look at the future, it’s really going to give us an opportunity to serve people in a broader sense populations that we might not have had access to before and help us to address some of the issues of unmet healthcare needs and some healthcare disparity issues also.
Host: So, are there circumstances in which you are still seeing patients in person?
Dr. Nielsen: Yeah, there are. And I should say that we’ve really worked hard from day one to set up a “safe” environment for both our patients to feel comfortable and for our staff to feel comfortable. So, we made a decision early on to go through a series of screening processes where we were able to have patients who were concerned about respiratory symptoms, the majority of which were not COVID, to be screened, to be treated via advice by our nurses or by our physicians. Those that needed to have a respiratory exam done, we cohorted those patients to five sites that were geographically located across our regions. Those sites were better prepared with personal protective equipment and we were able to take care of a lot of patients in that situation so that the risk to other patients coming to the office could be limited.
We still provided care particularly for patients who had what we would consider essential services kind of ongoing medical problems that needed attention that could only be done in a physical environment perhaps where we would have to auscultate the chest to listen to the lungs or the heart or something along those lines. So, we still had I would say in the early stages of the epidemic, our total volume of visits dropped about a half, maybe a little bit more than that. The remaining visits we had probably about a third were in the in person visit area. We had a fair amount of telephone visits and then maybe 25 to 30% were on Telemedicine. Now, we’re doing about 50-60% Telemedicine. But still we have some patients coming in.
Host: Wow. Okay so, how about people that are suffering from chronic illnesses? How do the care teams help patients control chronic illness remotely?
Dr. Nielsen: Well we have a great opportunity in that over the last four to five years we have developed a care team model where we use a variety of health coaches, nurses, diabetic educators, clinicians, behavioral health providers as part of a team to deliver care and we were able to do a lot of outreach and really look to patients who are at high risk. I would say that early on, the first five weeks now again, remember we have 57 practices and our panel size of patients that we take care of is about 270,000 patients so we have about 30,000 people cancel their appointments. And we were able to very quickly reschedule a number of those, some which are going to be coming yet in June and some will be transitioning to video visits but with each of those rescheduled visits, with that phone call we made sure that the patient had enough medications. If they didn’t have – we checked with them as far as food and did they have food in their house, were they maintaining their weight, were there any unmet needs. Did they have the ability for social contact because obviously depression and behavioral health issues are very prevalent during an epidemic like this where people are isolated.
And it was amazing the stories that occurred from that and what our nurses and our medical assistants were able to help people with and how our community response team for lack of a better word in our UPMC Pinnacle family was able to get food banks hooked up and some great, great stories about success. We also did the same thing then with patients who were at high risk, who maybe didn’t have appointments. So, we are fortunate enough to be on one electronic health record throughout our system and in that, we’ve built what are called disease registries so we are able to look at those patients who were maybe diabetics who hadn’t been seen in a while or patients who had high risk scores and do the same type of quick five minute check in with people which was greatly appreciated and the staff just did a marvelous job at taking that to the nth degree as far as the hard work that they did and some really good outcomes.
Host: I can see where a call like that would very much be appreciated. So, then what if someone needs to get labwork or imaging to help with the visit or diagnosis? Can they feel safe and comfortable doing that?
Dr. Nielsen: They certainly can. We went through a period where in all of our ambulatory facilities, including our diagnostics that we tried to ramp down, so we all can learn about COVID together and learn what is the safest and the best practices. We’ve now developed a series of methods of making sure that we can practice social distancing, that we mask appropriately, that we’ve put together a stepped up cleaning process the is much more with the COVID type responses that are needed and really create an environment where the person can be – can feel to be comfortable. We’ve staggered schedules. We try to work on the fact that people can come in one entrance and out the other, so they don’t have to bump into each other in the halls and to try to really minimize accidental exposures if at all possible.
And that’s in good stead for our staff too. That’s very important for our staff. So, we feel very comfortable that we’re in that position and can do that safely and have the appropriate PPE to accomplish that and we’re very comfortable with that and hopefully our patients will see that and feel that way also.
Host: Right. Let me ask you this. Are you concerned that people are foregoing care and may wind up getting sicker or having complications because they are reticent to come to the doctor’s office?
Dr. Nielsen: Yeah, I certainly am. I feel a great deal of concern about that. Because we know there is a number of patients who have chronic illnesses or have multiple chronic illnesses and the ability to control and intervene those chronic illnesses, you can prevent hospitalizations, unnecessary emergency rooms, and deterioration and many, many times, those are parts of care that the patient has trouble distinguishing that they are starting to get into trouble. So, again, video visits are a home run in this area. But also even if it’s a phone call to the doctor’s office, or an email message to have a check point to make sure that there’s reasons that many of us ask our chronically ill patients to come back every three to four months, it’s because they are a little bit more fragile and we would choose to engage with them in some fashion and again, the Telemedicine platform does a great job of that also.
Host: So, what other services can your UPMC care team provide beyond healthcare needs? Because that’s important as well, right now.
Dr. Nielsen: Well I think we’ve really found that addressing the whole person needs – do they have enough food to eat. Do they have people to contact them. Are they having – are there problems in their household or around their household that they don’t know where to get help? We have a lot of people unfortunately who are on their own and don’t have a great social support system or one that can’t get to them right now. So, again, I think those are areas – sometimes hearing a familiar voice. I have often thought when I’m in – as I’ve practiced Primary Care that many times one of my nurses calling a patient or my medical assistant sometimes means more to the patient than when I see them in the office as much as I’d like to think differently. I have to admit that. So, there’s a lot of outreach like that that just makes a difference in how you feel and there’s a comfort factor then that the patients would have in communicating their needs to the staff and that can lead to some wonderful results.
Host: That is so true and then is UPMC looking at ways to start helping people have access to essential care and procedures again and why is that important and tell us what steps is it taking?
Dr. Nielsen: So, we are, very definitely working within the guidelines and the recommendations of our state and federal government. There are many healthcare services, if they are delayed, they have outcomes down the line that are much more severe and much more consequential. So, in order to approach this and this is many times in the procedural or surgical area, we pretest any patients coming to the hospital for those services about 48 hours before they would arrive at the hospital. We ask them then to quarantine until they get there. And we make sure that they understand the risks and benefits of doing the procedure now as opposed to delaying it and that’s so important. That communication between the patient and their family and their healthcare providers. Why should I do this now instead of three weeks from now? What are the risks if I delay it? And there can be risks.
We had one case I’m aware of a woman who had a bad back and she had a lot of discogenic disease, and she couldn’t move, and she was scared, and she developed a decubitus because of that. And again, much more complicated than if we could have done her back surgery eight weeks ago. So, we’re looking at how we protect people. We’re looking at the protective gear we have for staff. We look at ways to minimize aerosolization of droplets and we can move forward in a much safer environment for the patients and we are looking at bringing people in again, acknowledging the importance of spacing and scheduling and minimizing that potential contact.
Host: So, Dr. Nielsen as a physician during probably the biggest health crisis in all of our lives; what’s your overall thought of this or view of the care being provided and any other thoughts you can provide as I think it would be interesting just to hear your perspective.
Dr. Nielsen: I’ve just been amazed. I’ve been in Primary Care for over 40 years. I had the pleasure of working in a really great group practice for about 35 years until I came to UPMC Pinnacle. But to watch how quickly our teams have mobilized both here in the ambulatory space but also in the leadership throughout the hospital, it have been just amazing to watch people collaborate across disciplines, look at problem solving in a very intense, a very rapid fire mechanism and always put the patient first. It has just been incredible the accuracy with the decisions that have been made by our staff in a time period where the science of what we’re dealing with has really changed. What we knew March 1st versus what we know today is very, very different. And some of them have – some of those changes have necessitated us changing approaches to patients in how we would do things. It’s also some of the reason that our patients are scared and confused at home because they think the data should be the same all the way through and it hasn’t. We’re learning. We’re learning as we go.
We’re learning what medicines may work. We’re learning what procedures may work. But it has been an incredible experience to be in a leadership role of a healthcare team that’s working with that. We like to remind people that if you’re having illness, please make sure you reach out. We have doctors and nurses who are available. Your primary care doctors. Our nurses Lifeline does an incredible job with triage. Their volume of calls during the early four to five weeks of COVID have gone up between two to three times their normal calls. They’ve been a great function as to saying who should go. We developed a COVID advice team of nurses and physicians who could handle COVID questions. If people are having any symptoms of a life threatening illness, we really need to pay attention to those. There are a number of stories that we’ve heard throughout the country of people who were having early symptoms of a stroke, who were afraid to come to the hospital because they were afraid, they were going to pick up COVID and be exposed to it. We have to pay attention to those things. Heart attacks that were missed because people were frightened. We can do a pretty good job at keeping people safe. We’re really – have worked hard at making our facilities safe and so I think in those emergency situations, it’s really important to continue to follow your basic process if you are having chest pain and shortness of breath it may not be COVID it may be a heart attack. So, we need to get you where we can give you great care.
And lastly, the whole area of chronic care. People need to pay attention to their chronic care. Need to pay attention to those preventative things that are safe to do today and then we can help them navigate this crisis. Very few of us were here 100 years ago, let alone I don’t think any of us were practicing medicine 100 years ago when the last pandemic hit. So, this is all new to us and it has really been an incredible experience to see the staff I work with everyday it’s been a privilege and makes you just so proud to be attached to an organization that has been able to pull together like this for the community.
Host: So, well said. I love what you said earlier, always put the patient first and how that always guides your decisions at UPMC Pinnacle. Dr. Nielsen, this has really been informative. Thank you so much for your time. We really appreciate it.
Dr. Nielsen: My absolute pleasure. Thank you for having me.
Host: That’s Dr. Robert Nielsen and for more information please visit www.upmcpinnacle.com/videovisits. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier YOU, a podcast from UPMC Pinnacle. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): So, how is UPMC still caring for patients during the Coronavirus health crisis? And how will this care continue for patients now and in the future? Well let’s find out with Dr. Robert Nielsen, President Pinnacle Health Medical Group at UPMC Pinnacle.
This is Healthier YOU, a podcast from UPMC Pinnacle. I’m Bill Klaproth. Dr. Nielsen, thank you so much for your time. We appreciate it. So, how is UPMC still caring for patients during this health crisis?
Robert Nielsen, MD (Guest): Well I think in our ambulatory practices, the important thing is to deliver care to the patients in whatever vehicle we need to do that. It’s about relationships. It’s about managing the person’s individual healthcare needs. It’s the opportunities to talk about things that are meaningful in their lives. We have to realize that this has been a frightening experience for many people including many of us in healthcare. And to try to allay their fears and give them the kind of care that they need. We’ve used a variety of techniques. We’ve used our traditional office visits which obviously, are much less utilized than they were prior to the epidemic and rightfully so. We’ve done a lot of telephone visits, both phone calls where patients have called in and done electronic visits via the telephone or outreach phone calls that we’ve made and then lastly, we’ve learned an awful lot about Telemedicine which is a platform we had been using but we had used probably on the average maybe 40 Telemedicine visits a week before COVID and now we are up above 7,000 a week which gives us a great vehicle to interact with our patients and many have let us know that they may prefer this as a way of interacting in the future.
Host: Wow, 7,000, that is amazing. So, from your perspective, and Telehealth is probably one of the main differences but what is different about the way patients are receiving care in this manner and then what hasn’t changed, what is the same?
Dr. Nielsen: Well I think what hasn’t changed is the interaction, the relationship. Primary care in particular is all relationship driven. And I think the more we can focus on the needs of the patient and meet them where they are at that time, the better off we are. It’s almost like you can see me in exam room one, you can see me in exam room two or you can see me via a telephone or a Telehealth type of visit. Telemedicine has been a tremendous opportunity to reach out to people. It’s fairly efficient once the technology gets down. We’ve been training our providers up in the skills of the “physical exam” via Telemedicine and there’s a lot of interesting best practices within that.
As we start to look at the future, it’s really going to give us an opportunity to serve people in a broader sense populations that we might not have had access to before and help us to address some of the issues of unmet healthcare needs and some healthcare disparity issues also.
Host: So, are there circumstances in which you are still seeing patients in person?
Dr. Nielsen: Yeah, there are. And I should say that we’ve really worked hard from day one to set up a “safe” environment for both our patients to feel comfortable and for our staff to feel comfortable. So, we made a decision early on to go through a series of screening processes where we were able to have patients who were concerned about respiratory symptoms, the majority of which were not COVID, to be screened, to be treated via advice by our nurses or by our physicians. Those that needed to have a respiratory exam done, we cohorted those patients to five sites that were geographically located across our regions. Those sites were better prepared with personal protective equipment and we were able to take care of a lot of patients in that situation so that the risk to other patients coming to the office could be limited.
We still provided care particularly for patients who had what we would consider essential services kind of ongoing medical problems that needed attention that could only be done in a physical environment perhaps where we would have to auscultate the chest to listen to the lungs or the heart or something along those lines. So, we still had I would say in the early stages of the epidemic, our total volume of visits dropped about a half, maybe a little bit more than that. The remaining visits we had probably about a third were in the in person visit area. We had a fair amount of telephone visits and then maybe 25 to 30% were on Telemedicine. Now, we’re doing about 50-60% Telemedicine. But still we have some patients coming in.
Host: Wow. Okay so, how about people that are suffering from chronic illnesses? How do the care teams help patients control chronic illness remotely?
Dr. Nielsen: Well we have a great opportunity in that over the last four to five years we have developed a care team model where we use a variety of health coaches, nurses, diabetic educators, clinicians, behavioral health providers as part of a team to deliver care and we were able to do a lot of outreach and really look to patients who are at high risk. I would say that early on, the first five weeks now again, remember we have 57 practices and our panel size of patients that we take care of is about 270,000 patients so we have about 30,000 people cancel their appointments. And we were able to very quickly reschedule a number of those, some which are going to be coming yet in June and some will be transitioning to video visits but with each of those rescheduled visits, with that phone call we made sure that the patient had enough medications. If they didn’t have – we checked with them as far as food and did they have food in their house, were they maintaining their weight, were there any unmet needs. Did they have the ability for social contact because obviously depression and behavioral health issues are very prevalent during an epidemic like this where people are isolated.
And it was amazing the stories that occurred from that and what our nurses and our medical assistants were able to help people with and how our community response team for lack of a better word in our UPMC Pinnacle family was able to get food banks hooked up and some great, great stories about success. We also did the same thing then with patients who were at high risk, who maybe didn’t have appointments. So, we are fortunate enough to be on one electronic health record throughout our system and in that, we’ve built what are called disease registries so we are able to look at those patients who were maybe diabetics who hadn’t been seen in a while or patients who had high risk scores and do the same type of quick five minute check in with people which was greatly appreciated and the staff just did a marvelous job at taking that to the nth degree as far as the hard work that they did and some really good outcomes.
Host: I can see where a call like that would very much be appreciated. So, then what if someone needs to get labwork or imaging to help with the visit or diagnosis? Can they feel safe and comfortable doing that?
Dr. Nielsen: They certainly can. We went through a period where in all of our ambulatory facilities, including our diagnostics that we tried to ramp down, so we all can learn about COVID together and learn what is the safest and the best practices. We’ve now developed a series of methods of making sure that we can practice social distancing, that we mask appropriately, that we’ve put together a stepped up cleaning process the is much more with the COVID type responses that are needed and really create an environment where the person can be – can feel to be comfortable. We’ve staggered schedules. We try to work on the fact that people can come in one entrance and out the other, so they don’t have to bump into each other in the halls and to try to really minimize accidental exposures if at all possible.
And that’s in good stead for our staff too. That’s very important for our staff. So, we feel very comfortable that we’re in that position and can do that safely and have the appropriate PPE to accomplish that and we’re very comfortable with that and hopefully our patients will see that and feel that way also.
Host: Right. Let me ask you this. Are you concerned that people are foregoing care and may wind up getting sicker or having complications because they are reticent to come to the doctor’s office?
Dr. Nielsen: Yeah, I certainly am. I feel a great deal of concern about that. Because we know there is a number of patients who have chronic illnesses or have multiple chronic illnesses and the ability to control and intervene those chronic illnesses, you can prevent hospitalizations, unnecessary emergency rooms, and deterioration and many, many times, those are parts of care that the patient has trouble distinguishing that they are starting to get into trouble. So, again, video visits are a home run in this area. But also even if it’s a phone call to the doctor’s office, or an email message to have a check point to make sure that there’s reasons that many of us ask our chronically ill patients to come back every three to four months, it’s because they are a little bit more fragile and we would choose to engage with them in some fashion and again, the Telemedicine platform does a great job of that also.
Host: So, what other services can your UPMC care team provide beyond healthcare needs? Because that’s important as well, right now.
Dr. Nielsen: Well I think we’ve really found that addressing the whole person needs – do they have enough food to eat. Do they have people to contact them. Are they having – are there problems in their household or around their household that they don’t know where to get help? We have a lot of people unfortunately who are on their own and don’t have a great social support system or one that can’t get to them right now. So, again, I think those are areas – sometimes hearing a familiar voice. I have often thought when I’m in – as I’ve practiced Primary Care that many times one of my nurses calling a patient or my medical assistant sometimes means more to the patient than when I see them in the office as much as I’d like to think differently. I have to admit that. So, there’s a lot of outreach like that that just makes a difference in how you feel and there’s a comfort factor then that the patients would have in communicating their needs to the staff and that can lead to some wonderful results.
Host: That is so true and then is UPMC looking at ways to start helping people have access to essential care and procedures again and why is that important and tell us what steps is it taking?
Dr. Nielsen: So, we are, very definitely working within the guidelines and the recommendations of our state and federal government. There are many healthcare services, if they are delayed, they have outcomes down the line that are much more severe and much more consequential. So, in order to approach this and this is many times in the procedural or surgical area, we pretest any patients coming to the hospital for those services about 48 hours before they would arrive at the hospital. We ask them then to quarantine until they get there. And we make sure that they understand the risks and benefits of doing the procedure now as opposed to delaying it and that’s so important. That communication between the patient and their family and their healthcare providers. Why should I do this now instead of three weeks from now? What are the risks if I delay it? And there can be risks.
We had one case I’m aware of a woman who had a bad back and she had a lot of discogenic disease, and she couldn’t move, and she was scared, and she developed a decubitus because of that. And again, much more complicated than if we could have done her back surgery eight weeks ago. So, we’re looking at how we protect people. We’re looking at the protective gear we have for staff. We look at ways to minimize aerosolization of droplets and we can move forward in a much safer environment for the patients and we are looking at bringing people in again, acknowledging the importance of spacing and scheduling and minimizing that potential contact.
Host: So, Dr. Nielsen as a physician during probably the biggest health crisis in all of our lives; what’s your overall thought of this or view of the care being provided and any other thoughts you can provide as I think it would be interesting just to hear your perspective.
Dr. Nielsen: I’ve just been amazed. I’ve been in Primary Care for over 40 years. I had the pleasure of working in a really great group practice for about 35 years until I came to UPMC Pinnacle. But to watch how quickly our teams have mobilized both here in the ambulatory space but also in the leadership throughout the hospital, it have been just amazing to watch people collaborate across disciplines, look at problem solving in a very intense, a very rapid fire mechanism and always put the patient first. It has just been incredible the accuracy with the decisions that have been made by our staff in a time period where the science of what we’re dealing with has really changed. What we knew March 1st versus what we know today is very, very different. And some of them have – some of those changes have necessitated us changing approaches to patients in how we would do things. It’s also some of the reason that our patients are scared and confused at home because they think the data should be the same all the way through and it hasn’t. We’re learning. We’re learning as we go.
We’re learning what medicines may work. We’re learning what procedures may work. But it has been an incredible experience to be in a leadership role of a healthcare team that’s working with that. We like to remind people that if you’re having illness, please make sure you reach out. We have doctors and nurses who are available. Your primary care doctors. Our nurses Lifeline does an incredible job with triage. Their volume of calls during the early four to five weeks of COVID have gone up between two to three times their normal calls. They’ve been a great function as to saying who should go. We developed a COVID advice team of nurses and physicians who could handle COVID questions. If people are having any symptoms of a life threatening illness, we really need to pay attention to those. There are a number of stories that we’ve heard throughout the country of people who were having early symptoms of a stroke, who were afraid to come to the hospital because they were afraid, they were going to pick up COVID and be exposed to it. We have to pay attention to those things. Heart attacks that were missed because people were frightened. We can do a pretty good job at keeping people safe. We’re really – have worked hard at making our facilities safe and so I think in those emergency situations, it’s really important to continue to follow your basic process if you are having chest pain and shortness of breath it may not be COVID it may be a heart attack. So, we need to get you where we can give you great care.
And lastly, the whole area of chronic care. People need to pay attention to their chronic care. Need to pay attention to those preventative things that are safe to do today and then we can help them navigate this crisis. Very few of us were here 100 years ago, let alone I don’t think any of us were practicing medicine 100 years ago when the last pandemic hit. So, this is all new to us and it has really been an incredible experience to see the staff I work with everyday it’s been a privilege and makes you just so proud to be attached to an organization that has been able to pull together like this for the community.
Host: So, well said. I love what you said earlier, always put the patient first and how that always guides your decisions at UPMC Pinnacle. Dr. Nielsen, this has really been informative. Thank you so much for your time. We really appreciate it.
Dr. Nielsen: My absolute pleasure. Thank you for having me.
Host: That’s Dr. Robert Nielsen and for more information please visit www.upmcpinnacle.com/videovisits. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier YOU, a podcast from UPMC Pinnacle. I’m Bill Klaproth. Thanks for listening.