High-Tech House Calls: Order of Malta Clinic Adopts Telemedicine During Pandemic

Telehealth has grown dramatically since the onset of the pandemic, including in Oakland, California.

Dr. Thomas Wallace conducts a telemedicine call at the Order of Malta Clinic in Oakland, California.
Dr. Thomas Wallace conducts a telemedicine call at the Order of Malta Clinic in Oakland, California. (photo: Courtesy of the Order of Malta Clinic)

OAKLAND, Calif. — The COVID-19 pandemic is changing the way the Diocese of Oakland’s Order of Malta Clinic is doing business. Fears of spreading COVID-19 led to the small, pro bono health clinic to physically shut its doors to patients, but volunteer medical staff are continuing their work through “telemedicine,” aided by a new partnership with Southern California-based medical software maker Kareo. When the pandemic further slows, the clinic will reopen its physical doors, but telemedicine is sure to play an important role in the clinic’s future.

Located alongside the entrance to the diocese’s Cathedral of Christ the Light in downtown Oakland, the Order of Malta Clinic was founded in 2008 at the request of the diocesan bishop under the auspices of the Order of Malta Western Association. Its purpose was to provide medical care free of charge to the uninsured and underinsured. Many of its staff are volunteers, and its 1,800-square-foot space is provided rent free via the Diocese of Oakland. It has received more than 35,000 patient visits since its founding, with 60,000 volunteer hours contributed.


A Good Connection

As concerns about the spread of COVID-19 led to a temporary closure of many businesses and institutions earlier this year, the clinic’s board thought closing the clinic’s physical doors was the best course of action, said Dr. Michael Matly, a board member who has a background in medical technology. He explained, “We wanted to protect our vulnerable patients, and as a high number of our volunteer physicians are older, we didn’t want to put them at risk, as well.”

Yet wanting to continue its work among the needy, on May 6 the clinic announced a telemedicine expansion. Irvine-based medical software maker Kareo offered the clinic pro bono the necessary technology so that its physicians could prescribe medications, place orders for lab work and easily manage each patient’s medical history with electronic health records. Matly spearheaded the effort to adopt the new technology.

Dr. Thomas Wallace, age 90, is a volunteer Order of Malta Clinic physician and a Knight of Malta himself. His Catholic faith has motivated him to forego retirement and donate his talents to help improve the health of the poor. He explained, “For many of our patients, our clinic is the only source of medical care they have access to. Before the transition to telemedicine, it was disturbing not being able to communicate with them. During a time of social distancing and following the shelter-in-place mandate, this is a window of hope to a community that is desperately in need of regular medical attention.”

The service, as is the case with all clinic services, is “completely free to our patients,” noted Sara Cumbelich, a Dame of Malta who is also on the clinic board. There are no plans to reopen the doors of the clinic anytime soon, Matly explained, so telemedicine will play a key role in the clinic’s operation for months to come. Additionally, once the clinic’s doors do reopen, telemedicine will likely continue as a significant component of the clinic’s operation.


A Phone Call Away

When patients are in need of medical care, they can call the clinic and make an appointment. They will be scheduled with a physician and receive an email link or text to click in order to teleconnect. Although the Kareo software allows for a quality video image, in its first few weeks of operation the doctor consultations have all been over the phone. Wallace explained, “So far it’s been awkward for the population of uninsured we serve to use the video capacity available.”

He also noted that the number of patients he sees has fallen to 15 or 20 a day, about half the number he saw before the pandemic.

Matly notes that while videoconference medicine has its strengths, it also has its drawbacks. On the plus side, the clinic is able to expand its reach to recruit staff volunteer doctors who live out of the geographic area. Additionally, patients who live out of the area can make use of clinic services. On the downside, physicians are unable to do physical examinations of patients.

“Video has advanced a lot, and we can see a lot. We do lose the physical exam, but we’re working on new solutions so that gives us the ability to do such things as remote EKGs or allow us to take blood pressure,” said Matly. “Right now, about 80% of our ‘bread and butter’ urgent care can be adequately provided through telehealth.”


Remote Possibilities

Telehealth has grown dramatically since the onset of the pandemic, he continued, with American health companies receiving large infusions of cash in recent months to develop teleheath products. As Matly said, “Telehealth is becoming a standard of care emerging in the post-COVID universe. It will never 100% replace a physician encounter, but it can be quite effective.”

Matly invites the public to follow Order of Malta Clinic news on Facebook and Twitter, and welcomes financial support of the clinic’s work. The pandemic has brought both fundraising and operational challenges, but “challenging times create opportunities. We’ve been forced to think of new ways to care for the poor and uninsured. Telehealth is one such way, and it is already showing great promise.”

Like Dr. Wallace, Dr. Matly is motivated to volunteer by his Catholic faith and will soon become a Knight of Malta himself. He said, “As a doctor, I have a passion for caring for the sick. Professionally, I focus on new technologies in health care. And my Catholic faith is important to me, so volunteering for the clinic brings all three components together for me. I feel blessed to be a part of the clinic.”

 Jim Graves writes from Newport Beach, California.