One Doctor’s Journey Into Telehealth

Dr. Mahmud Al Furgani, a Telehospitalist with Providence, loves the look on his patients’ faces when they experience telehealth technology for the first time.

“With the wireless telescope, I can listen to their heart and lungs, in high definition. I can hear everything,” he says. “With the camera, which I am controlling from my home in Michigan, I can see the action of the pupil. People can’t believe it. They are fascinated by it.”

The feeling is mutual. Dr. Al Furgani began practicing telemedicine in fall of 2019 and ever since, he’s been increasing his percentage of telehealth work, which now stands at 40 percent. Within a year, he hopes to be working in telemedicine fulltime.

Meanwhile, he’s working at two hospitals (one on each side of the Ohio/Michigan border) less and less, and working more and more from his home, where he lives with his wife and two young children.

“Medicine is a very demanding job, and it affects your work-life balance,” Dr. Al Furgani says. “So it’s kind of a dream to have found this job where I can spend time with my family at home and be working. I consider myself blessed to have this opportunity.”

His timing couldn’t have been better. Telehealth has experienced tremendous growth since the COVID-19 pandemic began spreading across the country. Previous obstacles around licensing and reimbursement disappeared with the federal emergency declaration, and today, 46 percent of patients say they are using telehealth, up from 11 percent in 2019, according to a McKinsey & Company COVID-19 consumer survey.

Telehealth Enables Physicians To:

Make Innovative Changes: New business models are easier to implement with telehealth, which expands access to care and reaches more patients. Clinical workflows become more efficient.

Conserve Finances and Increase Revenue: Patient cost goes down, and practice revenue goes up along with a reduction in overhead. For example, doctors may pay less for front desk support or have fewer exam rooms. Clinicians’ income increases, because they can see more patients.

For Dr. Al Furgani, his journey to becoming a Telehospitalist began in his home country of Libya, where he graduated at the top of his class from University of Al-Fateh. He arrived in the United States in 2008, where he met his wife in Oregon. Her entire family went to Providence for healthcare and spoke highly of its excellent providers. When he moved his young family to the Midwest, Dr. Al Furgani worked for various hospitals in Illinois, Missouri, Ohio and Michigan. But he always kept Providence in the back of his mind.

In 2019, he began supplementing his income by picking up some shifts with Teladoc, one of the biggest telehealth providers in the world. In 2020, he saw a job opening for a Telehospitalist with Providence and worked with Provider Solutions & Development to interview and accept the job.

“I was thrilled to find this position,” he says. “It’s exactly what I wanted, because I love being a hospitalist, and now I can do that remotely.”

Telehospitalists are critical, especially for rural hospitals who may not have one on staff. Patients would otherwise have to travel or experience long waits for needed treatment.

In his Providence role, Dr. Al Furgani works in tandem with nurses across the health system’s seven-state footprint. Using a Telepresenter machine, a nurse will facilitate Dr. Al Furgani’s examination, diagnosis and treatment from a hospital exam room.

“It’s like I’m sitting right there with the patient, the technology is so amazing,” he says.

At first, Dr. Al Furgani says there was a slight learning curve as he learned how to connect through the screen.

“The more I did it, the better my observation got,” he says. “Now I pay very good attention. I read my patients’ faces, their emotions, their voice and their hand movements. There is a lot of eye contact.”

In the midst of this pandemic, Dr. Al Furgani says eye contact has taken on a higher level of importance. He is responsible for the COVID unit at one of the hospitals he works at, and he also sees COVID patients through telehealth.

"The COVID experience for patients, it makes them anxious, but it’s more than that. There is a lot of fear,” he says.

“When I am talking with a COVID patient or a possible COVID patient through the screen, they look at you in the eyes; it’s like they want to read inside you. And sometimes I can see that this patient is going to get worse. But I cannot let the patient see that. You want them to feel like they’re in good hands. The patient will do much better this way. I’d say probably 30 to 50 percent better when they have reassurance and confidence in their care.”

Dr. Al Furgani says it’s gratifying to be able to see a quick turnaround in his telehealth patients.

“Just the other day, I had a patient who was crashing. It was COVID, and we started medication,” he says. “Within a few hours, we were able to avoid intubation. The next day, the patient was stabilized. I was able to talk with him on my computer and see the relief on his face. He was very, very happy.”

What advice would Dr. Al Furgani have for providers considering practicing telemedicine?

“Do a lot of reading about it,” he says. “You have to be able to work with technology. The normal patient-provider relationship will now be patient, provider, technology and ground team. You have a team now.”

He says the increased trend in telehealth is here to stay.

“I am a firm believer in it,” Dr. Al Furgani says. “There’s been a huge change, technology is booming, and medicine is adapting. Generation Y and X, the millennials — they want things immediately. They do not want to wait and see if they can get an appointment in six hours or six days. Soon, I don’t think anyone will be willing to take a half a day off work to see the doctor. In the future, people will know their provider like a friend. Everything will be teleconsult. Which makes sense, because more than 75 percent of what we do can be done over the phone. It will be an important part of any healthcare institution.”