. 2021 Mar 25;12:21501327211004285. doi: 10.1177/21501327211004285

Table 1.

Thematic Analysis of 24 Qualitative Interviews of the Impact of Virtual Health Transitions on Medical Assistant Roles During the 2020 Pandemic.

Roles	Operational definition	Theme	Relevant statements by Medical Assistants
Pre-visit care: physical care	Performing clinical care such as giving vaccines, running CLIA-waived tests (ie, point of care HbA1c/glucose), EKGs, obtaining vital signs, phlebotomy, assisting with procedures, and more	Role apprehension	“[The MA] does clinical work when patients are in-person (blood draws, vaccines, etc) and we doesn’t want to lose that skill or confidence.”
Pre-visit care: physical care		Role apprehension	“If they don’t have a blood pressure cuff or thermometer at home I’m not getting accurate information”
Pre-visit care: data gathering	Gathering data prior to the provider visit such as documenting vital signs, chief complaint, asking social history screening questions	Role expansion	“Patients would question me when I ask them about their weight or blood pressure. . .and wonder why I was asking them. This experience of obtaining their own vitals was new for them. Patients would sometimes just say ‘I just don’t have my vitals’.”
Pre-visit care: data gathering		Role expansion	“It is not that hard, the questions we would ask them in the room are the same. It’s just the vital signs we can’t really get. . .[virtual rooming] still gives us the ability to do our job in prepping the patient.”
Panel management	Proactive outreach to encourage patients to complete preventative health screenings	Role expansion	“We are reaching out to people who haven’t been to our clinic before and to families.”
Panel management		Role expansion	“Between myself and the other MA we created a whole workflow on virtual annual physicals which was very specific. We wanted to make sure that the first visit with the provider-the provider goes through the first part like the history and orders labs. Then we created a list to reach out to patients to bring them in for labs when we will be able to.”
Care coordinator/patient navigator	Assisting patients in navigating post-visit tasks such as referrals or obtaining prescriptions or lab tests	Role expansion	“One of our providers. . .. will staff message us and we will call the patient to wrap anything up or schedule follow ups. We try to do it as soon as possible, and patients are surprised by how quickly we can get back to them. I had a few patients who were like ‘Wow! Thanks for calling so quickly, I just got off the call with him [the provider],’ and were really happy to get called about discharge instructions and follow up.”
Care coordinator/patient navigator		Role expansion	“I started to send out records requests to outside providers and got some colonoscopy records from outside practices. . .It was fun getting these records and I was happy to not have to ask the patients about this and do it on my own.”
Patient flow coordinator	Adjusting provider schedules and patient appointment requests in real time to allow smooth patient flow through the clinic	Role expansion	“Adjusting providers’ schedules to help with the flow. . .mov[ing] visits to make more space between visits for certain providers who are struggling with the video system.”
Quality and process improvement lead	Identifying unmet patient, provider, and health system needs, and developing/evaluating interventions to meet those needs.	Role expansion	“[We are] very team-based here. We look for anything we can improve on. We look for any clinic issue and try to help.”
Quality and process improvement lead		Role expansion	“We have made small tweaks to the process when we found out we should be doing additional screening as part of virtual rooming, like tobacco screening.”
Technology support	Teaching and troubleshooting connection to the electronic health record, patient portal and/or video visit platform	Role expansion	“[We] offer a lot of IT support during pre-visit sessions.”
Technology support		Role expansion	“[Providing] Tech support is time consuming and challenging.”
Scribe/HIT documentation	Documenting the patient encounter	Mixed: expansion and apprehension	“I think that having a medical assistant staying on a video visit to scribe provides additional value. It worked for me to hear and scribe with virtual—it was really different. Joining somehow was better than nothing but not as good as in person.”
Scribe/HIT documentation	Documenting the patient encounter	Mixed: expansion and apprehension	“I would like to continue to scribe over video visits. This is important to me as I would be able to do my complete role and the work I do in clinic.”
Health system ambassador	Engaging as the patient’s first point of contact and guide through the clinical encounter	Mixed: expansion and apprehension	“I feel like what we are doing now is a great example of what our role is. Not only to facilitate, coordinate and provide support but to be the patient advocate and the provider advocate too. We are the bridge between patient, provider and organization.”
Health system ambassador		Mixed: expansion and apprehension	“By not seeing our patients in person, we are not as aware what is going on with them. I have also lost a lot of contact with patients who I was outreaching to regularly by phone.”