Getting care to where the patients will be
Thursday, August 25, 2016
Wayne Gretzky famously said his success came from "skating to where the puck will be." The recent InTouch Health Innovation Forum was an exploration of the telehealth ecosystem, and it highlighted a number of healthcare organizations that are creating strategies to deliver care to where the patients will be.
A rural physician set the tone of the day by describing his experience as a patient. The young physician suffered a stroke and received care at his local hospital from a neurologist located several states away using telemedicine technologies.
After a comprehensive clinical assessment, the neurologist ordered a tissue plasminogen activator (tPA) resulting in a full recovery — the physician returned to working full shifts in the ER after only three days. His personal story highlighted the important role of a telestroke network facilitating timely access to personalized care to reduce the risk of disability or death.
Key themes included the application of data analytics to better identify outcomes and contribute to improved telemedicine services and creation of strategies to align both patient and value-based care. Two best practices shared include:
After identifying underutilization in their telestroke network, OhioHealth shifted to a broader virtual health neurologist model. They reframed the service to highlight access to specialty care for initial diagnostic testing by virtual health neurologists — not just for stroke, but also for confusion, seizures, headaches, transient ischemic attack (TIA) and other neurologic conditions.
In addition to emergent consults, their service line has expanded across the continuum of care and now includes new virtual clinics for preoperative assessments. Value realized includes avoidance of unnecessary transfers, convenience for patients and improved utilization of resources.
Jefferson Health is changing how they select their physicians and looking for those who exhibit signs of creativity, adaptation to change and good communication. For existing medical staff, they are using simulation to assess continuous technical and teamwork competence instead of only relying upon CMEs and proctoring.
Both of these are helping to build a culture that values getting care out to where people are, such as conducting virtual rounds on patients to help keep family in the loop on care, or virtual discharges. They are also using predictive analytics for to predict which chronic heart failure patients will comeback. To pay for all of these technologies they are implementing, they have repurposed funds they would have used to build new patient beds.
Two important lessons were learned from all of the stories shared.
The first is that telehealth has evolved to become a true extension of care processes and is helping providers connect with important populations of patients before, during and after their hospital encounters for better outcomes. The second is the leveraging of data to demonstrate the value of telehealth and its impact on calculating risk, reducing costs and predicting patient outcomes.
InTouch's 10th Annual Innovation Forum showed telehealth and telemedicine have been skating to where the patients will be. The presenters also demonstrated the value of virtual access to patient-centered, effective and efficient care. Perhaps their efforts will lead to a reduction in challenges and barriers.
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