Aspire Health Partners in Orlando, Florida, last year was facing two problems: the need for remote monitoring of patients in its inpatient hospital units and the need to upgrade its network switch infrastructure to better handle the load on network resources related to the increase in telehealth services caused by the COVID-19 pandemic.

THE PROBLEM

Both projects would solve significant challenges for Aspire Health: One related to the safe, socially distanced monitoring and observation of clients, and the other related to more efficiently and securely managing network resources.

PROPOSAL

For remote patient monitoring, the health system purchased the ObservSmart product from InvisAlert Solutions. The switch upgrades were Cisco Meraki switches ordered from the health system's vendor Connection.

"Through the use of ObservSmart, we have been able to improve patient safety, increase quality of care and ensure improved compliance," said Zachary Hughes, vice president of innovation and technology at Aspire Health Partners. 

"ObservSmart allows supervisory staff to be proactively notified of any potential issues so they can immediately assist and correct the problem in real time."

The technology allows for client-specific, customizable alert thresholds; a coordinated, supervisory escalation process; request assistance/organized code response; missed observations, 1:1 out-of-range and off-unit lateness notifications; a nursing station dashboard; and patient risk and acuity flags.

"These system upgrades have allowed us to handle an expanded telemedicine volume from less than 500 sessions per month pre-pandemic to more than 20,000 per month currently."

Zachary Hughes, Aspire Health Partners

"This system fully supports the complexities and nuances of behavioral health workflows and improves communication among staff," Hughes said. "This system provides Aspire Health off-unit, non-observed patient synchronization; off-unit observed patient activities/program coordination; real-time quality feedback; and observation prioritization cues."

The system ensures better quality of care to patients and a decrease in human error, and provides a streamlined work process that creates an improved telehealth environment, he added.

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MEETING THE CHALLENGE

For remote patient monitoring, the ObservSmart system uses a Bluetooth wrist beacon paired with an iPad to provide socially distanced, safe patient observation and monitoring while on an inpatient unit. Once within range of the beacon, the ObservSmart software on the iPad allows the staff to record the patient's location on the unit, status and activity.

This has been a critical tool for performing 15-minute observations on patients in a time when physical distancing is encouraged.

"The network switch upgrade came at a critical moment, when demands on the network increased dramatically," Hughes explained. "Aspire Health moved from less than 500 telehealth appointments per month to more than 20,000 during the pandemic. The shift required the replacement of critical, aging infrastructure to provide stability, reliability and access to company resources remotely and on-site."

The remote patient monitoring solution is used by behavioral health technicians and acute care staff in the inpatient hospital.

The network upgrades affected every aspect of the organization, including smoother telehealth sessions, more reliable access to the electronic health record, and access to other organizational resources both on- and off-site.

RESULTS

"There are several areas that have been measured with regard to implementation of the ObservSmart technology," Hughes noted. "The key metrics have included: decrease in staff error, increase in compliance, decrease in risk incidents, increased staff engagement and increase in access to real-time data for providers.

"With regard to measuring the network upgrades, metrics include: decrease in network downtime, increase of speed of network and increase in amount of tele-support equipment able to operate simultaneously."

The implementation of the ObservSmart system led to a significant decrease in the amount of missed observations, an increase in compliance and audited observations, a decrease in risk incidents, an increase in staff engagement with clients and improved access to patient data by medical staff, said Hughes. 

The system has been embraced by program staff and has proved to make them more efficient and proficient in completing their job, he added.

Since the network switch upgrade, Aspire Health has experienced 99% network uptime and only one critical network outage, a significant decrease from the same period a year before.

USING FCC AWARD FUNDS

The FCC telehealth funding program last year awarded Aspire Health Partners $173,037 for connected devices, a patient safety platform and network equipment upgrades to support the increased need for telehealth services as a result of the COVID-19 pandemic.

"We have fully used our FCC telehealth funds through the implementation of the ObservSmart electronic monitoring platform and the system upgrades," said Hughes. 

The improvements provided through the FCC telehealth funds have far exceeded the health system's initial expectations, he added.

"These system upgrades have allowed us to handle an expanded telemedicine volume from less than 500 sessions per month pre-pandemic to more than 20,000 per month currently," he explained. "These upgrades have provided Aspire's teams with reliable access to our electronic health record, phone system, video- and voice-based telemedicine services, internet, and all internal and external communication."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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