One of Concentra's 150 clinics.
Photo: Concentra
Concentra is a Texas-based healthcare organization that serves the occupational health needs of one in four injured employees through 517 medical centers across the country, another 150 clinics at employer locations, and telemedicine.
THE PROBLEM
Concentra has seen telemedicine as a much-needed additional option for the delivery of care. It implemented the first model via kiosks, piloted with a single employer. It learned a lot of valuable information from the pilot – namely that the kiosk system was not scalable. The healthcare organization knew there could be a more cost-effective and efficient way to deliver virtual care.
"I joined Concentra in June 2017. Just before, I was a long-term Concentra client as vice president of risk management/claims for Macy's," said Ann Schnure, vice president of telemedicine at Concentra. "I wanted our retail organization to be a beta tester of Concentra's telemedicine program and was very interested in telemedicine as a way to increase access to care.
"I was thrilled to have the opportunity to join Concentra and lead our efforts to develop and implement a telemedicine solution that would provide high value to employers and their employees."
Before she joined the organization, Concentra had explored many software solutions. The first live telemedicine visit was in June 2017.
"Flexible workflows right out of the box and support of our multi-patient group waiting room – these are key to our efficient workflow, and allow us to focus our clinicians on the delivery of patient care."
Ann Schnure, Concentra
"Across about two years we saw steady growth in our program and maintained a continuous learning process to enhance this patient care delivery modality for our client organizations," she recalled. "But we also hit some significant barriers with too many clicks-to-visit and additional challenges.
"Then we learned of vendor eVisit's virtual care platform, which met our crucial criteria to fix these challenges and more. We made our purchase decision in 2019 and launched eVisit in 2020."
PROPOSAL
When Concentra started with eVisit, it was to address a video visit plug-in situation. But as the organization has continued to work with the vendor, the platform and team have become a longer-term solution.
"We knew it had rich end-to-end functionality, but what was so great for us in our occupational telemedicine workflows was its flexibility, its integration layer, ease of use, and tools like the scheduling tool and the platform's sophisticated reporting features, including real-time reports," Schnure said.
"Specifically, for our largest customers, connecting to the video visit is seamless – no plug-in required," she continued. "And for the patient clicks-to-visit, we have brought that from 27 down to about eight clicks, and that's a direct reflection of the ease of use of eVisit."
The Concentra Telemed offering offers a group waiting room with care coordinators who can see the multiple patients and their status. It also features multiple hand-offs to providers and back-to-care coordinators. It's a complicated virtual workflow and somewhat unique to occupational care. The platform enables this workflow seamlessly, she added.
"Our clinicians' time is maximized – our aim is to have clinicians focus 100% of their time on delivering patient care, and in our virtualized workflow they spend very little time on administrative tasks," she explained. "We have objectives for service and know in real time if we are meeting our service standards because the eVisit system allows us to track everything we need to have visibility against our goals and metrics."
MARKETPLACE
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MEETING THE CHALLENGE
The initial challenge was to find a system with seamless video connection, no plug-ins, and just a few clicks-to-visits for patients. What Concentra found in the platform were many features that allowed it to optimize and expand its telemedicine solution. Under a continuous improvement model, Concentra routinely is finding value and efficiencies.
A dedicated Concentra Telemed staff of 40-plus individuals serving virtual care patient needs with all clinicians who have a user profile and the ability to conduct a visit use the system.
"Flexible workflows right out of the box and support of our multi-patient group waiting room – these are key to our efficient workflow and allow us to focus our clinicians on the delivery of patient care," Schnure noted.
"The scheduling tool allows our care coordinators to send patients a link and all they need to do is click it to get into the visit. The charting tool is used to very effectively prep for second visits where we are reviewing labs or imagery.
"The eAnalyze tool is a sophisticated reporting system that tracks data we need to manage our telemedicine program – from patient wait times in the waiting room, virtual visits completed/canceled, provider usage and tasks performed, and more," she continued.
"This feature delivers up-to-the-minute real-time data. It's very useful for many reasons, but mostly to help us gain insights into where we can improve and make efficiencies."
RESULTS
Following are successes Schnure reports through using the new telemedicine system:
- Clicks to visit. Through efficiencies and ease of use of the technology, the organization got patient clicks from 27 down to 8 clicks to the visit.
- Real-time accurate reporting helps Concentra do better and address issues. Before, it did manual reporting, knitting together disparate spreadsheets of data. It was not fast, effective nor comprehensive. Now the organization has comprehensive reporting in real time across the entire platform, which allows staff to:
- Improve staffing models
- Immediately address cancellations – they can see the reason for the cancellation immediately; staff can address that same-day within minutes and get back on track with that patient and the schedule
- Training – if staff are seeing a care coordinator who is very efficient, they have modeled that and trained others to be more efficient and effective
- Helps with quality audits
- Reduced no-shows by 10%
ADVICE FOR OTHERS
"Carefully evaluate the video portion of the platform," Schnure advised her peers. "In many cases, the SaaS provider outsources that element of the platform, and they aren't experts on that piece of the technology. The video visit is important and connects the patient to the clinician. Also, ask about average click-to-visit stats and patient satisfaction metrics.
"Be careful with telemedicine platforms that come with D2C provider networks," she added. "Ask questions like, Do you provide patient care directly through the platform? And if so, what percentage of your company's revenue comes from providing these healthcare services?"
In Schnure's experience, they often are their own biggest customer and those technology providers tend to make technology development decisions based on their D2C models, and a client's technical requests may not be heard.
"There are hundreds of solutions out there, and telemedicine is moving at a rapid rate," she noted. "If a technology provider hasn't made any changes or enhancements to their platform over the past 18 months, that may be a concern.
"Find a partner with a vision of telemedicine that aligns with yours," she continued. "Look for partners who can power your telemedicine strategies and have flexible workflows, integration capabilities and sophisticated reporting functionality."
Many healthcare organizations have unique telemedicine needs when it comes to how to implement the technology, and it's important that a healthcare organization pick a technology vendor that is flexible and listens to distinct needs, goals, strategies and requirements, she concluded.
Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
