Prior to 2020, Franciscan Health, a health system based in Mishawaka, Indiana, conducted few telemedicine visits throughout the organization. Outside of some tele-stroke and behavioral health virtual care there wasn't any robust programming for patients to participate with Franciscan Alliance providers through telemedicine.

THE PROBLEM

In February 2020, some specialties were in the process of requesting telehealth technologies, and a few of them, such as urgent care, already were in the stage of testing. Everything changed in March 2020 when COVID-19 appeared.

The state of emergency and stay-at-home orders introduced the need to keep at-risk patients out of healthcare facilities and at home whenever possible. In addition, new challenges included providing care to COVID-19 patients, preserving personal protective equipment and protecting the healthcare team's own health.

Hospital outpatient departments prioritized providing care to patients at home rather than have them come into the clinic.

PROPOSAL

"As we have moved past the pandemic, these resources still are being used to reach our patients," said Craig Miller, administrative director of ambulatory services at the Franciscan Alliance. "Through the use of remote patient monitoring and virtual visits, we are able to connect patients to the physicians in new areas.

"Our use of virtual visits now has moved to several of our consulting physician practitioners, who are able to provide hospital consultations from their home facility," he continued. "With the staff challenges occurring and recruitment this has been a valuable tool for our physicians and providers to reach patients in other hospitals in the system."

The health system went with vendor Teladoc Health. The telehealth technology is fully integrated with the provider organization's Epic EHR and MyChart patient portal through context-aware linking to simplify provider and patient workflows, and to Canto for provider-to-provider consults.

"This allows Franciscan Health to automate outpatient appointment registration, check-in and checkout during visits," Miller explained. "Franciscan Health chose to use iPads for inpatient rounding and consults.

"Franciscan Health uses Teladoc Health virtual waiting room functionality to enable urgent care, company clinic, occupational health and travel medicine patients to conduct virtual visits," he continued. "The technology also allows group visits for bariatric support groups and diabetes education. Teladoc Health was helpful in assisting with education and training."

Franciscan Health conducted training in phases for its operations team, the providers and staff, technology, and patients. In addition to safely providing patient care, the ability to capture revenue growth was necessary, he added.

"Franciscan Health created a billing, coding and compliance team, and developed a payer crosswalk to ensure that clinicians were not required to learn both a new reimbursement process and the new telehealth technology," Miller said.

"Many of these ideas on how to utilize care would not have occurred as quickly without the FCC funding grant we received and the pandemic," he continued. "Using many of the processes and workflows from COVID, we have adapted those workflows within our normal practice of care."

MARKETPLACE

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MEETING THE CHALLENGE

Franciscan Health uses telehealth technology in multiple ways to help provide high-quality care to patients across the organization. The pandemic allowed teams to think differently and change care delivery to better support patients.

"Franciscan increased its remote patient monitoring, including COVID patients that presented to the ED, providing additional tools and support to allow them to feel comfortable recovering in their own home," Miller explained.

"From there, Franciscan built upon that work to identify opportunities to better connect patients with care teams across the care continuum, including virtual multidisciplinary care rounds, timely virtual consultations with specialists and a focus on developing a person-centric remote patient monitoring program that would provide additional support and care to patients with chronic conditions," he added.

RESULTS

Franciscan Health has seen some impressive results in the area of telemedicine, including:

• More than 540,000 virtual visits since March 2020.

• More than 8,500 visits weekly.

• More than 500 patients enrolled in COVID remote patient monitoring.

• Last month, more than 540 providers completed at least one virtual visit.

USING FCC AWARD FUNDS

The FCC telehealth grant program awarded Franciscan Health $747,665.

"The FCC telehealth award was very helpful in providing resource dollars for our telemedicine programming," Miller noted. "Without this support, we would not have been able to provide the resources and products to our patients in the ambulatory, home health and hospital settings.

"These funds have been used to purchase equipment and licensure for our remote patient monitoring program, and for Epic and Teladoc virtual programming," he concluded. "These funds have expanded programming, and have helped assist patients throughout the pandemic through the ability to monitor vitals and provide video visit technology."

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Email the writer: bsiwicki@himss.org
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