Helio Health in Syracuse, New York, treats patients with substance use disorder and behavioral health issues. Many times, these patients have exacerbating conditions on the medical side. On top of those, there is a COVID-19 threat for both staff and patients.

THE PROBLEM

Both sides were very vulnerable, and there is an epidemic of substance use disorder – and a pandemic on top of that.

"And so we needed to figure out a way to provide the continuity of care that continued necessary care for these folks and minimized their exposure to COVID-19 – and overall reduced risks," said Corey M. Zeigler, CIO at Helio Health.

PROPOSAL

"So we purchased iPads and Microsoft Surface laptops," he continued. "The Surface laptops went to staff, and that gave them the mobility to basically work from anywhere. And we gave the iPads to the patients."

Some of the patients are in residential care or transitioning out of inpatient. The iPads allowed them to receive services, regardless of where they were.

"We used Microsoft Teams as a conduit to connect the provider with the patient," Zeigler explained. "So it was a three-part solution: Microsoft Teams as the software, the iPads in the patients' hands and the laptops in the clinicians' hands. This allowed us to change telehealth from what was 5% of services prior to the pandemic to 85% of services during."

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MEETING THE CHALLENGE

There has definitely been a change at Helio Health. A big change in culture.

"If you remember back before the days of Teams and Zoom, we primarily had GoToMeeting and WebEx, and everybody hated them. They were clunky, and people wanted to meet in person," Zeigler said. 

"A lot of folks have their kids at home, and now they need care, and they don't have resources to take care of their kids. So now with telehealth they can do their sessions and receive their care right in their home."

Corey M. Zeigler, Helio Health

"They didn't like doing these things virtually. Neither did patients. And I think that the cultural change that has happened with the pandemic across the world with virtual care has changed the entire paradigm by which we view care, and folks are really appreciative of being able to receive care virtually.

"And before you know it, the new virtual care paradigm solved a lot of other exacerbating issues we had," he continued. "Transportation is huge. We have a large network that is predominantly Medicaid. And so we have a large population that doesn't have vehicles, or they have transportation challenges to get to care."

Now transportation problems for many of their visits have been solved, because those visits are handled virtually.

"The biggest challenge was just moving through that kind of cultural change," he said. "It wasn't a technology issue. It was just an acceptance issue. At first, patients were like, uh, what is this? How do I do it? It's unfamiliar. What if it doesn't work? Who can see my information? What's the security of it? You know, all these unanswered questions, and so we just had to keep a campaign of communication support and cheerleading behind it to keep it moving."

Staff kept it up until they hit a critical mass around September, when Helio Health really hit its stride.

"I would be surprised if we ever go back to the way we operated before the pandemic, even when COVID-19 is gone, that we ever go back to a full in-person care model," Zeigler said. "If I had a crystal ball, I would say more than 30% of care would be telehealth if we can stay pure telephonic, but if we stay with video, I would say 20-30% will be virtual care forever. People like it, they've gotten used to it and they're comfortable with it. Telehealth is going to be a permanent part of our care model."

RESULTS

The biggest result for Helio Health has been access to care, plain and simple.

"We solved the transportation issue," Zeigler said. "Access is hard to measure. What would happen? It's almost like actuarial and insurance. Like a risk measurement. How do I measure what doesn't occur? So we're challenged with all the folks out there that wouldn't have care or wouldn't have sought recovery if they didn't have access to medical services."

Helio Health never conducted a survey of patients asking what they would have done without telehealth. But speaking to the programs, Zeigler anecdotally can say patients have been "ecstatic" about the technical capabilities.

"And I didn't even mention childcare," he added. "The other big issue besides transportation is childcare. So with all the school closings, you have folks trying to figure out how they take care of their kids. And childcare is not available because of all the COVID-19 restrictions.

"So a lot of folks have their kids at home, and now they need care, and they don't have resources to take care of their kids. So now with telehealth they can do their sessions and receive their care right in their home."

These patients have been telling their counselors that telehealth has been a game-changer for them, he added.

USING FCC AWARD FUNDS

Last year, Helio Health was awarded $504,034 by the FCC telehealth fund for laptops, tablets and other telehealth equipment to conduct remote monitoring and treatment of patients with COVID-19, as well as voice and video consultations, to ensure continued care for the patient population while protecting the healthcare workforce.

"Our biggest purchase was the hardware," Zeigler related. "Almost in its entirety, we spent the money on iPads, laptops, and an upgraded network and phone system to support the increased demand of the remote traffic. We have a large outpatient building [that] we have made the brains of our phone system, and we brought everything into that building and centralized it so folks can, even if they're in other programs, be routed into that through that centralized model."

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