Holyoke Health Center in Holyoke, Massachusetts, has used NextGen as its electronic health records system for several years, and had to quickly pivot to telemedicine appointments when it became apparent that the COVID-19 pandemic would not allow for in-person appointments.

THE PROBLEM

The health center did not have a telehealth platform or workflow in place since it had not been providing telehealth services prior to the COVID-19 pandemic. So it needed to work quickly and efficiently to ensure that patients had continuity of care.

“We very quickly began to test various technologies, including FaceTime, OTTO and WebEx, before settling on a combination of video conferencing vendor Zoom and telehealth-technology vendor Doximity,” said Andrew Buscemi, director of information technology at Holyoke Health Center.

"The FCC funding allows us to greatly expand and upgrade our existing infrastructure to support various remote-health initiatives."

Andrew Buscemi, Holyoke Health Center

“With most of our patients and providers having access to cell phones, it was a fairly quick adoption of the new technologies, but it did require some upfront training and documentation before everyone was comfortable using the new systems.”

PROPOSAL

Zoom was purchased early on to standardize the way in which video conferencing was conducted, and the health center became heavily reliant on VPN technology to keep everyone connected while working from home.

Systems that previously were designed to accommodate a few dozen users were quickly being upgraded or replaced with technology that could accommodate hundreds of users. There initially were quite a few growing pains during this transition period, but most users were able to move to the new technology in a relatively short period of time.

MARKETPLACE

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MEETING THE CHALLENGE

Massachusetts issued a statewide stay-at-home order in early March, so it was imperative that robust VPN technology was in place to support hundreds of employees working from home, Buscemi said.

“Our local Internet service provider, Holyoke Gas & Electric, was kind enough to quadruple our Internet bandwidth for free,” Buscemi explained. “Once this was in place, we built a number of Microsoft terminal servers and managed the various RDP connections through an existing Barracuda VPN appliance.”

It took some time to get everyone comfortable working from home, but most were able to adjust to it within a matter of days, he added. This also gave the health center time to research and recommend hardware upgrades needed to support an extended work-from-home strategy.

RESULTS

Holyoke Health Center was able to replace in-person medical appointments with telehealth appointments using a combination of Zoom and Doximity. It’s still too early in the process to report hard results, but patients and providers have reported satisfaction with the new style of care during the pandemic.

USING FCC FUNDS

Holyoke Health Center was recently awarded $668,335 to use telehealth to provide its high-risk and vulnerable patients with HIV infectious disease services and management, substance use disorder program treatment and adherence counseling, and nutrition, medication management and oral health services. The goal is to reserve staff, equipment and other onsite supplies specifically for patients with COVID-19 symptoms and conditions.

“The FCC funding allows us to greatly expand and upgrade our existing infrastructure to support various remote health initiatives,” Buscemi explained. “We’ve already tripled our existing bandwidth through our local ISP, and we’ve already deployed a new Barracuda firewall system to allow for an almost unlimited number of remote VPN connections.”

With the increase in bandwidth, the health center has been able to standardize on Zoom video conferencing, and it now has unlimited licensing for all employees to host and attend meetings.

“We also are in the process of deploying hundreds of webcams and headphones, both of which were in short supply at the height of the pandemic,” he concluded. “We’ve also ordered hundreds of new PCs and monitors to support our NextGen EHR system, and we are in the process of upgrading our network backbone with 10GB Cisco switches.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himss.org
Healthcare IT News is a HIMSS Media publication.