Geisinger Health, based in Danville, Pennsylvania, embarked on a telehealth journey to develop a single solution that could bring care closer to home for patients across the care continuum.

Geisinger evolved its telehealth program for its patients and its health plan members, and then leveraged this program to respond to the COVID-19 pandemic. The telehealth program now offers more than 70 specialties, including neurology, pulmonology, dentistry, behavioral health and others. It connects patients to a local physician, urgent care or primary care clinic, or a regional hospital.

Telehealth models for in-home care

At his HIMSS21 educational session, "Providing Care Closer to Home," David A. Fletcher, associate vice president of the Center for Telehealth at Geisinger, will explain how an executive evaluates telehealth models that can be used for in-home care, even for patients with complex health needs.

"At Geisinger, we have multiple approaches to evaluating telehealth models for in-home care," he said. "We work with our clinicians to demo the product to ensure that it meets criteria, such as providing clinically useful data, ease of use for the providers and support staff, and ready integration with the EHR and existing patient records.

"Additionally, we work with our IT staff to ensure the model meets our information security requirements and can be supported in the long term," he continued. "We also work with our frontline staff and pilot the product with patients, then survey them to ensure they find it useful, easy to use, and would recommend its usage going forward."

The staff works with their Institute for Innovation to ensure the product is best in class or competitive with other solutions on the market and to evaluate the outcomes for the population, and uses the new model to determine if it is beneficial and its use should be continued, he added.

When to visit the ER

At Geisinger, telehealth technology can help patients and clinicians decide when to use ER services.

"We have several programs that use technology to help ensure appropriate use of ER services," Fletcher noted. "As one example, we have installed telemedicine carts in each of our urgent care locations so that our providers, who are frequently advanced-practice clinicians at these clinics, can consult with our system-triage officers, who are emergency department physicians located at our hospitals who can help determine if a patient who has presented with an acute condition needs to be routed to the nearest emergency room or can be treated at the clinic and scheduled for follow-up care."

Geisinger conducts more than 100 consults per month with this program.

"Another example of a program using technology to help direct ER usage is our Geisinger at Home program," he said. "In this service, we enroll patients with chronic conditions and multiple comorbidities who would normally have a high likelihood for ED usage and hospital readmission into a program in which community health assistants (CHAs) or nurses travel to the patients' homes to check on them and coordinate services.

"Additionally, the CHAs travel with a tablet and peripherals such as digital stethoscopes and otoscopes that they can use to follow up with a centrally located physician who is able to conduct exams, adjust medications or direct to an ER if necessary," he continued.

"This program is funded by Geisinger's health plan, which estimated it was able to save more than $2 million in the first year alone."

Patient and clinician safety and satisfaction

Fletcher also noted that executives can predict the impact of a telehealth program on patient and clinician safety and satisfaction.

"We have a multilayered approach to determining patient and clinician safety and satisfaction," he explained. "We pilot with the clinicians who are proposing to use the program to determine the effectiveness and safety of the program on a limited basis.

"We also vet the program with our IT department for technical security and compatibility with existing systems," he concluded. "Additionally, we conduct Press Ganey surveys of our patients who engage with telehealth tools, asking telehealth-specific questions to determine their level of satisfaction with the model."

Fletcher will offer more detail during his HIMSS21 session, "Providing Care Closer to Home." It's scheduled for August 12, from 11:45 to12:45 p.m. in Caesars Forum 131.

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