When the COVID-19 pandemic hit, it presented Portland, Oregon-based Legacy Health with a multitude of staffing challenges where clinicians and staff were unable to come to work safely in the hospitals and clinics.

Legacy Health had an established telehealth program, which involves specialty-care services providing remote consultations to a variety of facilities. The health system had been using vendor Teladoc for its inpatient telemedicine platform.

Eight telehealth-equipped hospitals

"Prior to COVID-19, most of these services were acute and hospital-based, allowing providers to extend their reach beyond the walls of the facility where they were located," said Lori Wakashige, program director for telehealth and regional outreach, at Legacy Health. 

"The existing inpatient specialty-care programs utilize equipment that is shared between services and located at each hospital, eight in total," she said.

Additional equipment would be needed to increase the number of specialty care services and expected potential volumes, she recalled.

"In addition to our hospital-based services, Legacy operates primary care and specialty care clinics, which were not consistently equipped to provide care remotely," said Wakashige. "The telehealth team and operations leaders developed workflows, and training modules were designed to provide a standard practice."

Last year, the FCC's telehealth funding program awarded Legacy Health $368,912 for telemedicine carts, tablets and remote diagnostic equipment to treat and monitor hospitalized patients in intensive care units and emergency departments, and to allow specialty and subspecialty providers to safely treat and monitor patients at multiple facilities using telehealth.

Adding ambulatory telemedicine

"The addition of Mend as our ambulatory telehealth vendor allowed Legacy Health to meet the needs of our patients, providing a safe environment for care delivery for our providers and staff," said Dr. Steven Seres, telehealth medical director at Legacy Health.

"All providers were offered the opportunity to participate in training that would allow for remote care and facilitate connections with patients from the providers' homes or offices."

In addition to physician providers, a variety of clinicians, therapists and staff were trained to provide services via telehealth using Mend. This allowed patients to continue to schedule and receive services without unnecessary exposure to COVID-19. The process adhered to the social distancing guidelines that were implemented in Oregon and Washington.

"Patients were able to schedule appointments with physician providers, as well as therapists and a variety of clinicians, to continue to receive care," Wakashige noted. 

"Work-streams were developed based on roles in the organization. A team of trainers mobilized from a variety of departments, which included physician and nurse informaticists, telehealth program staff, and information services training teams."

The majority of care providers were trained over a period of a few weeks. The trained clinicians required ongoing troubleshooting and operational support due to challenges that developed as a result of implementation, she added.

Investing FCC funds in virtual care

"The funds awarded from the FCC allowed Legacy to expand our existing video visit program and to implement a stable platform for all primary care and specialty care clinics for our outpatient services," Seres explained. "Our hospitals also required additional equipment as demands for inpatient specialty care services grew."

Further, Legacy Health used the FCC funds to purchase additional hardware from its current vendor, Teladoc, to augment its existing hospital telemedicine resources, he concluded.

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