Before the widespread adoption of telemedicine technology, there were several problems that hindered the delivery of healthcare services for most healthcare organizations.

THE PROBLEM

One of the main problems was access to healthcare, particularly with working families and those with chronic conditions. Many people lacked convenient access to medical care and providers, making it difficult for them to receive the care they needed.

Another problem was the cost of healthcare, which could be prohibitively expensive for many people. This was especially true for those without insurance or with limited coverage. Additionally, long wait times for appointments and limited availability of specialists further exacerbated the problem.

"Another problem was the lack of continuity of care," said William Manzie, administrative director of telehealth at Memorial Healthcare System, which is based in Hollywood, Florida. "Patients often had to see multiple providers for different health issues, and it was difficult for providers to keep track of a patient's medical history and treatment plan. This could lead to duplication of tests and procedures, and to miscommunication and errors.

"Finally, there also was the issue of patient engagement and adherence to treatment plans," he continued. "Many patients did not fully understand their condition or the importance of following their treatment plan, which could lead to poor outcomes and high costs."

"Telehealth has improved healthcare by evolving into a care-delivery model that has the potential to add value to many, if not all, disciplines of healthcare."

William Manzie, Memorial Healthcare System

Telehealth technology has helped to address many of these problems by providing remote access to healthcare services, so reducing costs, improving continuity of care, and increasing patient engagement and adherence to treatment plans.

At Memorial Healthcare System, telehealth has been a major help in addressing the issues of healthcare access during and after the COVID-19 pandemic.

"Through telehealth, patients have been able to access medical care from their own homes, avoiding potential exposure to the virus," Manzie noted. "Additionally, telehealth has enabled healthcare providers to maintain continuity of care for their patients and has enabled them to continue to provide medical care despite travel and other restrictions.

"Telehealth has been instrumental in helping to reduce the burden on our health system and has allowed patients to receive the care they need without putting themselves at risk," he added.

Telehealth technology can help with a variety of healthcare-related issues, Manzie spelled out, including:

1. Improving access to care for individuals in remote or underserved areas.

2. Reducing the spread of infectious diseases by allowing patients to consult with healthcare providers virtually.

3. Improving the continuity of care for patients with chronic conditions by allowing them to communicate with their healthcare providers more easily and passively.

4. Lowering healthcare costs by reducing the need for in-person visits.

5. Increasing patient satisfaction by allowing them to receive care in the comfort of their own homes.

6. Enhancing care coordination by allowing healthcare providers to share information and collaborate more easily.

7. Improving patient outcomes by providing patients with more timely and appropriate care.

"Overall, telehealth allows for better access to healthcare, improved communication between patients and healthcare providers, and more efficient use of resources," he added.

PROPOSAL

Memorial Healthcare System works with several vendors to help it achieve its virtual care goals. Some of these vendors include Telemetrix for remote patient monitoring, Apple for technology used during COVID-19, Epic's EHR for a fully integrated virtual care system, and TytoCare for the health system's "Doc-in-a-box" program.

At the beginning of the pandemic, Memorial Healthcare System received $974,968 from the FCC telehealth funding program to be used to expand the capacity of treating COVID-19 patients, as well as those with chronic comorbid conditions, with the aid of telehealth connectivity, devices and services.

Along with iPads, RPM devices enable use by high-risk patients for home monitoring and to facilitate telehealth visits for those with conditions that require frequent monitoring, disease management and medication management.

"Provision of these tablets is vital for the inclusion of those requiring frequent telehealth visits who lack smart technology devices," Manzie said. "The tablet devices also allow primary care physicians to monitor patients from their home. The physician will be able to visually see the patient and identify how the patient is progressing.

"Given the poor social determinants of health across communities in Memorial’s service area, a large portion of those served are prone to chronic health conditions including comorbidities," he continued. "Telehealth also has played a crucial role in keeping patients like these 'frequent flyers' out of the hospitals, so as to not burden the ED and inpatient admissions with additional patients."

Telehealth allows patients to have an appointment with a medical provider through a secure video link via the MyChart App or desktop portal. Video appointments may be scheduled for reviewing lab results, for talking to support services, for non-emergency or minor medical concerns, and for remote monitoring of patients with underlying chronic health conditions, including hypertension, heart failure, diabetes and other infectious diseases, such as HIV.

MARKETPLACE

There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News published a special report highlighting many of these vendors with detailed descriptions of their products. Click here to read the special report.

MEETING THE CHALLENGE

For Memorial Healthcare System, integrating its telehealth platform into its Epic EHR created a smoother and more efficient consumer virtual care experience. When connected to the EHR, the telehealth platform allows consumers to access their health records, track and manage their health information, schedule appointments, and connect with their healthcare providers, all in one location.

"This integrated platform gives consumers more control over their healthcare experience," Manzie stated. "By streamlining the telehealth access, consumers are inclined to focus more on their health and wellbeing. Ultimately, our integrated telehealth platform in Epic allows for increased convenience and a much more frictionless consumer experience as they seek a virtual health consultation.

"In order to also create a frictionless system for our providers, we introduced and implemented a one-click video solution," he continued. "Inherently, there has and always will be challenges with users utilizing technology. As such, finding a secondary video consult solution that was easy to use on both ends of the telehealth consult was critical."

For this effort, Memorial Healthcare System selected vendor Amwell. This platform served the organization well, and providers and patients were pleased with the results.

"As I mentioned, creating an integrated telehealth platform creates a smoother and more efficient consumer experience," he said. "We have since moved into working with Epic for a one-click solution for this reason, which has proven to be a satisfier, based on the satisfaction score of 95%.

"In 2022, Memorial went live with our first all-in remote patient monitoring program," he added. "This program is much like other RPM programs where we focus on the high-risk, chronic-condition patients. The devices used enable us to offer specific patient populations for home monitoring and to facilitate telehealth visits if needed."

The program offers frequent monitoring, disease management and medication management to those enrolled. Currently there are 129 active patients in the pilot program, and the organization is working through plans to expand to a much larger audience.

Memorial Healthcare System's Doc-in-a-box program started prior to the emergency of the pandemic.

"It was paused for safety reasons during the pandemic; however, the FCC grant has allowed us to purchase newer equipment to restart this program," Manzie reported. "Using the TytoCare telehealth technology to conduct in-home health visits is an invaluable resource for our Memorial Primary Care team.

"By allowing providers to connect with patients from a distance, telehealth technology helps to reduce the difficulty of seeing a provider in person that some patients may have," he continued. "The Doc-in-a-box telehealth technology can be especially beneficial for elderly patients, those with limited mobility, and those with challenges getting to an appointment."

By providing these services, in-home telehealth technology can help improve access to care while also reducing the costs associated with in-person visits at many levels, he added.

RESULTS

Since 2020, Memorial Healthcare System has achieved the following results:

• 363 Epic telehealth providers trained.

• 61 telehealth programs.

• 419,967 scheduled telehealth visits.

• 26,467 total Epic direct links.

• 97% patient satisfaction.

"Telehealth has revolutionized the current state of healthcare by providing improved access to care through the use of technology," Manzie said. "Telehealth allows patients to receive care from the comfort of their own home and reduces the need for unnecessary in-person visits, which can be costly and time consuming.

"It also allows providers to quickly connect with specialists, reducing wait times and increasing the availability of care," he continued. "This improved access to care has led to better outcomes for patients and an overall increase in the quality of care."

Additionally, telehealth has allowed for remote patient monitoring, providing real-time data to providers in order to better assess and manage patient conditions.

"Overall, telehealth has improved healthcare by evolving into a care-delivery model that has the potential to add value to many, if not all, disciplines of healthcare," he concluded.

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Email the writer: bsiwicki@himss.org
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