Hilltop Regional Health Center in Tacoma, Washington, had two big issues going into the COVID-19 pandemic's virus spread and shutdowns.

THE PROBLEM

The first issue was that it did not have a formal telemedicine solution in place. Second, it did not have sufficient resources to run telemedicine for the entire organization once it procured the necessary software.

Another big issue was money, though this was solved by applying for and receiving a grant from the FCC's telehealth funding program.

As a stopgap, Hilltop Regional had been using Zoom as best as it could, but it did not really fit staff workflows. Medical assistants had to check patients into the telemedicine encounter and then had to pass off the encounter to the provider.

PROPOSAL

The provider organization procured NextGen's Otto telemedicine system, which solved this issue.

"The next issue was we didn't quite have enough server resources, particularly for remote providers to run telemedicine when they were not on campus," said Michael Palais, IT and EHR manager at Hilltop Regional Health Center. "We were able to procure servers for a virtual desktop environment allowing remote providers to work with network resources they needed for telehealth.

"We were also able to increase our bandwidth at locations that did not quite have enough for the encounters to run smoothly," he continued. "Then, what seems a smaller issue that still involved cost to overcome to succeed, were the dearth of cameras with microphones for providers and support staff. We were able to purchase these for everyone that needed them."

NextGen's Otto helps the patient perform self-check-in, so they get an automatic text message with appointment information and how to check their system requirements before the appointment.

"This was much safer and convenient for the patient and helped ensure we took care of their needs."

Michael Palais, Hilltop Regional Health Center

"With Zoom, we had to try to help the patient more, and it was clunky," Palais recalled. "Otto automatically checks the patient appointment in when they connect, and automatically generates the encounter so the front desk doesn't have to do that work. 

"Once the patient is checked in, Otto goes through a series of questions to get consent for the video visit and other pertinent information in a secure manner. It was easy for the medical assistant to now do the intake and prepare the patient encounter for the provider."

MARKETPLACE

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MEETING THE CHALLENGE

Providers and their support staff all benefited from the grant and subsequent technologies in that they could successfully complete telehealth encounters smoothly.

"We have enough resources so there are not any glitches or lagging during the appointment; the audio and video are clear," Palais explained. "The grant helped us get into place items that would have been challenging to procure otherwise. We were able to meet the daunting challenge of serving patients during the COVID-19 pandemic and we did it pretty quickly.

"Our virtual environment is much more stable, as well," he added. "We were able to build in some redundancy, which was an issue in the past when equipment might glitch or need to be taken down for maintenance. We now can ensure that the resources are there on the network, so as not to disrupt the patient telehealth encounter."

RESULTS

Hilltop Regional Health Center increased telehealth visits from 1,308 in 2019 to 41,310 in 2020.

"More secure video visits was an achievement," Palais said. "And it is convenient for the patient, as they don't have to come in physically to receive care for many issues. And during COVID-19, that is much safer for everyone."

USING FCC AWARD FUNDS

Hilltop Regional Health Center was awarded $534,139 by the FCC last year for laptops, telehealth equipment and software, and network upgrades to provide care to patients with COVID-19 in a manner that maximizes patient and staff safety, to patients with limited transportation, and to patients in need of ongoing care due to chronic conditions or behavioral health needs.

"We wanted the funds to help us meet our mission to provide the highest quality healthcare with compassionate and accessible service for all," Palais explained. "The funds helped us do this by offering telemedicine to our patients who previously would have had to physically come to our facilities for all types of encounters.

"This was much safer and convenient for the patient and helped ensure we took care of their needs," he concluded. "The funds also ensured that the visits would be error free and happen in a way that didn't seem unfamiliar. It allowed our staff to help the user prior to the visit to make sure they were ready and they could get the most out of the encounter."

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