TriHealth, a health system based in Cincinnati, Ohio, had an access problem regarding patients who desired a first contact medical option that did not require a visit to a doctor’s office.

THE PROBLEM

Once TriHealth made the decision to research telemedicine platforms, from its point of view there were three major components needed for any platform to be seriously considered.

The first would be the platform’s ability to integrate into an electronic health record. TriHealth providers preferred EHR integration, as it alleviates the operational burden for front office staff and healthcare providers conducting telehealth services.

The second component was scalability. TriHealth has more than 135 locations, more than 700 providers and more than 250,000 attributed lives, so it was imperative that it have a product that could be scaled quickly and easily to meet demand.

The final component – and the one most important to TriHealth – was that the platform had to be easy to use for both healthcare providers and patients. Technology that is difficult to use can create a critical barrier to adoption and, in the case of remote care, simply would not work, the health system felt.

"During the peak of the pandemic, primary care telehealth visits accounted for more than 50% of our volume."

Nick Kostoff, TriHealth

“Telehealth platforms can enable access and care, but without a dually focused consumerism lens toward patient and provider it should be considered a failure in design and function,” said Nick Kostoff, senior manager for telehealth at TriHealth.

PROPOSAL

TriHealth opted to go with Zoom as its telehealth platform, which it believed met all three of its major considerations. Its existing telehealth vendor would have, in part, been too difficult to implement at scale.

MARKETPLACE

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MEETING THE CHALLENGE

TriHealth knew it needed to meet patients where they were, in their homes, and its pre-pandemic telehealth platform could not be scaled for use to patients outside the TriHealth network, due to security and authentication concerns. For that reason, the health system pursued what Kostoff calls a click-to-video platform.

“This platform allows patients to receive a link from a healthcare provider that launches into a HIPAA-compliant call without account build and authentication,” he explained. “This greatly alleviates the support burden from an information systems resource perspective, as well as the amount of time needed to get the patient on a functioning platform.”

TriHealth brought in Zoom at the beginning of April as the pandemic was working toward a peak. Integration into the Epic EHR began immediately. Within 10 days, TriHealth had a solution that met the three mentioned major requirements, and also had a system-wide rollout plan.

“The primary focus was twofold: First, ensure that we had a plan to assist with social distancing for the safety of our healthcare providers and patients, and second, get our primary care and specialty offices up and running as quickly as possible as business had slowed dramatically,” Kostoff said. “Once Zoom was implemented within the inpatient setting to ensure our providers could remain socially distant and safe, focus shifted to our more than 250 practices.”

Telehealth visits now are being carried out across all primary and specialty care services. Zoom is integrated with Epic and with TriHealth’s Language Line interpretive services. Implementing Zoom and embedding interpretive services into the Epic workflow created a seamless scalable solution, Kostoff added. This helped staff “take the reins off” and allowed staff to rapidly change the way care was being delivered in a way that was not possible prior to the pandemic, he said.

RESULTS

TriHealth has seen an increase of 3,650% in telehealth utilization over the last six months.

“Without our new solution, we wouldn’t have been able to meet patient needs without opening our digital front door,” Kostoff said. “During the peak of the pandemic, primary care telehealth visits accounted for more than 50% of our volume.”

USING FCC AWARD FUNDS

Earlier this year, TriHealth was awarded $537,471 for tablets, video monitors, and telehealth equipment and software to conduct remote monitoring and treatment for primary, specialty, urgent care and COVID-19 response, as well as for virtual evaluations of hospitalized patients to reduce exposure for providers and patients.

“The FCC award funds will go toward reimbursing the organization for the Zoom implementation and the endpoints that were purchased to supplement the needs of the practices,” Kostoff explained. “TriHealth purchased and deployed: 600 Lenovo monitors with integrated camera and microphone, 500 iPads and poles (iPads on wheels), and 300 USB cameras.”

The telehealth program grew from a handful of inpatient use cases to scaling across the whole health system overnight. TriHealth now has telehealth technology in every corner of the organization, changing the way care is delivered.

“The FCC funds helped us bring in the technology software and hardware needed to complete a system-wide rollout of Zoom,” Kostoff concluded. “This accomplished our goal of ensuring the safety of our patients and healthcare providers by providing care from a distance, as well as aiding a business continuity plan during an unprecedented public health emergency.”

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