Protecting pediatric patients, their families and hospital staff required a radical and rapid shift in care delivery strategies for Phoenix Children’s Hospital during the COVID-19 pandemic.

The organization took a fast-track approach to shift its ambulatory-patient encounters to virtual ones, moving away from in-person visits that had been the staple of Arizona’s only freestanding children’s hospital.

Telehealth within a week

Spurred by the urgency of the COVID-19 crisis, the healthcare organization made the shift to telehealth within a week, transitioning most of its 6,000 weekly appointments to a telemedicine platform.

The quick transition was in large part supported by a custom-made, in-house-developed analytics dashboard that helped coordinate the efforts of the clinicians, clinic managers and scheduling staff, while it provided a single view of the entire operation to senior leadership.

Using the dashboard, clinicians are able to carefully triage upcoming appointments to select patients who are appropriate for telemedicine visits versus those who should be seen in person, such as patients who need to come in for chemotherapy infusions.

The movement toward virtual visits aims to protect patients, their families and healthcare workers from exposure to COVID-19, thus making it essential to eliminate as much in-person patient traffic as possible at the hospital and its clinics.

Wide support for telemedicine

The telehealth initiative drew wide support from clinicians as well as patients, said Dr. Vinay Vaidya, Chief Medical Information Officer at the facility, which has 433 licensed beds.

The biggest hurdle was not so much in rapidly converting in-person visits to telemedicine visits or winning clinicians over to the idea, Vaidya said. Clinicians at the facility typically were quick to adopt new technologies and embraced change that improved patient care.

“The bigger challenge was the operational task of selecting the appropriate patients for telemedicine visits, communicating this change to the scheduling staff, contacting families and keeping track of the entire process for more than 6,000 patients each week, seen by more than 300 providers in more than 35 different pediatric subspecialties,” he said.

Zooming into telehealth

While a few clinicians at Phoenix Children’s had interacted with patients via consumer apps, the facility had no formal telemedicine platform as of mid-March. Many of the facility’s physicians already were familiar with Zoom, having used it mainly for meetings, and in some cases for telemedicine. In short order, Zoom became the core platform upon which the organization’s IT department was able to customize the basic offering, and integrate the dashboard functionality using Microsoft’s Power BI to build out its virtual-care capabilities.

The dashboard serves multiple audiences. For clinicians, it enables them to see their next appointments and whether encounters will be via the telehealth platform, simply by telephone or in person. They also can see the appointment time, approximate length of the visit, and a short explanation of the diagnosis and of the reason for the visit.

Use of the telehealth platform has been a boon to efficiency in other ways. For example, it enables multiple clinicians involved in a complex patient’s care to interact with the patient and adult caregiver at the same, thus helping with information transfer and collaboration, Vaidya noted.

API to the rescue

The dashboard reaches into the hospital’s clinical systems via an application programming interface to supply real-time data on patient visits for executives and schedulers. It can provide organization-wide as well as department-specific information – for example, enabling schedulers to see which specific patients can be shuffled from an in-person visit to a virtual encounter.

The dashboard also is able to drill down to actionable items, such as providing a daily call list for each of the facility’s more than 100 schedulers, and it can auto-text families when schedulers can’t reach them by phone.

The shift to virtual care was quick. For the week of March 8, all 6,670 ambulatory clinic visits were carried out as in-person visits. Just a few weeks later, more than two-thirds of the visits were successfully conducted using the telemedicine platform. And some departments were even able to convert as many as 80% to 90% of their visits to telemedicine, Vaidya said.

“We have been using data [to direct operations] for a long time,” he added. “We have various dashboards that drive clinical, operational and financial outcomes. We expect to really optimize this platform and continue to offer it to patients and their families.”

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Fred Bazzoli is a contributing writer to Healthcare IT News.
Twitter: @fbazzoli
Healthcare IT News is a HIMSS Media publication.