Wellpath is one of the largest correctional healthcare organizations in the country. With nearly 15,000 clinicians and professionals in 34 states across the U.S. and Australia, Wellpath delivers medical and behavioral healthcare services to nearly 300,000 patients located in inpatient and residential treatment facilities, civil commitment centers, and local, state and federal correctional facilities.

In 2021, Wellpath leveraged TSIM, the Telehealth Service Implementation Model that was developed at the Medical University of South Carolina's Center for Telehealth, an HRSA-designated National Telehealth Center of Excellence.

Wellpath used the telehealth framework to create and scale an emergency medicine telehealth service to local government county jails and state prisons across the country. Wellpath utilized TSIM to develop, implement and optimize the emergency medicine telehealth service to more than 100 facilities across the U.S.

Shawn Valenta is vice president for healthcare cloud in clinical services at Wellpath. In Valenta's previous administrator of telehealth role at the Medical University of South Carolina, he oversaw the strategic initiatives and operations of the MUSC Center for Telehealth.

Next month at HIMSS22, Valenta will deliver a presentation entitled "Scaling a National Emergency Medicine Telehealth Service." This presentation will review the Wellpath initiative and how the TSIM logic can be applied to any telehealth service.

Healthcare IT News interviewed Valenta to offer readers a sneak peek at his educational session.

Q. What are a couple of the challenges of developing a national telehealth service?

A. Since care has been defined as being delivered within the state where the patient is located, organizations looking to develop a national telehealth service must understand each individual state's telehealth laws and regulations. The Center for Connected Health Policy is a great resource for organizations interested in following the evolving landscape of telehealth policy.

A major component of creating a national telehealth service is the process to license your providers in each of the individual states in which they will deliver care. While state licensure compacts have gained momentum, the overall process can still be very challenging and costly.

At Wellpath, we partnered with a company that specializes in obtaining state licensure, and it has made a significant impact on streamlining the process for our providers.

Another major challenge is being able to provide education and training efficiently and effectively to partner sites across the country. We implemented Wellpath Now, our emergency medicine telehealth service, in more than 100 correctional facilities across 24 states within a nine-month period.

We could not have accomplished that without a centralized, coordinated team executing a standardized implementation approach delivered through remote education and training. In addition, local site champions who understand and can articulate the overall value of the telehealth service can have a significant impact on adoption and early change management issues.

Q. In brief, what are the phases of the TSIM framework?

A. During a period of rapid growth at the Medical University of South Carolina's Center for Telehealth, TSIM was created out of a necessity to simplify the complexities of telehealth service development and organize team dynamics and processes. TSIM has continued to evolve and is now being applied at different organizations across the country.

TSIM consists of six phases: pipeline, strategy, development, implementation, operations and continuous quality improvement. TSIM serves as a road map on how to take a telehealth idea through a standardized approach to service scale and optimization.

It provides an architecture and terminology to boost the clinical and technical collaboration required to successfully design high-quality, highly reliable telehealth services. It also establishes strategic principles and philosophies that aid in redesigning care delivery and not simply using video to replicate existing, often inefficient, care processes.

Finally, it helps teams identify their strengths and weaknesses within their structure and processes, which can be addressed through formalized quality improvement.

Q. What are a couple of the metrics used to evaluate the success of a telehealth service?

A. The telehealth measurement framework developed by the National Quality Forum is a great place to start your outcomes planning, including identifying metrics that fall within the core domains of access to care, financial impact/cost, experience and effectiveness.

TSIM requires that you identify metrics of success within the strategy phase, and the data reporting and validation should be completed during the development phase. Short-, medium- and long-term outcomes are then established to align with the maturity of the telehealth service and to provide a directional guide towards sustainable clinical transformation.

I always tell my team that if we execute on the short-term process metrics, the quality and financial impacts will follow.

At the most basic level, utilization – the number of telehealth interactions within a given time period – should be monitored. If the service is not being used as expected, there is an obvious issue that needs to be addressed.

Beyond utilization, we monitored our average provider response time to measure timely access to care. In addition, the onsite treatment rate was tracked to calculate the financial impact of ER cost avoidance, and the associated cost-savings attributed to our local partners. We also used a simple net promoter score question to measure user experience.

Finally, we collected quality of care delivery metrics – for example, mortality rate, ER send-outs within 48-hours after an onsite treatment plan – to assess the clinical effectiveness of the service. By identifying these success metrics within the strategy phase, we were able to establish documented alignment with our clinical, technical, operational and financial stakeholders.

Since then, Wellpath Now has made a significant impact on improving care delivery for the patient population we serve.

Shawn Valenta's HIMSS22 session, "Scaling a National Emergency Medicine Telehealth Service," is scheduled for Wednesday, March 16, 4-5 p.m. at the Orange County Convention Center, in room W230A.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.