United Health Services Hospitals is a health system serving South Central New York and based in Vestal, New York. Its virtual healthcare program began in July 2019 with the launch of the UHS Virtual Walk-In.

The Virtual Walk-In was a direct to patient offering for minor acute complaints. Zipnosis was chosen as the technology platform because of its ability to combine an asynchronous adaptive interview process with a step-up to video.

Virtual walk-in care

"The offering is staffed exclusively by the same providers who staff our in-person walk-in locations," said Sean J. Britton, system program manager, UHS virtual healthcare and digital transformation. "We achieved URAC Consumer-to-Provider Telehealth Accreditation for the Virtual Walk-In in December 2019 and hold the distinction of being the first health system to receive that designation.

"As the pandemic arrived, we used the Virtual Walk-In as the primary access point for care of suspected COVID patients," he added.

"We achieved URAC Consumer-to-Provider Telehealth Accreditation for the Virtual Walk-In in December 2019 and hold the distinction of being the first health system to receive that designation."

Sean J. Britton, United Health Services Hospitals

Over the course of three weeks in March 2020, the virtual healthcare team trained more than 400 primary care, specialty care and therapy services providers, as well as 800 support staff, on how to use Zipnosis for virtual health encounters. In April 2020, more than half of outpatient volume was performed virtually.

"In late 2020 and early 2021, we initiated three new virtual healthcare offerings," said Dr. John Giannone, medical director for virtual healthcare. "The first was the launch of a platform called Twiage, which allows for asynchronous and synchronous telehealth between our community ambulance services and our receiving hospital emergency departments.

"The second was the launch of our Hospital Care at Home Program, also technologically supported by Zipnosis, which is a fully virtual offering to both reduce inpatient length of stay and assist with transitions of care between inpatient hospital stay and the return to home," he continued.

Chronic disease RPM

Lastly, the provider organization implemented a remote patient monitoring program focused on management of chronic diseases such as hypertension and congestive heart failure.

Since the launch of Twiage, United Health Services Hospitals has averaged more than 10,000 cases per year of ambulance-to-ED telehealth communications. The Hospital Care at Home program has had more than 700 patients, and it monitors for decreases in inpatient length of stay and readmission rates.

The remote patient monitoring program has had more than 300 patients, and it tracks events such as provider-ordered medication changes, virtual visits and in-person visits in response to out-of-parameter readings.

"We have found our greatest success has been the utilization of new technology and clinical programs to decrease inpatient length of stay by providing more clinical care in the home setting."

Dr. John Giannone, United Health Services Hospitals

United Health Services Hospitals was awarded $562,116 from the FCC telehealth grant program for telemedicine carts and patient monitoring devices to provide telehealth services to patients at home, many of whom are located within high-poverty, rural and underserved areas.

Expanding the use of telehealth

"Most of the FCC funding was used for the technology to support Hospital Care at Home and remote patient monitoring," Britton explained. "The funding was beneficial in allowing us to expand the use cases for telehealth broadly and explore different modalities.

"The funding has provided technological infrastructure as well as operational knowledge to carry our virtual healthcare program forward as we identify new opportunities to provide care to patients within the home virtually as well as with hybrid models of care that incorporate clinicians on-site supported by telehealth," he added.

The biggest problem the healthcare organization has faced has been, and continues to be, hospital capacity, Giannone noted.

"So we have found our greatest success has been the utilization of new technology and clinical programs to decrease inpatient length of stay by providing more clinical care in the home setting," he concluded.

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