Most healthcare consumers have experienced certain pain points in receiving care for family and friends.

THE PROBLEM

Patient access is a top priority for AdventHealth, a health system based in Altamonte Springs, Florida. For the health system, improving the way it delivers care to patients starts with meeting them at the place of their needs.

"Looking for ways to solve for bringing the right care to the right patient at the right place and time is imperative to stay ahead of the ever-changing landscape," said Ashley Bard, IT director, care navigation and virtual care technology, at AdventHealth. "In recent years, our users of healthcare services have had the ability to shop for services, through marketplace and many other tools offered through payers and individual platforms.

"To ensure we offer the highest quality services to our recipients, AdventHealth went on a journey to provide telehealth services that can support the continuum of care, through COVID and beyond," she continued. "Our journey started well before COVID; we leveraged video visits to offset the increased demand of urgent care and look to reduce over utilization of the emergency departments."

This was a space still within "toddlerhood" for the industry and not widely adopted across the country as the standards for medicine were not well documented for these use cases, she added.

"To mitigate this, we went through a process of assessing telehealth throughout the continuum, where we begin to leverage other technology to introduce to the patient through other means: inpatient consults, remote patient monitoring, and ultimately bringing home services to the forefront," she said.

"By engaging with multiple vendors, we were able to create a landscape of service offerings across AdventHealth that could address remote needs and reduction of time to care across the network," she continued. "This allowed our providers to monitor patients for chronic conditions while living their day-to-day lives but were able to manage their post-discharge needs through use of the Vivify care portal."

This alleviated the need for many follow-up appointments, while allowing transparency in the care plan progress.

"Amwell became our partner in both video visits and inpatient use cases," Bard said. "Video visits grew substantially with COVID accounting for almost 75% of our outpatient visits during COVID. It quickly expanded into educational and outpatient service offerings that allowed us to bring care to the patients where they are.

"This allowed us to continue serving our population during COVID but has also become a standard in delivering care," she continued. "Leveraging Amwell in our inpatient settings during COVID allowed providers to work through isolation restrictions and ensure we kept our team members at the front line safe."

Telehealth will continue to grow within the healthcare industry and provide an opportunity for patients to receive care where they need it and how they want it, Bard said.

"In the digital world we live in, it is imperative that the connectedness of our patients and consumers of the services have the access they need to care not only through regulation requirements but integrated into their day-to-day care plans," she noted.

PROPOSAL

Telehealth technology, although not new to the industry, can still be viewed and used as ancillary products, Bard contended.

"Finding a way to integrate the technology into clinicians’ standard work is essential for long-term adoption," she explained. "Having segregation between the delivery of services virtually versus the clinical record will create poor consumer experiences, increase clinical risk, and generate difficulty navigating the continuum of care.

"Our vendors are focused on the ability to integrate within our EHR, digital front door platform, and connectedness of clinical care operations," she added. "Focusing on these areas allowed us to improve our access to care for our patients leveraging existing tools for self-scheduling and improve clinical outcomes through the care management resources."

MARKETPLACE

There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News published a special report highlighting many of these vendors with detailed descriptions of their products. Click here to read the special report.

MEETING THE CHALLENGE

After selecting telehealth vendors, AdventHealth began by establishing a cross-functional governance group. It solicited their feedback on the top workflows that bring the most value to consumers and clinicians.

Ensuring appropriate representation from revenue, clinical, legal, IT and operations is essential in a successful launch of the platform, Bard said.

"Formalizing project plans that included planning, discovery, design, build, test, activation and support tasks were required to ensure we did not have any missing pieces to the puzzle," she explained. "Ongoing optimization efforts to continue to build bridges are essential to stay relevant in the various use cases across our organization and with our community partnerships.

"Through consistent evaluation of operational workflows, we are able to identify ongoing needs and gaps that allow us to continue to expand and optimize the telehealth footprint," she added.

RESULTS

Increasing access to care through a reduction of scheduling throughput has been one of the highlighted metrics AdventHealth achieved by offering video visits. Ease of access with video visits was achieved; continued focus and effort around operationalizing a hybrid approach to care has been an ongoing effort, Bard reported.

"For the inpatient setting, we have been able to reduce time to care for patients requiring consults, and for those needing assessments prior to transfers," she said. "Having the ability to remotely consult and assess patients allowed our providers to reduce travel time between facilities during on-call rotations and improve quality of care.

"With remote patient monitoring, we saw a 60% reduction in hospital admissions for those who were ongoing users of the emergency departments for chronic conditions," she continued. "Leveraging at-home devices to monitor the patients and follow them through a clinical pathway allowed us to provide early intervention and reduce the number of hospital visits during and following the program completion."