Elliott Wilson Manager, Telehealth and Mobility Programs 856-248-6575 exwilson@virtua.org
THE TELEHEALTH JOURNEY Challenges and Opportunity Across the Continuum
Agenda and Objectives Overview of Virtua What is Telehealth? Bob s Bad Day How Telehealth fits into Virtua s Continuum Virtua s Implementation Challenges and Lessons Learned Telehealth s Barriers and Promise
Overview of Virtua 3 hospital health system with approximately 1000 beds Over 80 primary care and subspecialty practices Over 80 other Virtua Locations: 11 Outpatient Labs 9 Surgery Centers 8 Corporate Offices 7 PT/Rehab Centers 5 Imaging Centers 5 Urgent Cares 4 Centers for Nutrition and Diabetes Care 4 Occupational Health Centers 4 Weight Management Centers 4 Sleep Centers 3 Cancer/Oncology Centers 3 Cardiac Rehab Centers 3 Health and Wellness Centers 2 Long Term Care Facilities 2 Freestanding EDs 2 Ob/Gyn Clinics 2 Spas 2 Outpatient Centers 2 Wound Healing Centers 1 Eye Diagnostic Treatment Center 1 Joint Replacement Institute Partnerships with CHOP and Penn Medicine Mission Virtua helps you be well, get well, and stay well. Vision Virtua, the premier choice in health and wellness Credo Our community is our family. We provide genuine, caring service every time. We believe every interaction is an opportunity to build relationships and loyalty through listening, anticipating needs, collaboration, and engagement.
What is Telehealth? Use of medical information exchanged from one site to another via electronic communications to improve a patient s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. Telemedicine is not a separate medical specialty - American Telemedicine Association
What is Telehealth Really? Synchronous Video Consults Asynchronous Care (a.k.a. Store and Forward) Remote Patient Monitoring
Governance/Mission Telehealth Program Department Coordinates efforts to identify, vet, and prioritize new programs Manages the project launch of new programs Telehealth Oversight Committee Executive leadership level governance Representing: Physicians Nursing Strategy and Business Population Health Integrated Care Management Medical Group Information Services Government Relations Telehealth Mission Virtua helps you be well, get well, and stay well from anywhere.
Patient Profile Meet Bob 59 years old History of Hypertension, CAD, and CHF Regularly sees a Virtua Cardiology Physician Bob is about to celebrate 30 years of marriage to Betty Bob is a Virgo, enjoys playing piano and taking care of his garden
Bob Has A Cardiology Visit Uses Virtua s Telehealth Application for his medication check up During the visit, Bob tells his Cardiologist how great he feels They decide to keep his medications and doses the same for now Synchronous Video Consults
Bob Has a Stroke Bob wakes up the next night with facial droop Bob is taken to Virtua Memorial where a Specialist on Call cart is set up Clear for thrombolytic therapy following results of a CT Scan Image source: specialistsoncall.com Synchronous Video Consults
Bob Gets a CT Scan Middle of the night and there s no Radiologist on site Study is electronically sent to a remote Radiologist The time to read mimics in-person reads. Bob gets his thrombolytic in time Asynchronous Consults (a.k.a. Store and Forward)
Bob is Admitted to the Hospital Transferred to a medical floor once stable Provided a tablet with EPIC MyChart Bedside* View personal health information Communicate with both inpatient and outpatient providers *Expected go-live 2018 Image source: highgroundnews.com Asynchronous Consults (a.k.a. Store and Forward)
Bob Has a Cardiology Consult Virtua hospitalist orders a cardiology consult. Cardiologist and Bob connect with Bob s regular cardiologist via Virtua s Telehealth Application Synchronous Video Consults
Bob Has a Psychiatric Consult Bob tells the Virtua Hospitalist that he s been depressed about his health for a while The Hospitalist would like to get a psychiatric consult, but the psychiatrist has already left for the day The Hospitalist orders a remote psychiatric consult from InSight Telepsychiatry Image source: insighttelepsychiatry.com Synchronous Video Consults
Bob is Discharged to Sub-Acute Rehab Bob is discharged to postacute service at the Virtua Mt. Holly Long Term Care facility Bob develops some shortness of breath. The Long Term Care staff contact his cardiologist through Virtua s Telehealth Application and develop a care plan Synchronous Video Consults
Bob Returns Home Bob is discharged to home on Virtua s Remote Patient Monitoring Program A clinical team monitors his weight, blood pressure, and pulse ox The monitoring team coordinates his care with his assigned community based health manager Remote Patient Monitoring
Bob Catches a Cold Bob gets a cold on the weekend and his Primary Care office is closed Bob goes to Virtua.org/Teladoc and requests a video consult with a physician During the visit, Bob forgets his medication and goes onto Virtua s MyChart mobile app to look them up Synchronous Video Consults Asynchronous Consults (a.k.a. Store and Forward)
Telehealth is Everywhere
Early Implementation Challenges Physician support and availability Maintaining physician engagement Technology adoption Limitations of technology Integrating technology into workflows
Lessons Learned Listen to your stakeholders Focus on need first, and not what is available Don t force technology Adapt to current workflows Involve staff early and often Minimize pain, maximize gain Build partners and collaborate Telehealth
Components of a Successful Program
Barriers to Telehealth Physician Buy In and Leadership More Research Interoperability Between Systems Regulatory Issues Access to Broadband Internet Reimbursement Reed Tuckson Keynote Address MATRC 2016 matrc.org
The Promise of Telehealth Improved Access Cost Reduction Improved Quality Patient Engagement American Telemedicine Association americantelemed.org
Telehealth Forum