Prior to the pandemic, Parkview Health had many of these technologies in place, but only in small pilot areas because the ability to gain large adoption by both providers and patients was hindered by numerous insurance constraints.
The pandemic helped bring telemedicine to the forefront of care for nearly every health system, first out of necessity and then out of the realization that many patients could be cared for in this remote manner.
“With the adoption barriers now overcome, and the payers now accepting the method of care, telemedicine is now here as both a standard of care and a retention tool in a competitive patient market,” said Maximilian Maile, senior vice president of digital health at Parkview Health System.
“In order to deliver our digital health solutions, we have a number of key vendors and partners that we work with,” he continued. “But perhaps none is more important than our electronic health record, as it serves as the backbone of our communications between providers and patients.”
Parkview Health made strategic moves in 2012 to implement and integrate Epic as its EHR for all hospitals and providers. This move has allowed the organization to be unified along the implementation and capabilities.
“That unification cannot be underscored enough, as it allows us to implement vendors that can be leveraged across the entire health system, rather than purchasing multiple vendors for the same end goal,” Maile explained.
“Additionally, we used other key partners to drive some of the patient experiences,” he continued. “While Epic is our key platform to deliver the video visits or the patient portal, we also have Veta Health to accomplish some of our remote patient monitoring and hospital at home initiatives. Veta Health has been a great partner to come alongside our organization and develop some of the tools that we need for patient engagement and devices.”
Best Buy has played a key role in the sale of in-home devices, he added. If patients want to purchase a scale, blood pressure cuff or other home item, Parkview Health has a curated site with Best Buy that enables patients to purchase devices that have been reviewed by Parkview physicians and digital health staff.
“This leverages the core strengths of both organizations, as Best Buy can provide robust ecommerce solutions and Parkview can focus on care delivery,” Maile said. “Technology will continue to help the healthcare industry evolve care models for patients in the home.
“There now are numerous ways that we can connect to patients and deliver care in a convenient way,” he continued. “Digital health not only provides ways to keep the patient engaged in care, but it can provide transparency about the care through shared notes, it can allow for better rural care, and it can provide solutions for those who may struggle with transportation or other social determinants that would typically pose barriers.”
Prior to the development of digital health and the widespread use of video visits, there were significant challenges for receiving specialty care in rural hospitals. Parkview Health has two large metropolitan sites and several community hospitals. Many specialties and subspecialties are only available in the metro locations.
“This poses both a challenge from a patient experience standpoint, driving into the city, which increases the stress and time burdens on the patient, but also from a health system perspective, that beds are filled by transferred patients simply because a consult wasn’t able to be provided in the community location,” Maile explained.
“In 2016, we introduced video visits to several community hospitals, for consults by cardiology and psych,” he continued. “Additional specialties followed, as the concept of being able to provide the same high-quality care was proven out, and the savings for the provider time and transfers was recognized.
Video visits were also permissible by payers if a patient came on-site to a specific location, but this proved cumbersome and undesired by patients. When the COVID-19 pandemic hit and payers allowed patients to remain in their home, the use of video visits became far more widespread.
“For several months, it became one of the few ways to receive care, as the country was encouraged to stay home,” Maile recalled. “Parkview Health was able to retain nearly 70% of our standard care visits with patients by using video services within our EHR and patient portal, even as the physical offices were closed.
“Once again, this served as a pilot opportunity to then showcase that digital health can provide meaningful interactions and deliver high-quality outcomes without the need to be face-to-face,” he said.
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
One of the key pieces of technology that Parkview Health leveraged to meet the challenges was its MyChart patient portal.
“Our digital health team had been developing the patient portal for several years, but it takes constant refinement and evolution of the product to continue to make it meaningful,” Maile said. “The constant addition of features is incredibly important to ensure that it meets the needs of patients and engages them in their own healthcare decision making.
“Since we had MyChart in place for many years, and had piloted the video technologies and communications within that portal, we strongly encourage all of our patients to use this as the primary communication tool for their records and health information,” he continued. “This focused approach has allowed us to more than double our adoption rates over the past three years, growing from approximately 28% to nearly 70% of our patients actively using the portal over the past year.”
Again, going back to the engagement side, Parkview Health now sees patients logging into their accounts on average seven times per month. Staff love seeing this growth as it strengthens their overall ability to communicate effectively.
“With a strong patient portal, we are able to leverage other benefits that digital health can provide, with scalability and cost savings,” Maile noted. “For example, we recently have made all of our paperwork and check-in work available prior to the visit.
“This allows patients to complete an eCheck-in up to several days prior to the visit from the convenience of their own home,” he continued. “When they arrive at the office, all of that paperwork is already completed, and our office staff saves an average of three minutes per patient from checking them in.”
This is a significant amount of time over the course of thousands of transactions at many offices.
“Another example of savings with the patient portal is the ability to promote healthcare reminders to patients and allow them to schedule appointments without ever having to speak to someone,” Maile said. “This not only saves the health system from expanding call services, it also allows the patient to seamlessly create an appointment with a time that works for them.”
Maile spoke about the adoption of the patient portal, which he thinks is a significant result achieved. Being able to grow that allows for strong adoption in other initiatives, such as eCheck-in, Open Notes, online scheduling options, and features such as remote line queues.
“Having nearly seven out of 10 of our patients using the portal gives the economy of scale to implement the other features and quickly gain traction or savings,” Maile explained. “We also have a large base of patients who are engaged with their care and able to communicate back to us, in the form of surveys or other feedback mechanisms. This is helpful for us to refine and improve initiatives.
“Parkview launched a Hospital at Home initiative last fall, and that couldn’t have been done without incredible teams using incredible technologies,” he added. “This program allows for patients to be admitted as an inpatient, into their own homes, while still receiving inpatient services such as oxygen, IV and nurse rounding.”
Patients are able to be connected by video with a physician, as a nurse is in the home, and have their vitals monitored remotely. It took several teams in order to make this technology build come together, and was a significant effort.
“However, the outcome is that patients are able to relax and recover in their home, which has been proven to give better recovery times and outcomes,” Maile said. “Our home health team leads this effort.”
ADVICE FOR OTHERS
Maile has two recommendations for his peers who have to navigate digital health or telemedicine initiatives.
“First is to constantly evaluate your solutions – even ones that are in place and working well – on a two- to three-year timescale,” he advised. “With the rate of technology, there are so many new options every two years that you have to be vigilant in order to ensure you are incorporating the right solutions to meet the right needs.
“We try to view this through a lens of ‘1,000 day journeys,'” he continued. “Do we have the right solution for the next 1,000 days? Do we anticipate a different solution or a lower cost solution in 1,000 days? A difficult part of this process is sometimes a conversion from something that worked to get you here to a new product that will get you where you need to be.”
Maile’s second recommendation is to constantly look at the scale of a project.
“A significant benefit of digital health, and technology in general, is the overall scale at which it can be grown,” he said. “Once a technology is implemented, there are very few limitations to expanding it. There are a lot of things to consider in that approach, such as the right care setting, the right patient engagement levels and the right quality outcomes.
“But if those can be aligned and you can leverage your initial investment over a larger audience, it will help maximize the overall ROI,” he continued. “Right now, all health systems need to fully leverage these tools and ensure they are investing in the right solutions for the next two to three years.”
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email the writer: email@example.com
Healthcare IT News is a HIMSS Media publication.