Home' The Source : Third Quarter 2017 Contents through its telehealth offerings, it reaches patients in nearly 300
sites across 30 states.
Over the past 24 months, HCA’s telehealth operations have grown
by nearly 90 percent. Telehealth became an enterprise service line
within HCA three years ago, which allowed HCA to begin truly scal-
ing and integrating on a national level.
“In order for HCA to develop a national strategy, our telehealth
programs across the enterprise had to reach a tipping point of volume
and integration into their clinical workflows,” says Christopher
Northam, vice president of telehealth for HCA. “Over the past
couple of years, we have standardized our telehealth operations to
include most aspects of clinical and technical education and support
across the company.”
The cornerstones of HCA’s telehealth offerings are teleneurol-
ogy and telebehavioral health. “Telehealth allows us to provide
high-quality, timely access to our patients wherever they may be,”
The organization also offers emergent and non-emergent telehealth
services in multiple other service areas, including pediatrics and
critical care. “We continue to develop our multi-year service
expansion strategy, which includes remote monitoring of discharged
patients as they return home or to skilled nursing facilities. We see
this as a critical step in our evolution of patient care aided by the use
of telehealth,” Northam says.
“We’ll be providing our patients with ongoing personalized sup-
port so they can get back to their daily routine while more effectively
staying in contact with their care team to ensure the best possible
outcomes,” he continues.
A 20-year telehealth veteran, Northam cautions against viewing
telehealth as a panacea. “For each service offering, we first must
determine if telehealth can effectively meet four requirements for
our patient populations—improve quality, increase access, optimize
coverage and control costs—for our patient populations,” he says.
BY UTILIZING TELEHEALTH technology,
KentuckyOne Health is making care more
convenient and accessible for patients—
where and when they need it.
In 2013, Louisville, Kentucky-based
KentuckyOne, part of Catholic Health
Initiatives, became one of the first health
systems in the country to launch a virtual
24/7 urgent care service. For the past
four years, Anywhere Care has used the
Carena telehealth platform to connect
patients located anywhere in the state of
Kentucky with board-certified physicians
and nurse practitioners who can diagnose
and treat a variety of common conditions,
such as colds, flu, rashes and bladder
infections. Patients can access the service
via the web or a smartphone app, and
each visit costs just $35, whether or not
the patient has insurance.
Since launch, KentuckyOne has provided
1,231 virtual urgent care visits. The cur-
rent monthly volume is around 130 such
visits. The majority of them still occur by
phone—patients register on the platform
and a provider calls them back—but every
month video visits are increasing as a total
percentage of visits, says Kathy Love,
division director of strategy and business
development for KentuckyOne.
Meanwhile, average patient wait time
for the virtual urgent care service is 11
minutes, with 95 percent of visits occur-
ring within 30 minutes. Usage by females
is double that of males.
One of the goals of the service is to
capture a population of people who
don’t have a primary care provider (PCP),
which now represent more than half of
Anywhere Care users.
“After the virtual visit, we give these
patients a path to follow to create a
relationship with a PCP at KentuckyOne,”
Love says. “We always provide them with
referrals, and if follow-up is required, we
try to make sure they have the opportuni-
ty to do that with a KentuckyOne provider
in their community.”
There were some challenges getting buy-
in from patients who already had a PCP.
“We found that those people were
actually more hesitant to use the service,”
Love says. “We struggled with how to
make it an extension of their PCP’s office.
Now many practices utilize Anywhere
Care as an after-hours call service,
offering better coordination between
offices and virtual care.”
The virtual care service isn’t
KentuckyOne’s only foray into telehealth.
The service line also includes provider-
to-provider connection for telestroke
assessment, emergency department-
based psychiatric assessments, and
genetic counseling and prenatal care for
KentuckyOne recently received a grant
to launch a scheduling and documenta-
tion platform for telehealth visits. Patients
can schedule time with a certain provider,
and the platform, which is integrated
with the health system’s electronic health
record, manages the video feed and
documentation of the visit.
Up next is incorporating telehealth in
its bundled payment strategy.
“Rolling out Anywhere Care helped
us cut our teeth on providing telehealth
services,” Love says. “We’ve built the ex-
pertise and infrastructure and know how
to handle the physical connection and
documentation of the visit. Now we plan
to apply what we know to more complex
situations, like connecting our specialty
providers to patients we are managing in
bundles. We think we can interact with
these patients more efficiently, effectively
and frequently through telehealth than
having them come in for traditional in-
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