{"id":27912,"date":"2020-06-25T16:15:14","date_gmt":"2020-06-25T16:15:14","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=27912"},"modified":"2020-06-25T16:15:14","modified_gmt":"2020-06-25T16:15:14","slug":"telehealth-sustainability-requires-a-willingness-to-adapt-to-new-ideas","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/telehealth-sustainability-requires-a-willingness-to-adapt-to-new-ideas\/","title":{"rendered":"Telehealth Sustainability Requires a Willingness to Adapt to New Ideas"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">When its three-year telehealth pilot ended and the grant money ran out, Long Island Select Healthcare took stock of its options and decided to change its approach to connected health.<\/h4>\n\n\n\n<p>By\u00a0<a href=\"mailto:ewicklund@xtelligentmedia.com\">Eric Wicklund<\/a><\/p>\n\n\n\n<p>June 25, 2020&nbsp;&#8211;&nbsp;When&nbsp;<a href=\"https:\/\/www.lishcare.org\/about\/?tab=2\">Long Island Select Healthcare<\/a>&nbsp;tallied up the results of a three-year, grant-funded telehealth program in 2017, administrators saw strong results \u2013 an 86 percent reduction in ER visits, a 50 percent increase in access to care, a 26 percent reduction in highest cost use, an 86 percent improvement in patient activation and a 98 percent patient satisfaction rate.<\/p>\n\n\n\n<p>But the $6 million dollar grant from the New York Department of Health was gone, and there was little hope of making that funding up through Medicare or Medicaid. In order to make those telehealth gains sustainable, LISH had to shift gears.<\/p>\n\n\n\n<p>\u201cWe had to rethink and rescale the program,\u201d said Terry-Ann Seppala of Telehealth Associates, a consulting firm brought in to help the health system with sustainability.<\/p>\n\n\n\n<p>Sustainability is one of the taller challenges to telehealth success, as it requires those in charge to think beyond grants and pilot projects and those first few years to map out a program that proves consistent value over time. Those early successes may look great, but without funding and administrative support those numbers fade away very quickly.<\/p>\n\n\n\n<p>Seppala and James Powell, LISH\u2019s chief executive officer and CMO, were on hand during the first day of&nbsp;<a href=\"https:\/\/telehealth2020.swoogo.com\/launchtelehealth2020\/\">a virtual conference organized by the Northeast Regional Telehealth Resource Center and Mid-Atlantic Telehealth Resource Center<\/a>&nbsp;to explain how the health system moved from a pilot to a platform that now supports several connected health services.<\/p>\n\n\n\n<p>To begin with, they looked at a program that was serving a very specific population \u2013 roughly 2,000 patients with neurodevelopmental and intellectual disabilities \u2013 and expanded the envelope. As a federally qualified health center, LISH served a large population, many of which have chronic care needs that often go unmet.<\/p>\n\n\n\n<p>Powell and Seppala designed a connected health platform that included remote patient monitoring and telehealth tools, qualifying for CCM reimbursement through Medicare. They trained medical assistants to be CCM coordinators to help expand that care management envelope to the home.<\/p>\n\n\n\n<p>The idea, they said, was to create a platform that focused on so much more than one select group of patients or one reimburseable service. Adjust to more patients\u2019 needs, and be flexible enough to think in terms of virtual care.<\/p>\n\n\n\n<p>\u201cIf we can make a robust CCM project, it will offset the visits we are not reimbursed for,\u201d Powell pointed out. &nbsp;\u201cYou really have to be agnostic in your approach. \u2026 You really can\u2019t have a one-size-fits-all with anything.\u201d<\/p>\n\n\n\n<p>To make this work, the health system had to think beyond episodic care and embrace multiple touch points, in a move toward continuous care. Scheduled telehealth visits were preceded by e-mails or messages to make sure patients were prepared for their virtual appointment, and followed up with messages to make sure they had understood the treatment plan.<\/p>\n\n\n\n<p>\u201cWhat worked well was the engagement and the interaction with everybody,\u201d said Powell, who calls this the \u201cquality of touch.\u201d<\/p>\n\n\n\n<p>They also learned that going digital means investing in education. Many of their patients needed help acclimating to the technology \u2013 either full-on lesson in how to use telehealth or just a helping hand. The health system developed protocols to screen patients for technical literacy, and to tach those who needed help, and they secured funding from the Federal Communications Commission to improve broadband resources for their patients.<\/p>\n\n\n\n<p>Of course, the coronavirus pandemic had a part to play in this transition.<\/p>\n\n\n\n<p>COVID-19 \u201cchanged the game,\u201d Powell said. \u201cOur walk turned into a very quick race\u201d to shift from a predominantly in-person care provider to a virtual care provider. \u201cMany of us became experts in change management.\u201d<\/p>\n\n\n\n<p>Moving forward, the health system is embracing virtual care as a necessary part of the platform. They\u2019re adopting what is called a \u201chybrid approach.\u201d<\/p>\n\n\n\n<p>\u201cBe mindful of where the new normal is and all the variations of the new normal,\u201d said Powell, who expects his July in-person traffic to be one-third of what it would normally be.<\/p>\n\n\n\n<p>Seppala said healthcare providers like LISH have to balance virtual care with in-person care, and give patients the flexibility to choose how to receive care.<\/p>\n\n\n\n<p>\u201cIf you\u2019re a hybrid practice, you can care for patients who are not digitally competent and who never will be,\u201d she said.<\/p>\n\n\n\n<p>By thinking outside the box, LISH has parlayed that three-year, $6 million pilot program serving 2,000 people into a network of telehealth and mHealth services, serving not only the FQHC but a diagnostic and treatment clinic in the Bronx and a home health agency and skilled nursing facility in Nassau County. They\u2019re securing more than $2 million in grants for these programs, as well as additional institutional investment and reimbursements. And they\u2019re launching new pilot programs to expand their RPM network and offer telemental health services.<\/p>\n\n\n\n<p>\u201cPeople aren\u2019t mindful of the whole process and all of the variables that go into virtual care,\u201d said Powell, who noted that care providers often look for value in only one service, such as urgent care, or one modality, such as the video visit, instead of considering the broad envelope of care that can be provided. &nbsp;<\/p>\n\n\n\n<p>\u201cThinking about all those opportunities makes a big difference.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>When its three-year telehealth pilot ended and the grant money ran out, Long Island Select [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":27913,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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