Prime Healthcare operates 51 hospitals and more than 360 outpatient locations in 14 states, providing more than 2.5 million patient visits annually. It has nearly 57,000 employees and physicians.
The health system is dedicated to enhancing patient care in the emergency department by providing around-the-clock access to specialist consultations.
“Timely specialty input is essential for ensuring accurate diagnoses, effective treatment plans and improved patient outcomes,” said Harsha Gopinath, director of telemedicine services at Prime Healthcare.
THE CHALLENGE
But Prime Healthcare leaders wanted to further shrink the gap in access to critical services and reinforce its commitment to high-quality, equitable care for all patients. Telehealth offered a way to do that.
PROPOSAL
Prime saw the opportunity to use acute care telemedicine services – which can help ensure patients in remote areas have prompt access to specialty care without the need to travel long distances – not just to deliver care but to expand access and help address other social determinant challenges faced by rural hospitals
“With respect to staffing and specialty access challenges, telemedicine technology serves as a real-time solution, allowing physician services to be requested on-demand for emergent patient issues,” Gopinath noted. “For rural hospitals in particular, more specialists for medically underserved areas can provide services to patients in the hospital.”
A platform from Equum Medical, an acute care telehealth technology and services company, would enable attending providers and nurses within a hospital to call a specialist physician before connecting to a telemedicine device in the unit or patient room. The telemedicine specialist would have access to the hospital EHR directly so they can review patient charts, tests and imaging as needed for their specialty.
MEETING THE CHALLENGE
“We first deployed this telemedicine platform to patients presenting in the emergency department who required psychiatric or neurological consultations,” Gopinath recalled. “Telepsychiatry coverage helped facilitate a more efficient process while still featuring important clinical evaluations, as is the case with tele-neurology.
“For both telepsychiatry and tele-neurology, the requesting clinician for the service is the emergency medicine provider,” he continued. “Once the EM provider determines a consult is needed, the request is placed into the telemedicine platform, which then signals the telemedicine provider to connect into the designated camera device in the emergency department for the patient evaluation.”
Another use case is specialty coverage at Prime’s rural hospitals.
“The services include pulmonology/critical care, infectious disease, hematology/oncology and nephrology,” Gopinath said. “ID, hem-onc, nephrology and cardiology are consultative specialties that help the hospitalist and critical care providers provide the most well-rounded and informed care to patients.
“And the telemedicine platform is integrated with the Prime EHR, where the provider has a real-time view of the unit through the telemedicine platform,” he added.
RESULTS
Gopinath reported results achieved to date included:
Improved patient throughput in the ED for behavioral health patients.
Primary stroke certification and reduced door-to-needle times for stroke patients.
Rural hospital capability to retain more patients in the community through increased specialist provider access.
“Behavioral health is a focus area for Prime and having telepsychiatry available on a 24-7, on-demand basis is a crucial resource for patients to access compassionate, appropriate care,” he said. “Many of Prime’s hospitals have inpatient behavioral health units that enable the telepsychiatrists to refer a patient to this level of care when indicated in a very efficient manner.
“The important metric is the timely care journey of the patient and efficient follow-up for additional treatment, if necessary,” he added.
Today, almost every Prime Healthcare hospital has tele-neurology coverage available in the ED.
“This resource has brought down the response times and intervention windows dramatically,” he reported. “With any neurological condition, a quicker response time yields improved outcomes. Prime has seen improvements in this area since system-wide adoption began in 2019.
“Our rural hospitals also have been able to better serve their community needs given the additional medical specialties available for inpatient care,” he said.
ADVICE FOR OTHERS
First and foremost, Gopinath advised, is to understand what it is one actually needs with acute care telemedicine services. Is it related to access? Staffing? Technologies can be tailored accordingly, he explained.
“Most important, track your telemedicine usage,” he concluded. “Make sure the provider group and/or technology platform has the means to report consults, visits or patient rounds so you can see how much telemedicine is being used. This will enable you to better understand utilization and growth trends.”
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
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