Ascension is building far more than a telehealth program across its sprawling footprint of 110 hospitals and nearly 2,000 care sites.
The St. Louis-based health system is developing what Krisda Chaiyachati, MD, associate vice president of clinical transformation at Ascension, describes as a virtual care infrastructure layer designed to connect clinicians, patients and specialty services across nine states, regardless of which EHR platform a hospital uses.
“For example, a teleneurologist could see a stroke patient in Wisconsin and then, 30 minutes later, see another patient in Florida without logging into separate systems or searching for data in different places,” Dr. Chaiyachati told Becker’s. “This is all without having to go into each individual EHR and do a login process and figure out where all the data is.”
The effort reflects how some health systems are moving beyond pandemic-era telehealth expansion and into a new phase focused on integrating virtual care into core operations, workforce strategy and specialty access.
At Ascension, virtual care now spans acute and ambulatory settings, including teleneurology, telepsychiatry, teleinfectious disease and same-day virtual care programs.
But Dr. Chaiyachati said the larger story is the infrastructure supporting those programs.
“We’ve built or collaborated to create a technology layer that allows one physician or nurse practitioner or PA or nurse to basically be able to hop in and out of every EHR instance to provide that care,” he said.
The goal, he added, is to make the complexity invisible to patients.
“What they should feel here is that the provider is able to fully know who they are as a patient, know their medical history, know the labs [and] images that have been ordered on their behalf, and then for that physician to just provide that care directly on the spot,” Dr. Chaiyachati said.
The infrastructure is also reshaping how Ascension thinks about workforce deployment.
As physician shortages continue nationwide, the health system is increasingly relying on centralized virtual teams to extend specialty care access across markets.
“There are people who become more virtualists by their very nature,” Dr. Chaiyachati said. “They practice more virtual medicine or virtual care as a whole.”
At the same time, Ascension is working to integrate virtual clinicians with bedside teams.
In stroke care, for example, onsite nurses and staff help facilitate virtual examinations and coordinate care with remote neurologists.
“That team-based care has now transcended between the virtual environment and the physical space,” Dr. Chaiyachati said.
Access remains the driving force behind Ascension’s virtual care strategy, particularly as the organization serves diverse patient populations across urban and rural communities.
“Ascension can’t be monolithic,” Dr. Chaiyachati said. “It can’t just be hyper-focused on just virtual or just the physical spaces. It needs to really offer a diversity of options here to match the diversity of patients that we have.”
Rather than positioning virtual care as a replacement for in-person care, Ascension sees it as an entry point into a broader continuum.
“We actually want to be the place that says, ‘Hey, we’re providing you a virtual visit. It really is convenient for you. It’s meeting your needs,’” Dr. Chaiyachati said. “But now actually we really need to have you come in person because the in-person doc is going to be able to do something that I can’t do in a virtual environment.”
The health system is also prioritizing underserved populations as it expands virtual care offerings.
“We do serve a lot of poor and underserved patients and populations here,” Dr. Chaiyachati said. “We’re really designing for low-income populations, uninsured populations, Medicaid populations, Medicare populations to be able to access care in a different way.”
That requires intentional design decisions around both services and technology, he said.
“We’re not just designing a telepractice that is just designed for self-pay or privately insured individuals,” Dr. Chaiyachati said.
Looking ahead, Ascension plans to continue expanding specialty access programs and virtual support for transitions of care, including hospital-to-home and emergency department-to-home models.
Still, Dr. Chaiyachati said the organization does not view virtual care as a standalone strategy.
“I think more and more it’ll just be a part of how we deliver care,” he said.
And while technology and infrastructure are central to that evolution, he said the organization’s guiding principle remains unchanged.
“Access, access, access is the key paradigm here,” Dr. Chaiyachati said.
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