Building a virtual care program for the pediatric population: 5 strategy insights from Nemours Children's Health System

Since launching its telehealth programs in 2015, Nemours Children's Health System in Melbourne, Fla., has pursued digital health innovations with a clear strategic vision in mind: to make healthcare simpler for its patients and families.

With on-demand virtual urgent care and specialty care telehealth programs, Nemours has been growing its digital health initiatives over the past five years through innovations in remote patient monitoring, a new consumer-driven app for patients and integrations with its EHR to best meet clinician workflows.

During an Aug. 26 webinar hosted by Becker's Hospital Review and sponsored by Amwell, Nemours executives discussed the strategies behind their pediatric telehealth programs and the best practices that have delivered the most successful patient and parent experiences.

The speakers were:

  • Carey Officer, operational vice president of Nemours CareConnect and the Center for Health Delivery Innovation at Nemours Children's Health System
  • Patrick Barth, MD, medical director of telehealth specialty care at Nemours Children's Health System
  • Joanne Murren-Boezem, MD, medical director of Nemours CareConnect 24/7 On Demand Urgent Care at Nemours Children's Health System

Five takeaways:

1. Telehealth program foundation spurs new opportunities. Nemours' vision, to meet patients where they are, has been driving telehealth innovations since the launch of its on-demand urgent care platform in 2015. In addition to offering 24/7 telehealth visits, the health system has launched other digital initiatives such as its emergency room and hospital follow-up program, which aims to help patients and parents be as informed as possible following a trip to the ER or urgent care.

"We know that when patients or parents are in hospitals or the ER, they're stressed and they're not always hearing exactly what you're saying," Dr. Murren-Boezem said. "For the first 48 hours after discharge, we give them the opportunity to see the on-demand team for free. It's a chance to answer questions they have, to talk about labs, medications or surveillance, and provide reassurance."

2. Nemours designed urgent and specialty care telehealth programs based on consumer and provider feedback. When embarking on its digital health and telehealth journey in 2014, Nemours assembled a consumer insights team to help derive a better understanding of what patients and parents would want from its urgent and specialty care telehealth programs. They found that consumers wanted more accessible care and an easier way to connect with clinicians, which drove Nemours to build virtual care solutions within its mobile app. In addition to creating a family-friendly digital experience, the health system also worked with clinicians to integrate their thoughts and workflow processes as they built their various digital tools, according to Ms. Officer.

3. Nemours' app creates a seamless patient, provider experience. The health system recently launched its new consumer app, which integrates its Epic MyChart patient portal, Amwell telehealth platform, KidsHealth educational tools and custom features into a single platform. A patient or parent can log onto the app and immediately find their lab test results, connect with a physician virtually or access educational content, among other resources. In addition to designing it to be user-friendly for patients and parents, Nemours also ensured the app would be easy for clinicians to use.

"What I love about the thoughtfulness of what they developed is that it's not only an easy-to-use consumer app, but we really listened to our clinicians to ensure we integrated it into their workflow," Ms. Officer said. "All that data in the app that the patient and family might be entering transfers automatically into Nemours' EHR so it is integrated into the clinician workflow."

4. Innovation in specialty care. With more than 45 telehealth specialty care offerings, the key to delivering successful solutions is ensuring each specialty has the necessary tools and resources to provide their same high-level care via telehealth as they would in person, Dr. Barth said. These specialty care virtual visits are delivered to patients at local Nemours pediatrician offices, partner regional hospitals and directly to their homes.

"We've instituted provider-assisted physical exams [within partner hospitals] where either a nurse or medical assistant may be able to perform parts of the exam or use a peripheral device to assist," Dr. Barth said. "We've also deployed peripheral devices such as remote blood pressure monitors into patients' homes for them to use during virtual visits and enable better physical exams and evaluations."

5. Building on momentum introduced by COVID-19. Due to the COVID-19 pandemic, Nemours has seen incredible growth in its virtual care program. In April 2020, Nemours saw a 2,395 percent growth in virtual visits. And while virtual visits have begun to slowly decrease again as brick and mortar facilities continue to reopen Dr. Barth said the health system is pushing forward with lobbying efforts for permanent state licensure changes and continued payer reimbursement so they can continue providing virtual care to families wherever they are and across state lines.

Click here to view the full webinar.

More articles on telehealth:
NYU Langone Health creates template for remote COVID-19 care delivery: 4 details 
5 ways to fuse telehealth into primary care beyond the pandemic
Kaiser Permanente launches virtual healthcare plan: 6 details

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