How Phoenix Children's built a telemedicine dashboard and transitioned 6K visits in one week

Phoenix Children's Hospital developed a digital dashboard last month that allowed clinicians, administrators and schedulers to transition 6,000 weekly appointments from in-person to telemedicine after stay-at-home orders were issued in response to the COVID-19 pandemic.

The initiative took the hospital just one week to complete, Vinay Vaidya, MD, senior vice president and chief medical information officer at Phoenix Children's Hospital, told Becker's Hospital Review. He credits the health system's strong data infrastructure and the willingness of staff across all areas, including physicians, clinic managers, schedulers and administrators, with helping to deploy the dashboard so rapidly.

"To launch an operation like this, communication, visibility and coordination is really the key," he said. "I can set up one telemedicine appointment and it will work well, but how do you scale it across the entire system?"

Phoenix Children's Hospital did not have an established telemedicine vendor program, so the hospital adapted its Zoom video conferencing platform, which was used for internal communications, to conduct telemedicine visits. The health system added various patient and physician-centric features such as integrating the platform with Phoenix Children's EHR system and creating a virtual waiting room space for patients to log into prior to their appointment.

For the dashboard, Dr. Vaidya and his team started by asking physicians' to determine what types of patients were suitable for telemedicine visits and whether the appointments should be video, audio or both. Triaging patients was an important first step because it allowed the IT team to create the template of which patients to transition to telemedicine and which ones still needed to come into the hospital for services. Ultimately, Phoenix Children's was able to move patients from 31 divisions from in-person to telemedicine.

Phoenix Children's has been using data and creating EHR-integrated dashboards for more than three years, well before the COVID-19 pandemic. By tapping into the EHR, the health system is able to pull a wide range of information, from order sets to surgery encounters, to derive insights. 

"All the data has been readily available to us, so putting the dashboard together was really not a challenge for us at all," Dr. Vaidya said. "This is why we were able to move so quickly because it happened completely in the background and behind the scenes but still very rapidly."

The dashboard has been a key component of the health system's telemedicine expansion, allowing various stakeholders to transition to scheduling and conducting virtual visits seamlessly. From March 18 through April 24, Phoenix Children's completed 14,810 telemedicine visits. The health system's total visits, including telemedicine, phone-based and in-person appointments, during the same time period was 31,815.  

For physicians, there's also been added benefit transitioning to telemedicine visits during the pandemic, according to Dr. Vaidya. Some physicians have told him that virtual visits have fostered a more natural information exchange between the patient and their parents and the physician during an appointment.

"[They told me] the quality of information exchange was so natural and informal that it was not like being in an antiseptic clinic room in an office where you feel you're being interrogated," Dr. Vaidya said. "It was such a natural, familial element that they felt the value of the clinical information that was coming from the family was much stronger than just checking boxes or asking the same seven questions in a row."

More articles on telehealth:
Some patients still being billed for telehealth despite changes in insurance regulations 
Nearly half of physicians seeing patients through telemedicine
7 things rural health clinics need to know about Medicare telehealth reimbursement

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