NewYork-Presbyterian is leveraging telehealth to redesign ambulatory care

Across the country, healthcare organizations are pivoting to digital strategies to improve access to care and drive down costs. Telehealth is becoming a key part of hospital strategy, as it combines low-cost, quality care with the convenience that patients now demand.

During a May 15 webinar, hosted by Becker's Hospital Review and sponsored by American Well, Graeme Ossey, manager of innovation at New York City-based NewYork-Presbyterian, detailed his organization's approach to digital health and the growth of its telehealth program.

NewYork-Presbyterian is an 11-hospital system that experiences 2.6 million patient visits annually. The system employs 10,000-plus physicians and is equipped with 4,000-plus certified beds.

The sheer size of the organization offers a lot of opportunities, but also presents challenges since it provides care via several different settings. To successfully deploy telehealth, NewYork-Presbyterian needed an innovative and efficient approach.

Mr. Ossey said the organization formalized its telehealth program in 2016, prior to which it only offered telestroke services. They established the formalized NYP OnDemand program to provide care to patients where they are and when they need it, not just in the traditional setting. The program initially had four pillars but has grown to include 50-plus virtual programs, involving more than 1,400 providers. Thus far, the organization's caregivers have conducted more than 180,000 virtual visits.

NewYork-Presbyterian's digital health strategy aims to provide wraparound digital services to ensure the patient remains connected to the organization through the entire continuum of care.

"We're going down that path to being able to provide those support wellness and patient empowerment services digitally," Mr. Ossey said. "We think that will create that wraparound journey… We really want to make sure we are providing a comprehensive, cohesive patient experience."

Three types of digital interactions to support a wraparound patient journey

Mr. Ossey discussed what types of digital health offerings a NewYork-Presbyterian patient might interact with during their care journey.

1. Initial interactions. Patients can begin engaging with the organization in many ways, including through NYP OnDemand kiosks located in Walgreens stores, NYP OnDemand app ,or its express care services in emergency rooms—all of which are powered by American Well. These options allow patients to connect with NewYork-Presbyterian caregivers in a quick and convenient way, said Mr. Ossey.

It also enables NewYork-Presbyterian to identify patients who need inpatient care quicker than if they used the traditional set-up of scheduling an appointment. Appendicitis is one condition where telehealth has really helped streamline the steps to getting patients into inpatient care, according to Mr. Ossey.

2. The inpatient experience. NewYork-Presbyterian has deployed several digital strategies in the inpatient setting designed to streamline operations and provide patients with the answers they need faster, according to Mr. Ossey. Offerings include patient monitoring that help clinicians keep track of patients and their needs and reduce instances of falls, as well as virtual medication education that helps ensure patients are given the correct medication at each step of their journey and that they understand what medications they are taking.

3. Post-discharge care. NewYork-Presbyterian uses technology to keep track of patient progress after they leave the hospital. The health system offers virtual follow-ups that allow caregivers to redesign care plans and implement interventions to drive patient recovery. They also provide a community tele-paramedicine program where the organization can send a paramedic and an EMT to the patient's home, and allow them to connect back to a physician who can help make changes to the patient's care plan, Mr. Ossey said.

Partnership to enhance digital strategy & lessons learned

NewYork-Presbyterian partnered with American Well to further its digital strategy. It uses American Well solutions across the continuum of care, including for retail urgent care and direct-to-patient scheduled visits. American Well also helped the organization streamline the entry points for all its technology so that workflow is simplified.

"We really see our technology as the delivery channel to equip clinicians, patients and the industry with the tools to empower them to realize a better healthcare experience," said Genny Stulb, account director at American Well.

Implementing a comprehensive digital strategy, however, was not without its challenges. Mr. Ossey shared some lessons learned over the course of NewYork-Presbyterian's digital journey.

First, a key aspect of embarking on digital strategy is changing the culture. Organizations need to invest in training providers and getting them involved in telehealth programs and other digital initiatives. NewYork-Presbyterian aims to train more than 5,000 physicians in telehealth by the end of 2019.

Another important lesson learned is to make sure patients feel supported using the technology. They need to feel confident they're receiving high-quality care and can ask questions if needed.

"Our fundamental philosophy is technology is not the most important thing," Mr. Ossey said. "We really think that its 80 percent people and 15 percent process. And while the technology is there and the technology is an enabler, we really need to focus on our people, our processes, everyone involved in the journey to ensure great delivery of care over telemedicine."

To learn more about American Well, click here, and view the full webinar here.


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