Telehealth 2.0: How Providence is taking its platform to the next level

Telehealth became the prevailing mode for medical providers to see patients during the early days of the pandemic, and while use has leveled off in many areas, virtual care has become a permanent part of the healthcare ecosystem.

Hospitals and health systems across the U.S. are now building telehealth, remote patient monitoring and hospital-at-home programs as part of their growth strategies. Patients also prefer telehealth as a convenient way to see their clinicians when an in-person visit isn't necessary. Most health systems have built a functioning telehealth program, but what opportunities are there to refine these programs for a better patient and clinician experience?

Todd Czartoski, MD, chief medical technology officer at Renton, Wash.-based Providence, joined the Becker's "Digital Health + Health IT" podcast to talk about where the health system's virtual care program is headed. Click here to subscribe to the podcast and keep an eye out for Dr. Czartoski's episode.

Note: Response below is edited lightly for clarity.

Question: Where do you see telehealth becoming a better tool for clinicians and patients? How is virtual care at Providence evolving?

Dr. Todd Czartoski: Over the last two years, our organization has done just over 4 million [telehealth] visits. For perspective, in 2019 we did 67,000 visits, and in one year we were doing 70,000 visits a week in April and May of 2020. That was a huge shift. Now, turning the lights on and being able to walk into the room is one thing, moving furniture around and optimizing the flow is another. A lot of our focus in the last couple years has been improving the experience for the provider, clinic staff and for the patient. We have really gotten it down to where the basic technical components of [telehealth] work pretty darn well, and we don't have a lot of issues with the connectivity piece.

We've added interpreter services, and we've added in the ability to talk to more than one person at a time so you can have a family member in a different part of the country join the visit. Those types of things have been important add-ons, in addition to waiting room functionalities where you can add a survey or information tailored to the patient while they're waiting to see their provider in the virtual waiting room. Those are the things you're going to see continuing to evolve and emerge as additional capabilities.

The support staff for the physician or provider's clinic also see their function and role evolving. If you think about a traditional clinic, a lot of those roles require putting patients in the room, checking their vitals, ordering labs or getting patients a follow-up appointment. Some of these things still exist, and some are going to be automated or done as part of a telehealth visit. That's where some of the opportunities are arising to continue to optimize the experience for the patients, staff and provider. You're going to see big trends overall here.

Telehealth as a video visit, as a functionality, is somewhat limited. What we've learned is that whether you're a behavioral health specialist, a primary care provider or a subspecialty surgeon … all of those specialist visits can be done safely and effectively with telehealth. It's opened the door for looking at what else could we do beyond just a face-to-face visit. Specifically, the door has been opened for home monitoring. We have a remote patient monitoring solution that we built for COVID-19 home monitoring specifically, and because of the success of that, we've monitored over 30,000 patients up to two weeks who either confirmed or were under suspicion of having COVID-19. That opens the door for what we could do in terms of other types of home monitoring for COPD, diabetes, hypertension or whatever the case may be. That's a big area for growth and development.

Finally, moving services outside the hospital, hospital-at-home, is a big initiative for us. We've been working on it for a long time and we're seeing some success. We're rapidly deploying that across our ecosystem and a lot of other health systems are as well. It really checks a lot of the boxes for patient experience; our patients absolutely love it. It's bending the cost curve, improving access and helping improve capacity so we don't have to build more super expensive towers and hospitals. Some of the outcomes with hospital-at-home have been shown to be better than traditional hospitalization when it comes to delirium, falls, length of stay and complications. People actually heal better on their own in a comfortable home environment. Those are a few examples of areas that we're going to see growth in our ecosystem.

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