Telehealth tips, torn from the playbook of Intermountain's massive virtual hospital

Salt Lake City-based Intermountain Healthcare launched a virtual hospital services program late February, comprised of 35 telehealth programs and more than 500 caregivers, to address rural Utah's care needs.

The program, dubbed Intermountain Connect Care Pro, is available to Intermountain's 10 rural hospitals, as well as nine hospitals outside of the system, and all Intermountain hospitals are currently using the offerings of the virtual hospital to add to their existing services. Connect Care Pro is the next iteration of Intermountain's original telehealth program, Connect Care. The latest version focuses on amplifying the reach of Intermountain's specialist expertise in rural settings.

"Connect Care is designed to facilitate direct communication between patients and their providers. It's part of our effort to help keep patients well, and out of healthcare facilities whenever we can," explains Intermountain's Chief of Clinical and Outreach Services Mike Phillips, MD. "Connect Care Pro links providers together to optimize the care of patients. It encompasses telehealth programs within clinics and hospitals, designed to avoid transfers and export expert clinicians and specialists to locations where they are not available."

Services are both online and digital, so patients can receive much of the same care expected at a large, medically advanced hospital in a community hospital. However, Connect Care Pro also includes provider support services including a Clinical Coordination Team that helps facilitate patient transfers to a higher-level facility, even if those patients must be airlifted.

Becker's Hospital Review recently spoke with Dr. Phillips and Jim Sheets, Intermountain's vice president of outreach services development, about the lessons they've learned from rolling out a comprehensive telehealth program and their advice for hospitals looking to take on a telehealth program.

Editor's Note: Responses have been edited lightly for length and style.

Question: What were the biggest challenges in rolling out Intermountain's initial telehealth program and how did your teams overcome them?

Mike Phillips: Adapting our culture to use telehealth while still providing in person care was a challenge. We want our providers to seamlessly use technology to meet the patient in the best possible environment of care.

Jim Sheets: I agree. Part of that is ensuring you have the right providers staffing telehealth services — they have to feel comfortable providing a different type of care and be adaptable enough to work within the advantages and constraints of the technology. They also have to help the bedside clinician feel comfortable with the technology and with having a remote provider as part of the care team. We have a lot of great clinicians who are really doing this well.

Q: What is the No. 1 consideration hospitals need to make when approaching their telehealth programs?

MP: Patient experience should always be the first consideration, including quality, safety and the experience of care.

JS: I agree. With that as the true north, it's also important hospitals be prepared for the time it takes for providers and patients to adapt to this technology being part of care. It took many years for Amazon to convince consumers online shopping was safe, and some pushback from patients and providers is inevitable here too. Healthcare is much more complicated and people need to see it as a safe and viable option for them. It's also important to select the right technology and partners to ensure you have a stable system to provide the service.  

Q: What advice do you have for other hospitals developing their telehealth strategies?

JS: It's important that executives and clinicians both see telehealth as an important and integrated part of the institution's strategy for providing care. It's also important to have a way of prioritizing projects [within the telehealth program]. Intermountain developed a centralized governance model early on, which helped us to prioritize services as requests were made, and really scale those services across our system quickly and efficiently.

MP: It's also important to actively seek continuous input from stakeholders — such as patients, providers and information services — and be willing to iterate and adapt the platform and process.

JS: And to be able to do that you also need to have the right skills at the table. Telehealth is a full-time effort, and legal, finance, compliance, technology, payer relations, revenue cycle and marketing are only some of the groups required to make a telehealth program successful.  

Q: How can rural hospitals launch their own telehealth programs to benefit their communities?

JS: Rural hospitals have challenges in recruiting specialty providers and retaining them and in having adequate patient volume to make telehealth financially viable. Telehealth can help with these issues, but implementing the technology can be difficult and expensive. Teaming up with an integrated health care system like Intermountain Healthcare offers a great opportunity to provide specialty care to rural communities in a sustainable manner. We offer clinical expertise in newborn resuscitation, infectious disease, pediatric critical care and many others that simply wouldn't be available in rural hospitals. And, our goal is to keep people in their communities whenever possible, close to their primary care teams, families and the environment that is most comfortable to them.

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