What happened at 4 health systems when telehealth demand spiked

Telehealth is expanding across the country as people aim to stay out of the hospital unless they are experiencing severe coronavirus symptoms.

Many health systems require patients experiencing mild symptoms, or those exposed to individuals with confirmed cases of COVID-19, to use virtual visits to check in with their providers. Primary care physicians and specialists are also turning to telehealth for their regular clinic visits as patients self-quarantine to stem the spread of the coronavirus.

Renton, Wash.-based Providence was among the first to treat COVID-19 patients and reported that virtual visits increased 20 to 30 fold in the first few weeks of the pandemic. The system reported confusion around billing for the virtual visits, and it had to act quickly to spread the correct coding and billing information.

The system also ramped up quickly to add virtual visit capabilities to around 7,000 providers who would have otherwise seen patients in the physical clinic. The system provided education for the clinicians on how to use the technology and then updated their EHR to automate as much as possible for easy documentation and billing.

Patients can now use a chatbot to enter their symptoms and then are triaged to the appropriate place, often a virtual visit. As a result, patients with symptoms of the coronavirus are not flooding the emergency departments, and the ED can focus its resources on the most acute patients.

LCMC Health
New Orleans-based LCMC Health rolled out its telehealth program quickly amid the coronavirus outbreak. The system had a COVID-19 hotline that patients could call to get screened by a nurse and then if the screen was positive, the patient engaged in a telehealth visit with an emergency department visit. The system reports 10 percent of the patients were directed to the ED at the University Medical Center New Orleans and routed to video-equipped isolated rooms, according to an AAMC report.

The hospital had to quickly acquire additional laptops and more than 100 iPads to ensure virtual visits could be done. The virtual visits are done through Zoom in a HIPAA-compliant manner.

Jefferson Health
Philadelphia-based Jefferson Health needed to scale up to 50 percent virtual care rapidly, according to the AAMC report, and due to its existing efforts to create an infrastructure for telehealth they were able to do that. The 14-hospital system reported virtual screening demand jumped 10-fold in a week due to the demand from the coronavirus pandemic. Individuals can use an online screening system as well for an initial touchpoint.

The system is also transitioning its outpatient visits to telemedicine, which would be 500 to 600 visits per week. "We're lucky in the sense that we’ve been implementing this across the enterprise for more than 10 years. Even if our providers only did 12 video visits a year [before the coronavirus pandemic], they know how to do it," said Judd Hollarder, MD, associate dean of strategic initiatives, in the AAMC report.

Stony Brook University Hospital
New York is one of the hardest-hit states with COVID-19 cases, and demand for telehealth services has increased 312 percent amid the pandemic. Stony Brook (N.Y.) University Hospital has seen an increase in demand for telecommunications within the hospital and is in search of resources to support those visits. The hospital has asked community members to donate iPads to connect inpatients to their providers and families. IT is in need of around 100 iPads as of March 25.


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