Mayo Growing Via Technology

Most health systems grow through mergers and acquisitions, which is a costly and complex process. Merging the existing operations and cultures of healthcare organizations can be an overwhelming task.

Mayo Clinic thinks there’s a smarter way: reaching millions of new patients through technology. In just four years, the Mayo Clinic Care Network (MCCN) has grown to include dozens of affiliated facilities in 18 states, Mexico and Puerto Rico. Bear in mind that Mayo doesn’t own any of these partner organizations. It’s a relationship that’s based primarily on information sharing – and telemedicine plays an important role.

A great example is the Altru Health System in Grand Forks, North Dakota. Neurologists there conduct frequent e-consultations with Mayo specialists. This allows many more patients to be treated close to home, without requiring a trip to Mayo’s headquarters in Rochester, Minnesota.

Last year, MCCN reached seven million patients, which means that Mayo’s clinical footprint has increased threefold to about 63 million people. Mayo CEO Dr. John Noseworthy has set an organizational goal for that number to reach 200 million people by 2020. That’s nearly two-thirds of the U.S. population.

Mayo isn’t alone when it comes to adopting this “growth through technology” approach. The new Memorial Sloan-Kettering Cancer Alliance has found a pioneering partner in the Hartford Healthcare system in central Connecticut. Just like the Mayo network, the Sloan-Kettering alliance will allow cancer patients to get expert care without having to go to New York City for weeks or months of treatment.

Mayo and Sloan-Kettering are two of the biggest “brands” in healthcare. By demonstrating telemedicine’s many clinical and financial benefits, they’re setting the stage for similar partnerships in the near future.


Redefining “Access”

Polls consistently show that “access” to healthcare is a high priority for most patients. But a patient’s definition of access is a far cry from how providers see it.

For most hospitals and health systems, the Patient Access department is a large and complex operation. In many cases, it includes the call center employees who schedule appointments and all the folks who handle patient registration, insurance verification and payments.

In short, this team preps the patient to see the doctor, but do their efforts really ensure that you’re getting access to the right care at the right time at the right place? What happens if the specialist you’re scheduled to see is sick or stuck in traffic?

Most providers approach “patient access” either as a workflow issue or an opportunity to get upfront payment for services. They may have a check-in kiosk to expedite the process, but that’s about as far as their technology goes.

So here’s a novel idea: why not take greater advantage of telemedicine technology?

Let’s say that you visit your ophthalmologist, who’s baffled by a retinal condition she’s never seen before. It would clearly be advantageous to have “access” to a retina specialist who is familiar with it so you could get the right treatment without delay.

That’s the sort of improved access that health reform is aiming for – not just a faster way to get an appointment.

As technology-enabled consultations become more commonplace, we may not need an on-site army of registration and billing people anymore. Telemedicine is redefining “access” to mean something very simple: putting the patient in touch with the best provider, whenever and wherever needed.



An eBola Solution

In sci-fi movies, people infected with intergalactic viruses are usually treated by contagion-free robots. In similar fashion, technology is playing a role in the battle to prevent the spread of Ebola…but it needs to be deployed in a more robust way.

Currently, some of the CDC’s special biocontainment units across the country are using technology to connect Ebola patients and caregivers inside with consulting physicians and family members at remote locations. The most recent example is that of Dr. Richard Sacra, a U.S. doctor who contracted Ebola in Liberia and was taken to a biocontainment unit in Nebraska.

That’s a smart – but fairly limited – use of technology. Telemedicine would be immensely more effective if used in the danger zone. Imagine, if you will, that the government of Liberia has just built a special Ebola clinic equipped with telemedicine robots and supporting technologies. The robots could allow a remote clinician to watch the attending physician put on and take off protective apparel, reducing the risk of accidental exposure.

Robots can glide right into harm’s way, and obviously don’t require any of the fancy air filtration and ultraviolet light environments that are standard in U.S. biocontainment units.

Using robotic helpers would be an incredible “force multiplier” for the courageous doctors and nurses helping to contain the outbreak. It’s likely that fewer of them would be needed on the front lines, which would mean fewer quarantines for returning caregivers.

The prefix “e” (for electronic) is used everywhere these days: e-commerce, eBay, and so on. Maybe it’s time to thwart a deadly disease with an eBola strategy using telemedicine.



Telepsychiatry Cuts ED Wait Times

HealthONE in Denver cuts ED wait times while improving behavioral health care through remote presence.

A recent study published in the Annals of Emergency Medicine revealed that behavioral health patients wait on average an astounding 11.5 hours before being treated or released.

These half-day waits are mainly due to the fact that many hospitals don’t even operate psychiatric wards anymore. And because reimbursement for behavioral health is among the lowest in medicine, many hospitals see these units as risky investments.

But the HealthONE hospital chain in Denver is bucking the trend by opening a new 40-bed psychiatric ward – one of the first in Colorado in quite some time. The new unit has implemented remote presence technology with a dual aim: to improve service to behavioral health patients while helping to shorten ED wait times. A remote psychiatrist can use the InTouch Telemedicine System and a device like the RP-Lite or RP-VITA to talk with the patient and make a timely diagnosis.

Dr. George Bussey, HealthONE’s chief medical officer, recently shared his organization’s strategic vision in an interview with National Public Radio. “ER wait times are often a function of how many people are in your waiting room and how many available beds you have,” said Bussey. “And if you have, for example, a 30-bed ED with five [behavioral health] patients who aren’t being moved out of beds, you’ve effectively turned yourself into a 25-bed emergency department, at which point you begin to get the backup.”

By directing behavioral health patients to a more appropriate care setting, HealthONE’s EDs can operate more profitably – and the shorter wait times give the organization a competitive edge over other area hospitals. Telepsychiatry also creates goodwill in the community. Patients love wait times that can be measured in minutes, not the time it takes to watch all three Lord of the Rings movies.

Making behavioral health patients wait 12 hours for treatment is downright medieval. Remote presence is helping them get the prompt, expert care they deserve – and helping EDs reduce wait times and improve the bottom line. You don’t have to be Carl Jung to understand why telepsychiatry is rapidly gaining momentum.

Is Your ED a Hub?

Telemedicine can help unclog crowded Emergency Departments.

There are basically two ways to run an Emergency Department. Most are designed like the Department of Motor Vehicles where you sign in and wait for service. The emerging way is to use the Grand Central Station model, where the ED is the service hub. People don’t hang out at Grand Central; they get quickly routed to the places they need to go.

Today’s most innovative EDs are using this hub approach to better serve patients – and remote presence plays a vital role in that process. For too long, Emergency Departments have seen themselves as the hospital’s front door, not the center of the entire enterprise. But a hub-style ED offers a host of benefits: more efficient workflow, better resource utilization, greater throughput, and higher quality care.

In a hub-style ED, the idea is to quickly triage and route each patient to the most appropriate care setting. How does telemedicine help? For starters, it provides better service for the ED’s most frequent users: behavioral health and pain management patients, plus those who rely on the ED for routine primary care. Because those patients aren’t in critical condition, they often sit for hours waiting to be seen. But with remote presence, they can get high-quality care without clogging up the ED. A remote physician can quickly make an assessment through devices like the RP-7i robot. That means that ED physicians have more time for patients with life-threatening emergencies.

It’s obvious that the most expensive resource in today’s ED is the provider. Highly trained ED physicians and nurses have more pressing things to do than treat sinus infections or try to determine whether a patient is depressed (especially when a behavioral health professional can be reached quickly with remote presence).

So the choice is clear: your ED can either be a plodding DMV or a fast-paced hub capable of delivering higher throughput and better care while improving the hospital’s bottom line.