At the start of the COVID-19 pandemic, Jordan Valley Community University Hospital in Springfield, Missouri, was facing the issue of offering quality client care in a safe environment while most of its client base was staying home.
THE PROBLEM
The service provider organization thought telehealth was the future, but had only been utilizing the technology in small specific niches, such as school-based care. When COVID-19 hit, the organization was needed to utilize telehealth in a much more comprehensive sense.
” We expanded our services to consist of TytoCare, Zoom video conferencing and OTTO, which is a NextGen item,” stated Dr. Matthew Stinson, vice president of medical and behavioral health services at Jordan Valley Neighborhood Health. “In the early stages of the pandemic, we likewise utilized telephone sees for behavioral health visits, medication refills, chronic illness management like diabetes symptom management, etc.”
While these platforms worked fairly well, he added, the scope of medical diagnoses that can be made in video or audio consults is restricted.
PROPOSAL
One of the workarounds Jordan Valley considered looked for to include data points to the video seeks advice from by supplying clients with unconnected peripherals– weighing scales, high blood pressure cuffs, pulse oximeters, and so on– and inquiring to manually input or interact the data from those peripherals during a Zoom call or OTTO go to.
” This was only ever seen as a bridge option, as there is no opportunity for EHR combination with the non-connected peripherals, or any method for a company to take live, real-time, concurrent inputs from non-connected peripherals,” Stinson described. “The store-and-forward nature of this solution left more chance for user mistake, and made it hard for service providers to verify the info being communicated from the patient.”
Jordan Valley also had actually trialed making use of the TytoCare devices by sending community health employees into the patient houses to augment video seek advice from a company using an otoscope, stethoscope, thermometer, test electronic camera and tongue depressor, which are linked to the TytoCare gadget.
” Extra funding from the State of Missouri has actually provided Web hotspot gadgets to ensure clients without high-speed Web access are still able to gain access to broadened and improved telehealth services.”
Dr. Matthew Stinson, Jordan Valley Neighborhood University Hospital
” While this service assisted to broaden the clinical factors to consider that could be made by means of telehealth, the accessibility of neighborhood health workers and pandemic conditions were limiting factors in scaling up this service,” Stinson stated.
MARKET
There are lots of suppliers of telemedicine technology and services on the health IT market today.
FULFILLING THE CHALLENGE
Jordan Valley was granted telehealth financing from the FCC. This enabled it to supply TytoHome systems to 700 health center clients for in-home usage, so allowing the patient to ask for a visit and connect to a supplier who can synchronously ask for and utilize inputs from a linked otoscope, stethoscope, basal thermometer, exam camera (with a tongue depressor attachment), blood pressure cuff, and pulse oximeter to enhance the video consultation and notify clinical medical diagnosis.
” Scientific workstations are configured to permit the service provider to access the TytoCare platform, including controls for the patient-side TytoHome device on one screen, while charting directly into the EHR on another screen,” Stinson kept in mind. “Combination between the TytoCare platform and our NextGen EHR still is being built out to enhance the scheduling and check out experiences for patients and simplify some workflows on the medical side.”
As the largest federally qualified university hospital in the State of Missouri, Jordan Valley’s service location covers a substantial rural population dealing with distinct access barriers due to their geographic distance from clinical sites and relentless concerns with broadband availability, reliability and cost.
” Extra funding from the State of Missouri has offered Web hotspot gadgets to make sure clients without high-speed Web access are still able to access expanded and enhanced telehealth services,” he stated. “In distributing TytoHome devices, we think about Web schedule in the home, and have the ability to include hotspots and connected tablets for those households who do not have Internet connection or a suitable individual gadget to utilize with Tyto.”
Jordan Valley’s service area largely is categorized as a health expert shortage location, or HPSA, implying even clients with access to medical care may not have the ability to gain access to experts, behavioral health service providers or other necessary services.
” An example of this is medication-assisted treatment for substance usage disorder,” Stinson discussed. “While Jordan Valley has a number of MAT-waivered service providers who deliver MAT on a walk-in basis at some of our larger center places, in rural areas the wait for these services can be considerable and frequently excessive.”
By enhancing telehealth offerings, including the use of Tyto kiosks in satellite center places, Jordan Valley has had the ability to expand access to specialists, behavioral health services and MAT for compound usage disorder to people in more remote or backwoods.
OUTCOMES
Jordan Valley still is in the execution stage of the rollout of the 700 TytoHome systems and the set-up of clinical telehealth kiosks. In looking more broadly at telehealth usage, the supplier company has actually observed a 50- fold boost in telehealth check outs, comparing the duration of March 2020 and August 2020 (six months) to the duration of March 2019 through February 2020 (12 months).
While some of this was because of an unwillingness to attend consultations face to face due to COVID-19 concerns, Jordan Valley expects need for telehealth to support and remain greater than pre-pandemic levels as patients grow accustomed to the convenience, security and ease of access of receiving services by means of telehealth.
” Second, we have had the ability to expand MAT to backwoods,” Stinson included. “We currently have a kiosk in place at our center in Lebanon, Missouri, and have actually had the ability to supply walk-in services for substance usage condition.”
USING FCC AWARD FUNDS
Jordan Valley Community University hospital was granted $742,780 for a telehealth platform, remote diagnostic and tracking devices, and tablets to offer diagnostic services and treatment for COVID-19 clients at the patients’ houses and, by using numerous telehealth solutions, provide access to health care for all other clients and broaden scientific applications of the telehealth technology.
” The FCC financing allows for the distribution of TytoHome units to 700 households in Jordan Valley’s service location,” Stinson concluded.
Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Health care IT News is a HIMSS Media publication.
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