providence health & services telehealthsnapshot of providence • providence health &...
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Providence Health & Services
Telehealth
Tammy Cress, RN, MSN
Sr. Director, Telehealth
Snapshot of Providence• Providence Health & Services include 34 hospitals, 475 physician clinics, senior
services, supportive housing, hospice, home health and many other health and educational services. The health system and its affiliates employs more than 76,000 people across five states –Alaska, California, Montana, Oregon and Washington.
• Recent WA Affiliations
– Swedish Health Services – 2012
– Pacific Medical Centers – 2014
– Kadlec Health System – 2014
• Operating company (multi-state health system) for more than 10 years.
• First telemedicine program: 2004
• Annual telemedicine consultations: 7000
• Number of partner hospitals and clinics: 80
• Telemedicine services offered: 41
Providence Telehealth Experience
Providence’s Telehealth Business
4
• Provider-to provider specialty consultations
• Health eXpress for Employer Clinics
• Direct-to-Consumer (Health eXpress)• Retail Kiosks (Health eXpress)• Primary Care Virtual Visits
Enterprise Solutions
Consumer Solutions
PHS Telehealth Continuum of Services
Telestroke
TelehospitalistTelepsychHealtheXpress – Non-urgent careTelebehavioral Health (ED)TelephysiatryTelebrain Injury ClinicTelecardiologyTelecase ManagementTelecritical CareTelediabetes EducationTeleECGTele ED Hand TraumaTele EEGTele EKG
Tele Epilepsy-PediatricsTele Gastroenterology (Medical) TeleICUTeleintensivistTelemovement DisordersTeleneonatal ResuscitationTeleneurosurgeryTeleoncologyTeleotolayngologyTeleotologyTelepediatric EndocrinologyTelepediatricsTeleSANETelesleepTelespeechTelespineTeleTIATelewound - In PatientVirtual Multi-Specialty Clinic – CardiologyVirtual Multi-Specialty Clinic - Infectious DiseaseVirtual Multi-Specialty Clinic – MSVirtual Multi-Specialty Clinic - Post Stroke
5Integrated services spanning the continuum
Digital Roadmap
Nail the Basics
On Demand Health Care
Social “App-less” Health Care
2015 2016 2017
Make Healthcare
Online Similar to Other
Industries
Deliver Healthcare on
My Terms
(My Schedule,
Telehealth, In-home)
Care Team = Clinicians
+ Family and Friends
Supported by
Algorithms
2015
REMOVE
OBSTACLES TO SCALING TELEHEALTH
2016+
BETTER
HEALTHCARE VIA TELEHEALTH
Telehealth for Employers• Convenience - patients can access their provider from home and
on their schedule
• High satisfaction scores- 81% rate online care better than in-person care
• Differentiation in benefit package- offering employees options and innovative solutions
Improves employee satisfaction
• Allows employees flexibility
• Lower absenteeism: average time savings 2 hours per visit within the work day
• Increase capacity – Same day, flexible appointments
Increases productivity and capacity
• Direct savings of 45% to 50% per visit average
• Better utilization of care - higher cost visits avoided (i.e. late night ED visits because nothing else is available)
Reduces cost of care
A Challenge: Treating Stroke
8
Quality
Billings
Cost
Reimbursement
Can’t assess accurately& quickly
Can’t administer rtPA
Must transfer
Diminished Pt Satisfaction
Every transfer has a logarithmically negative impact on revenue
49.7% of hospitals have no neurologist on staff
63% don’t have stroke coverage 24x7
ER Backlog
A Challenge: Telehospitalist
9
Quality
Billings
Cost
Quality
Reimbursement
Delayed Dx
Delayed Admission
Delayed Treatment
Lengthened LOS
Sub-optimal Quality
Diminished Pt Satisfaction
Every transfer has a logarithmically negative impact on revenue
Majority of CAHs don’t have hospitalists 7pm – 7am
Most ‘on-call’ programs not effective
Telepresenting
Telepresenter Role
• Facilitate examinations with remote provider
• Manage room where patient is located– Technology
– Patient and family needs
• Schedule telemedicine consultations
• Follow up documentation & scheduling
Telemedicine Technology:
Mimicking In-Person Visits
Cart and Peripherals
• Digital ophthalmoscope
• Digital otoscope
• Digital stethoscope
• Digital exam camera
