Remote patient monitoring improves access to care for Avera patients
By reimagining the technology it was already using, the South Dakota health system has also preserved supplies and earned high satisfaction.
Avera Chief Medical Information Officer and Chair of Family Medicine Dr. Andy Burchett speaks at the HIMSS22 conference in Orlando.
Photo: Jeff Lagasse/Healthcare Finance News
In the spring of 2020, the virus that causes COVID-19 was tearing across the country and wreaking havoc on patients and the healthcare systems that served them. No hospital, system or ancillary facility was left unaffected.
In South Dakota, when the regional health system Avera Health saw clinics shut down and its hospitals in near lock-down mode, Avera knew it had to get creative.
Its approach was remote patient monitoring, a solution that has worked so well the hospital system is continuing the care-at-home program.
Dr. Andy Burchett, Avera's chief medical information officer and chair of family medicine, was instrumental in pushing the program, which in some ways grew out of the health system's telehealth program. Certainly, the technologies were similar; what was required was a reimagining of the tech so that it could be used to monitor, and even treat, patients inside their own homes. With social distancing and isolation rampant, reaching patients where they were was a critical goal.
In his session "Remote Patient Monitoring: Reaching Out and Breaking Through" at the HIMSS22 conference in Orlando, Florida, last week, Burchett said that after tweaking the payment model, absorbing some of the cost and picking a platform, Avera committed to bridging the hospital-to-home gap.
"We had to have an infrastructure in place to monitor the data and keep a clinical eye on it," he said. "That required human capital and structure to do that. We also needed operational buy-in. We didn't have a lot of capital, or a lot of support, until the pandemic. It was a project that was out there in the periphery, and it became the most important thing we did for about two years."
For this hospital-at-home program – not to be confused with the Johns Hopkins Hospital at Home trademark – patients were given a thermometer and pulse oximeter, which were connected digitally to Avera's data-monitoring center, where the data could be watched and patients triaged appropriately. This not only saved patients and staff from unnecessary exposure to the virus, but helped preserve much-needed personal protective equipment, which was in short supply at the beginning of the pandemic.
For those not triaged to hospitals, staff saw patients daily through virtual visits. And the program proved popular, hitting an 85% approval rate among participants.
"So, this has really become the new standard in our specialty-care clinics," said Burchett. "Endocrinology, psychiatry, dermatology and cardiology are a few specialties where virtual care has been critical. Their no-show rates have been cut in half on the virtual side."
The program, dubbed eCare, was successful in preserving PPE and other resources, helping absorb some of the up-front implementation costs. Additionally, care staff were able to pinpoint effective approaches to care – having only essential personnel in the room during intubation, for example, and using a machine to administer CPR, if necessary. Prescribing services were all handled virtually.
As with any program, there were challenges to overcome.
"We had to be flexible and innovative with the technology we already had," said Burchett. "We embraced multiple technology platforms and devices, monitored high-risk patients recovering at home, maintained open communication between administration and staff, and kept everyone aware of process changes and why they were important. We were at capacity every day, so it was really a life-saving measure."
His advice to other healthcare professionals is to make small but impactful changes to processes now to better prepare for and mitigate risk during a potential future virus surge. It's critical, he said, to continue providing accessible care to the most vulnerable patients no matter what.
"Telehealth can and should be embraced in all areas of medicine, not just primary care," said Burchett. "It will prevent the spread of disease, the cancellation of scheduled appointments and help avoid unnecessary care delays."
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Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
