Recruiting staff for urgent care facilities has always been a challenge at Baptist Health, which is headquartered in Louisville, Kentucky and serves that state and Indiana.
PROBLEM
Baptist Health staff can look at previous models but sometimes have difficulty making accurate predictions for specific days and times. Furthermore, with current healthcare staffing challenges, even if Baptist Health recognizes the need for additional staff, they may not have the resources to increase staffing appropriately.
“The wait times at our urgent care centers and therefore the patient experience can be greatly impacted by these unusual changes in the patients who come in,” said Dr. Brett A. Oliver, chief medical information officer at Baptist Health. “This is especially true in the final hour before the clinic closes.
“In fact, one emergency room in our Hardin market had a competitor emergency room that changed its hours to close earlier, causing even more traffic to our emergency room later in the day,” he continued.
“This influx of patients results in long wait times, which is bad for patients, and also causes doctors and staff to stay late, which is bad for their experience and can increase costs for the health system.”
Because health systems cannot add additional staff, providers, or clinics, they need to find ways to increase productivity and provide patients with the fastest and most appropriate form of clinical care possible.
PROPOSE
Proposal is a must a standalone video exam kiosk at urgent care locations to provide patients with low-acuity issues an alternative to longer wait times when seen in person.
“When a patient comes in and their chief complaint is on the pre-approved list of issues that can be seen virtually, the front desk staff simply gives them options,” says Nick Sarantis, director of digital health systems at Baptist Health. “For example, the staff will say, ‘Our current wait time is about 90 minutes; however, for your current complaint, we have an online option and the virtual provider can see you right now.’
“If a patient selects the virtual option, they are taken back to the self-service kiosk, logged into their MyChart account on a tablet, and placed into our virtual urgent care provider pool,” he continued. “These virtual providers are centralized within our system and, prior to the implementation of urgent care, were available 24/7 for other virtual care needs.”
“Where can you get health care with a wait time of only six minutes, especially when you are a walk-in patient?”
Dr. Brett A. Oliver, Baptist Health
With this With powerful telemedicine equipment from provider TytoCare, a visit is more than just a simple video connection. The virtual provider can listen to the patient’s heart and lungs, look into their ears and throat, and examine their skin and eyes. This is a huge improvement over traditional video visits.
“When our online care providers see ‘TytoClinic’ in their schedule, they immediately move their schedule to the front of the queue because these are patients waiting at an urgent care location versus patients waiting in their own homes,” Sarantis explains.
“Being able to provide patients with a quicker option to be seen will increase patient satisfaction, as well as reduce the time it takes for doctors and staff to be on-site, on time.”
Facing the Challenge
TytoClinic allows patients to be seen online instead of having to wait long in line for an in-person appointment. It also gives patients access to technology that they can use at home if they encounter a similar issue in the future.
“Patients using the TytoClinic system are integrated into our system Epic EHR, log into their MyChart account, and the virtual urgent care providers will connect with that patient through their Epic schedule,” Oliver said. “The documentation is also done through Epic. There are no scanned documents.
“Virtual urgent care notes are saved to Epic just as they would be seen in person, so other caregivers can review them,” he adds. “The convenience is that if the virtual care provider determines the patient needs a higher level of care, they can simply transfer to an in-person provider at that location.”
RESULT
In the eight months since its launch, Baptist Health has had about 1,700 TytoClinic visits from urgent care locations. The average wait time is just six minutes.
“What other health care service can you get with a six-minute wait time, especially if you’re a walk-in patient?” Oliver asked. “We’ve been very pleased with how patients are using this option and how some of our busy clinics are using this technology.”
A patient comment Oliver reported: “I was going to the ER for flu-like symptoms. Barbi introduced me to the online visit. I just wanted to say how much I love this. I feel like I’m getting the same care as I would in person. Everyone is still very professional, even though I’m talking to the doctor through a screen. Thank you to everyone who saw me this way.”
Following this success, Baptist Health decided to test the TytoClinic device in all primary care clinics in one of its markets.
“This is a more rural market where getting someone to the emergency room can mean driving an hour or more,” Oliver explains. “By adding equipment to these offices, in many ways we’ve added an urgent care location for patients in these neighborhoods. We’re excited to see the improved access we’ll provide in these underserved areas.”
ADVICE FOR OTHERS
For peers looking to run a similar program As with the telemedicine program, Oliver and Sarantis encourage them to continue collaborating with operational partners throughout the implementation process.
“We were really able to come up with this solution by listening to the challenges in our urgent care operations,” Sarantis noted. “This strong partnership really benefits both our patients and our staff.
“Introducing the technology is the easy part, but the change management to implement a completely new workflow requires a lot of communication and follow-up,” he concludes. “To help maintain camaraderie and communication after implementation, our digital health team sponsored a pizza party competition for the ER with the most telehealth visits in a month.”
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: [email protected]
Healthcare IT News is a publication of HIMSS Media.
