Inpatient telemedicine at Providence Health System provides critical access to care for more than 100 hospitals across nine service lines. And it has improved quality and access across the health system.
Providence’s inpatient telehealth services include telestroke, teleEEG, teleneuropsychiatry, telehospitalist, Hospital at Home, and teleICU. The large health system recently launched a teleinfectious disease program and a virtual nursing program called CoCaring. These programs are important given the physician shortage and the difficulty in recruiting specialists to rural areas.
Dr. Eve Cunningham is the corporate vice president and director of virtual care and digital health at Providence and the founder of the AI-enhanced clinical intelligence tool MedPearl. She reports that her inpatient telemedicine programs are “growing like crazy.” So we sat down with her for a first-hand tour.
Q. First, let’s talk a little bit about the inpatient telemedicine services at Providence.
ONE. Traditionally, access to medical expertise has been limited to the four walls of a hospital or clinic, often requiring referrals from community hospitals to specialists outside the community. With telemedicine, we can now “signal” these specialists to remote, underserved, and rural communities to assess and consult with patients, and empower the local medical community with expert consultations and support.
Through telehealth, we not only save time by eliminating the need for travel, but also ensure that specialists are used efficiently across the entire care network. Using technologies such as tele-carts and cameras, specialists can conduct assessments and work alongside field health care teams to provide the necessary care and develop appropriate treatment plans.
This setup also helps manage physical hospital space constraints. As some regions face legal and financial challenges in expanding hospital bed capacity, optimizing the use of existing beds becomes essential. Inpatient telemedicine facilitates this by ensuring that patients receive the appropriate level of care in the most appropriate settings without the need for physical relocation.
Overall, Providence inpatient telemedicine services enhance the quality of care delivery by making expertise more accessible, supporting clinical teams, optimizing bed utilization, and improving patient management and flow across facilities.
Q. You report that inpatient telemedicine is “growing like wildfire” at Providence. Why? What are the driving factors?
ONE. The growth of inpatient telemedicine services at Providence was driven by three key factors, each essential to addressing the changing healthcare landscape.
First is the ongoing physician shortage. Several factors contribute to this shortage, including an aging physician demographic and increasing number of physician retirements, burnout that is forcing many physicians to reduce FTE or leave the profession altogether, and challenges recruiting to residency and fellowship programs.
The shortage is particularly acute in the field of neurology, a concern raised in a 2019 call to action by the American Association of Neurologists. In addition, the difficulty in recruiting specialists to serve in rural communities exacerbates the problem, as these areas traditionally have fewer physicians per capita than urban centers.
Another driver of telemedicine adoption is the need to optimize hospital beds and improve patient flow within hospitals. In states with certificate-of-need regulations that limit bed expansion, maximizing the use of existing hospital beds is critical.
Telehealth programs help achieve this by ensuring hospital beds are used at peak capacity, reducing unnecessary patient transfers and admissions. This capability is especially beneficial for smaller community hospitals, allowing them to handle more complex cases that might otherwise be referred to overburdened tertiary hospitals.
Finally, the shift to a hybrid work model among physicians is also driving the expansion of telemedicine. Many healthcare professionals now enjoy the balance between on-site duties and the flexibility of remote work.
Not only does this promote job satisfaction and retention, it also increases the overall efficiency of healthcare delivery. Because our providers can deliver care remotely, travel time between facilities is reduced and patient care is delivered more quickly.
The convergence of these factors – physician shortages, the need for efficient bed utilization, and the preference for hybrid work models – has contributed to the growth of inpatient telemedicine services at Providence. Our programs support more efficient care delivery, address critical staffing and resource constraints, and deliver better patient outcomes.
Q. What kind of patient outcomes are you achieving through this technology? How does it help outcomes?
ONE. Our telehealth programs have significantly reduced unnecessary patient transfers between facilities. Our clinicians can provide specialist consultations remotely, allowing patients to receive appropriate care where they are. Telehealth allows patients and clinicians to avoid the need for physical travel unless absolutely necessary.
We have also seen a reduction in unnecessary hospital admissions, particularly through our telepsychiatry program, which provides effective assessment services to patients directly from the emergency department, allowing for safe discharge without the need for hospital admission in approximately 30% of our consultations.
At the same time, the telepsychiatry consultation program helps ensure that patients are placed in the most appropriate care setting based on their specific needs.
The implementation of telehealth services, managed by resident physicians and virtual nursing programs, has reduced overall length of stay in hospitals. This efficiency not only improves patient throughput but also increases the availability of hospital beds for new patients requiring inpatient care.
In critical care settings, the tele-ICU program has played a significant role in reducing the time patients require mechanical ventilation. By optimizing treatment plans and allowing for more timely interventions, patient recovery times have improved, thereby improving the management of ICU resources.
Our newly launched infectious disease telemedicine program focuses on enhancing antibiotic stewardship and ensuring adherence to guideline-based therapies, aiming to reduce the incidence of antibiotic-resistant infections through more appropriate antibiotic use.
Finally, our telestroke program has made significant strides in reducing treatment times. Faster use of thrombolytics and clot-dissolving interventions is essential to improving outcomes in stroke care, potentially reducing long-term disability.
We were also able to keep 70% of stroke patients referred remotely to community hospitals, thereby reducing unnecessary transfers of care to overwhelmed medical facilities.
Q. What problems or challenges does inpatient telemedicine solve or at least help alleviate? For example, does it help address staff shortages or burnout?
ONE. One of the most important issues our program addresses is staff shortages and burnout, especially in rural and underserved areas. The pressure on our existing clinicians is already immense. Telemedicine alleviates this challenge by allowing clinicians to provide care remotely, reducing the need to be physically present in multiple locations and thus reducing travel stress and burnout.
This also helps maximize the utilization of limited number of physicians by expanding their scope of practice to more facilities without additional time and physical burden.
Another area where telemedicine has an impact is in optimizing hospital beds and patient flow. With strict regulations and financial constraints often preventing expansion of hospital bed capacity, telemedicine plays a key role in making the most of existing resources.
It supports more efficient triage and treatment of patients, ensuring that patients are cared for in the most appropriate environment without the need for transfer. This is particularly important in areas where the number of beds cannot be increased due to administrative or financial constraints.
Telemedicine also improves access to specialist care. Using telemedicine technology, specialists can assess, diagnose and plan treatment for patients remotely. This is especially beneficial in areas with specialist shortages, allowing patients in these areas to receive high-level care that might otherwise be out of reach, democratizing access to specialist medical services.
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: [email protected]
Healthcare IT News is a publication of HIMSS Media.
