Health

Telemedicine and RPM transform care delivery in Alabama, reaping the rewards



As the University of Alabama at Birmingham health system creates a telehealth program, the main problem it is trying to solve is how to improve access to care across the country. state.

PROBLEM

Alabama has some of the worst health care outcomes in the country. Dr Eric Wallace, professor of medicine, medical director of telehealth and medical director of UAB eMedicine, said that telehealth technologies have been adopted to eliminate the geographical reason leading to these outcomes. this result and begin to solve the problems.

“Access to care issues is both outpatient and inpatient,” he explains. “Video conferencing has enabled us to redistribute care across our state. UAB partnered with our Alabama Department of Public Health to obtain funding and purchase video conferencing equipment. model for each of our county health departments We have used these county health departments as a way to provide specialty care throughout our state.

“Furthermore, we started telehealth for inpatients at Whitfield Rural Hospital. We rolled out the tele-stroke program and general neurology to get started. Then , we expanded into teleneuropathy, remote critical care, and telecardiology.”

The COVID-19 pandemic allows video conferencing to extend to the door. UAB has grown from 1,000 video hits in 2019 to 280,000 video hits in 2020. Today, about 15% of total ambulance volume is still telemedicine.

Also during the pandemic, UAB implemented a remote patient monitoring program to better address the needs of patients with diabetes and hypertension.

PROPOSE

Telehealth aims to reduce access to care in Alabama.

“We have many hospital beds in our state, but despite this, 70 percent of our rural hospitals are operating under an anemic condition,” notes Wallace. “This is largely because patients start to skip rural hospitals when they don’t have the services they need to care for them. Urban area hospitals have qualified specialists but beds. disease is always full.

“Telehealth allows us to redistribute this care,” he continued. “This was all too clear during the COVID period. We had a time when rural hospitals didn’t have telehealth subspecialty support for critical care and kidney patients referred patients to them. other rural hospitals have these subspecialties.

“Once healthcare professionals see how telemedicine can radically transform care delivery if properly organized, they understand that virtual care is not only essential but also required if the industry is to reform the health care system in a meaningful way.”

Financially, UAB’s inpatient telehealth services have transformed hospitals.

Wallace notes: “One of our hospitals went from a median inpatient census of 20 to a median inpatient census of 50. “Their case mix increased from 1 to 1.5 as well as the mixed-case index moving them to UAB.

“We’re not just seeing improvements in care in rural areas,” he added. “Even internally at UAB, we have fully deployed the tele-ICU capabilities in over 250 beds and have seen a significant and sustained reduction in observed rates compared to rates and mortality. expected death.”

On the ambulance side, UAB has seen telehealth give access to rare disease specialists, not only in rural areas but across the region and even internationally. It has seen improved access to all of its sub-specialty services.

“More importantly, we saw a tool with which we can continue to transform care delivery,” he said.

MARKET

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RESULT

Through its telemedicine programs, UAB has achieved many solid successes, including:

  • Increase census and case composite index of rural hospitals.
  • Increase the case composite index of patients referred to UAB hospital.
  • Achieved more than 650,000 emergency telemedicine visits.
  • Patients with remote monitoring of systolic blood pressure decreased an average of 9 mmHg over 45 days.

TIPS FOR OTHER PEOPLE

Wallace advises his colleagues: “To create a telehealth program, you have to take lessons from the software industry. “Healthcare needs to plan for the minimum viable product. Once that’s in place, you need to start with the goal of seeing one patient. Then two, then three.

He continued: “With the deployment of the technology, there was no time for a randomized controlled trial, and when the trial was complete and analyzed, the technology changed.

He added: “Find the problem, then decide if technology is a viable means to eliminate the problem.

“If so, plan just enough to see one patient and scale from there,” he concludes. “We often planned too much and nothing happened. In the end, having a clinical team leader combined with an excellent executive team leader worked well for UAB.”

Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: [email protected]
Healthcare IT News is a publication of HIMSS Media.

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