Zsolt Kulcsar, chief medical officer at Lee Health based in Fort Myers, Florida, said what he’s learned in recent years is that telemedicine is great, but it also has its limitations. . There are only so many people can solve through video interaction.
PROBLEM
“When the first wave of COVID-19 passed, we met with all of our deans, including cardiology, pulmonology and other critical service lines, and we asked them about it,” he recalls. limits of that telehealth interaction”.
“What we learned is that we need data,” he continued. “We can’t make data-driven decisions because we don’t have blood pressure, we don’t have oxygen saturation, we don’t have weight, we don’t have the data to go with the decision-making. clinical. “
The caregivers only have the patient and they can check some things through video, but they don’t have that supporting data for decision making and management.
It’s time for remote patient monitoring – bringing devices into the home that can collect clinical data, including blood pressure, oxygen and weight. But more importantly for Kulcsar, RPM can also collect questionnaires from patients that can help detect early clues of exacerbation, decompensation, or deterioration.
“The program we built here is an RPM store, and it has the tools we need to collect that data,” he said. “That was very important before COVID and even more important after COVID.
“There’s a term called ‘virtual first’ that we use,” he added. “For example, would a patient be in their living room and call their doctor to let them know that they have a specific condition that they’re worried about, and they’re wondering what they should do about it?”
“Our digital footprint is suddenly expanding from more passive surveillance to surveillance plus intervention.”
Dr. Zsolt Kulcsar, Lee Health
Patients can do this from their living room, as opposed to driving to an urgent care facility or emergency department. Then, if they need to drive to an urgent care facility or emergency room, they will be asked to do so.
“To go further, some patients don’t want to go to the office and sit in the waiting room,” said Jonathan Witenko, director of telemedicine and virtual health systems. “Then there are patients who want to be seen and have that relationship with their doctor. So it’s also a bit of a patient preference and what the patient’s taste is, and figuring out what’s going on. suitable for the patient.
He continued: “Telehealth isn’t just intended to replace face-to-face visits – it’s a supplement. “Once someone is seen by their primary care physician, they can use telehealth to check in and check in on the spot, so patients don’t have to go to the office as much but they can still get services. personal care they need help with with their condition.”
SUGGESTIONS
Lee Health’s remote patient monitoring technology and services provider is Health Recovery Solutions.
“They are a high-performance and forward-thinking supplier,” asserts Witenko. “They can help deliver the technology and set it up in the patient’s home. This helps us gather the data-driven intelligence we need to provide patients with optimal care when and where they need it.”
Kulcsar reported that the health system was able to get up and running two days after Hurricane Ian passed through the community in September 2022 and continues to monitor patients’ conditions.
“Our digital footprint suddenly expanded from more passive surveillance programs to surveillance plus intervention,” he recalls. “Those interventions are really important for our health system to keep people at home or move home from the hospital and do it safely.
“We helped monitor the data and then reported it to the appropriate experts,” he added. “We’re also helping with those situations in the home.”
MARKET
There are many telemedicine technology and service providers in the medical IT market today. Healthcare IT News published a special report highlighting many of these vendors with detailed descriptions of their products. Click here to read the special report.
MEET CHALLENGES ONLY
Health Recovery Solutions may feed information into the electronic health records of Lee Health, Epic, so all providers involved in patient care can know the complete clinical record of the patient and continuity of care demonstrated throughout the process.
“Additionally, I can call the cardiologist or text them that their patient’s blood pressure or weight has gone up in the past few days and have them look at what they think,” says Kulcsar. clinically worrisome”. “And if something goes wrong, we can coordinate services in-house, because everyone can see what we’re seeing.
He continued: “We have a full clinical team, including those who perform day-to-day interactions with patients. “There’s a customer service rep and three nurses who do data analysis on a daily basis and do escalation reports.”
“Telehealth isn’t just intended to replace face-to-face visits – it’s a complement.”
Jonathan Witenko, Lee Health
Lee has a clinical team of two cutting-edge providers and a chief medical officer to monitor data, coordinate care, and liaise with dispatch specialists and internists.
“We can only act,” explains Kulcsar. “We see it. We get the announcement and make a plan.”
Lee Health has officially received its first payment for RPM services provided. Services performed through the RPM team are billed and reimbursed.
RESULT
Lee Health is sending fewer people to hospitals and emergency departments.
“A few months ago, about 17% of our tele-monitored patients needed a higher level of care,” Kulcsar reported. “Now we fluctuate between 3% and 5%. We’ve been able to keep people in their homes and coordinate that care.
He continued: “We have also partnered with DispatchHealth, which provides direct-to-home care. “They can draw blood, take X-rays and deploy drugs, and that helps us a lot.”
Surveys show that Lee has actively engaged patients who are very satisfied with their overall care, equipment, and program itself.
“Our provider claims an 80% compliance rate, meaning patients enrolled in the program also receive their biometrics and are compliant 80% of the time in a typical month , which is quite impressive,” Kulcsar added.
USE FCC AWARD FUNDS
Lee Health was awarded $1 million by the FCC’s telehealth grant to support a remote patient monitoring program.
“We’ve used this money for a remote patient monitoring program, placing cameras inside the NICU in each crib so family members can watch the baby grow and develop while he or she receives them. I care for and to grow our telehealth infrastructure,” explains Witenko.
“We are also taking steps to position ourselves for the future and be proactive rather than reactive,” he continued. “COVID and Hurricane Ian helped us recognize the challenges and address them, and we are now working to deliver those solutions.”
Supplier organization laid the groundwork, Kulcsar added.
“We have clinical staff,” he said. “We have the right technologies and people are approaching me now about other specialties that could benefit from these implementations, such as oncology. We’re looking at different data, reflecting respond differently to that data and collaborate with another expert.
He concluded: “Now you can be really creative and it helps with digital transformation too. “This is step one and two to digital transformation and now the real hard work can begin.”
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Healthcare IT News is a publication of HIMSS Media.
