Health Partners deploys school-based telehealth that even lay people can operate
Last year, Health Partners of Western Ohio had been tasked with providing school-based healthcare in 71 sites across the Toledo, Ohio, area.
Many of these locations would not have Health Partners' employees present to administer examinations, and some of the personnel on-site had minimal or no medical training. So telemedicine immediately came to mind.
When it came to personnel with no medical training, of the telemedicine platforms that Health Partners auditioned, only Tyto Care was intuitive enough so that even lay people could provide meaningful examinations to assist with off-site providers.
The telehealth platform's software and hardware provides in-examination guidance to the patient or lay assistant through video imaging on the examination device that gives directions to the examiner on placement and guidance to acquire medical-quality audio recording, video recording and still images to be sent to the provider back at Health Partners.
"Orientation of new personnel has been very straightforward, starting with the YouTube videos posted by Tyto Care, which show the hardware and software in action," said Dr. Warren "Calvin" Morris, chief clinical officer at Health Partners of Western Ohio. "Even those who are squeamish around computers quickly gain the skills they need to be effective.
"By far this hardware and software [are] the least intimidating of anything else we auditioned, while providing equal or superior clinical information."
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MEETING THE CHALLENGE
"We designated several key personnel to become Tyto super users and trainers," Morris explained. "They went on to oversee the installation of Tyto Clinic hardware and our IT contractor either connected the system to the host school network when appropriate or connected the Tyto Clinic to the Internet via cradle points that use 4G LTE broadband. All of our examiners are connected to the Tyto Clinic from our 20 clinical sites through our own secure WiFi."
"Orientation of new personnel has been very straightforward, starting with the YouTube videos, which show the hardware and software in action."
Dr. Warren "Calvin" Morris, Health Partners of Western Ohio
The rollout took place well before COVID-19 testing was commonly available, and so pulse oximeters connected to the clinic hardware via Bluetooth were used to further assess patients with pulmonary symptoms beyond auscultation already provided by the clinic hardware.
Patients with fever, altered lung sounds and decreased blood oxygen saturation were tested for COVID-19 while patients who were showing further signs were triaged in other ways.
First and foremost, the telehealth platform allowed Health Partners to quickly deploy examination and testing equipment into more than 70 locations, some of which could not support a fully staffed student health center, but whose patients have medical needs and often limited choices for meeting them.
By allowing Health Partners to use staff already on site in addition to some Health Partners staff, the skills of the healthcare organization's physicians and certified nurse practitioners can be deployed where and when they are needed and not be hampered by distance and geography.
"The ease of use Tyto Care gives us allows for rapid adoption by even skeptical and technology-averse support staff, and the quality of the examinations and images allows our certified nurse practitioners and physicians to diagnose and prescribe care confidently."
This is especially important during the ever-changing situation brought on by the pandemic by providing meaningful and accurate triage to make use of scarce COVID-19 testing and treatment resources.
"It is clear that many patients assessed at our sites through Tyto Clinic were able to avoid the emergency room with the expense and COVID-19 exposure that comes with that," Morris added.
ADVICE FOR OTHERS
When choosing a telemedicine platform, health IT professionals need to expect pushback by staff and providers who will find faults with any hardware, software and user interface that in their minds casts doubts on their ability to provide meaningful care remotely, Morris advised. Morris has been told by some professionals outside of Health Partners that telemedicine is not "real" medicine.
Any platform health IT professionals choose, Morris said, must:
- Offer a flat learning curve for all roles of the care team, especially the computer shy.
- Deliver accurate and meaningful clinical images, sounds and numeric telemetry.
- Be versatile enough to deal with a variety of installation scenarios.
- Be reliable and well-supported.
- Be accepted by the patient.