How one 500-doc physicians group scaled up telehealth to 130 clinics in a week

From March 23 through July 20, Florida’s Millennium Physician Group has performed more than 90,000 telemedicine encounters – more than 30% of its total visits.
By Bill Siwicki
11:47 AM
How one 500-doc physicians group scaled up telehealth to 130 clinics in a week

Back in 2017, Millennium Physician Group, one of the largest independent physician groups in the U.S., with more than 500 providers throughout Florida, saw the paradigm shift in the healthcare model away from fee-for-service and toward value-based care on the way.

Consequently, the group felt healthcare delivery was moving away from the physician’s office and into the patient’s home, with services like routine check-ups via telehealth and remote patient monitoring. The group also believed the reimbursement model was going to shift and allow for expanded reimbursements in this setting.

 

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THE PROBLEM

“Even though there was no clear guidance on how this would occur, we knew we needed to find a way to better connect with our patients while allowing for a more flexible care-management model,” said Jeff Nelson, chief information officer at Millennium Physician Group.

“Millennium’s mission is connecting the best doctors, service and quality. Every patient, every time. To achieve this, we knew we needed to look beyond the leading edge of medicine at the time and take our patients where the future of healthcare was headed.”

PROPOSAL

Millennium Physician Group embarked on a journey to find the right solution to move its care model in this new direction, to include the patient’s home.

“As we researched the industry, we found many vendors offering standalone video visit technology and disparate remote patient monitoring systems,” Nelson recalled. “We needed a fully integrated solution that was a single system that could offer a full range of telehealth solutions – video visits, remote patient monitoring and medication-adherence solutions.”

"Identifying physicians to serve as early adopters and change champions can help demonstrate success early in the implementation process."

Jeff Nelson, Millennium Physician Group

During its research, the group came across Hale Health, a telemedicine technology and services vendor. Staff reviewed the vendor’s technology and found that it was more of a platform solution than a product solution, Nelson described.

“This meant we could partner with Hale and collaborate in building on the robust foundational platform they already had in place” he explained. “The platform they had developed allowed us to create a fully integrated solution into our EHR, giving birth to our MPG Connect platform, with the ability to support Millennium’s mission while preparing us for the future of the changing healthcare cycle.”

MARKETPLACE

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MEETING THE CHALLENGE

The MPG Connect platform has been deployed to keep the group’s patients connected with their physician through remote patient monitoring, medication adherence and telehealth visits, all in support of the group’s value-based initiatives.

“We created workflows for our physicians and care team staff to leverage our integrated toolset in providing the same experience to patients as if they were in a face-to-face office visit, with the convenience of being in their home,” said Nelson. “The process we designed also allows for physicians to see patients even when they are not in the office, in what we call ‘reverse telehealth,’ expanding our ability to deliver care after hours or even if the physician is quarantined.”

An email or text message informs a patient of their part in the care process, including medication reminders, prompts to check-in for their visit, and links to attend a telehealth session. The MPG Connect platform is available on a patient’s computer, smartphone or tablet through a branded application that is found in the Apple and Google stores.

“We have complete integration with our athenahealth EHR, My Health Direct online scheduling, QueueDr schedule management program, and Phreesia automated online check-in systems,” Nelson said. “This integration creates a flexible and complete solution for our patients, providers and support staff that not only mimics the patient experience of the doctor’s office but also takes things into the future.”

RESULTS

The COVID-19 pandemic brought with it a tremendous opportunity for Millennium Physician Group to demonstrate how its foresight and Hale Health technology would benefit both patients and the group, Nelson said. As the pandemic started to hit the group’s market around March 16, the group decided to accelerate its deployment within the enterprise, which consists of more than 500 providers and 130 clinic locations throughout Florida. Within one week, the group had fully deployed the MPG Connect platform to all providers and offices.

“By March 23, we had completed this task and started offering telehealth visits to our entire patient population, consisting of more than 450,000 people,” he added. “During the first week of April, 74% of our visits were being conducted via telehealth. And as of the week of July 20, we have performed well over 90,000 telehealth visits, equaling more than 30% of our total visits.”

Because of telehealth, the group was able to continue to care for its patients during the state-mandated safer-at-home order while assuring the healthcare continuum remained intact for patients with chronic conditions, he said.

“Of course, remaining open for the business of caring for patients helped minimize the financial impact on Millennium due to COVID-19,” he noted. “The ability to roll out this kind of platform in record time has allowed Millennium to navigate the COVID-19 pandemic and truly transform our care model. Plus, the patients love it.”

The group currently is working on expanding its remote patient monitoring to its chronic-need patients to enhance care and reduce unnecessary hospital admissions.

ADVICE FOR OTHERS

“Healthcare providers first should consider their strategic direction to clarify how the platform will fit into their overall care continuum,” Nelson advised. “This will help ensure the solution will be part of a long-term sustainable model. Next, organizations should prioritize the needed capabilities to consider a modular design where components can be added or optimized over time.”

Organizations also should assess the level of integration needed with core and supporting systems for ease of use, he added. The more integrated the environment, the easier it will be for patients, care teams and physicians, he said. The requirements of each of these stakeholders must be carefully identified and addressed, including variation in patient populations, he added.

“And finally, the organization must be ready for the change, as any resistance will hinder adoption,” he said. “Careful attention should be given to how the platform will be introduced. Identifying physicians to serve as early adopters and change champions can help demonstrate success early in the implementation process. Dashboards that provide transparency on success measures must be available so that wins can be celebrated, and countermeasures can be enacted to rectify any issues.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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