Earlier this year, the FCC awarded Parker Jewish Institute for Health Care and Rehabilitation in New Hyde Park, New York, $97,965 for telehealth services and connected devices, including remote monitoring devices, to care for the elderly and chronically ill in its 527-bed skilled nursing facility and rehabilitation center specializing in the care of older adults.
Social distancing is a key factor in reducing the spread of the COVID-19 coronavirus, and tele-visits can be a safe and secure means for providers to deliver certain types of care for their patients.
“The FCC COVID-19 Telehealth Program will enable Parker to reduce patient face-to-face encounters in the nursing home and the possible impact of COVID-19, reduce PPE, and minimize staff burden,” said Lorraine Breuer, senior vice president for research and grants, and compliance officer, at Parker Jewish Institute for Health Care and Rehabilitation. “Successfully limiting the need for patients to physically access providers due to Parker’s telehealth program will mitigate the risk of patients becoming infected with COVID-19 or spreading the disease to providers and other medically vulnerable individuals, such as immunocompromised elderly residents.”
Because residents will have the opportunity to receive primary care services in a safer environment through telehealth, Parker will contribute to public health goals of reducing the spread of COVID-19 while reducing excess burden on the hospital systems throughout New York City that may be overwhelmed with COVID-19 patients.
“Through this measure, our elderly residents and patients will be able to receive routine, non-emergent access to care, with their preferred healthcare providers, to address their chronic medical problems as well as anxiety, depression and other diagnosed disorders,” Breuer said. “Using this measure, we will be able to minimize the need for patient visits to the emergency department or other medical providers, ultimately lessening the burden on our local hospitals.”
Parker is using the Healow application by eClinicalWorks for its telemedicine program.
Parker is located in Queens County, the hardest hit borough in New York City with 32,749 positive cases, representing 32% of New York City’s cases. The area continues to face an increase in severe COVID-19 cases that require hospitalization – overwhelming many hospitals. The spread of COVID-19 has been devastating on the healthcare system in Queens.
"The FCC COVID-19 Telehealth Program will enable Parker to reduce patient face-to-face encounters in the nursing home and the possible impact of COVID-19, reduce PPE, and minimize staff burden."
Lorraine Breuer, Parker Jewish Institute for Health Care and Rehabilitation
“Within the nursing home, older individuals and individuals with multiple co-morbidities like the residents at Parker tend to have more severe symptoms if they contract COVID-19,” Breuer explained. “In addition to their congregate nature, residents of nursing homes tend to be more frail, have more functional limitations, and have more chronic and complex conditions like diabetes and heart failure than other older adults.”
Based on the data that Parker has about COVID-19, that puts Parker’s nursing home residents at the highest risk for serious illness and mortality as a result of exposure. Social distancing is one of the best ways to prevent spread of the virus. The FCC Telehealth Program will help Parker reduce pressure on the already strained hospital system in the area by helping staff treat their residents in place and save the lives of their elderly patients by reducing in-person contact, Breuer said.
“Another urgent concern as the pandemic grows and workers may be forced to self-quarantine is the potential for workforce shortages,” Breuer noted. “It is more critical than ever that we work to identify ways to supplement our nursing home providers so they can treat nursing home residents from home and avoid sending their residents to the hospital.”
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MEETING THE CHALLENGE
Parker serves medically complex and severely immunocompromised, frail elderly patients requiring intense skilled nursing and medical care. Parker shares a campus with the Long Island Jewish Medical Center, a large tertiary care facility with which it has a clinical affiliation and is physically connected through an underground tunnel.
“Due to Parker’s close proximity to New York City and the multitude of services that it has to offer, it has become an important partner with the New York City Office of Emergency Management, and assists in the transition from post-incident recovery,” Breuer explained. “During crisis events, Parker’s auditorium has been converted to a holding area for patients who must be evacuated from area hospitals during emergencies like 9/11 and Hurricane Sandy.”
In addition to partnering with the New York City Office of Emergency Management, Parker serves as a triage partner with Long Island Jewish Medical Center (LIJ) and a repository for patients who must be moved from the hospital during an emergency, as Parker did in opening its auditorium to LIJ as a surge emergency room during the COVID-19 crisis.
“It should be noted that Parker is a member of the New York City of Emergency Management Communication Network,” Breuer said. “Parker is also an integral part of the New York City Mayor’s Office of Emergency Management disaster readiness plan. Parker is a member of the UJA-Federation and works with the Jewish Community Relations Council of New York network of agencies on disaster response issues. Parker also is a member of the NYC emergency response system.”
Parker admits approximately 1,500 geriatric patients annually, including many from LIJ, which makes Parker as busy as many of the area’s acute care hospitals. These patients are markedly different from the usual long-term care residents or small sub-acute populations of most large nursing homes as they require advanced and sophisticated care. Patients with these conditions come to Parker because of the organization’s staff’s high level of expertise and experience.
When it comes to the telehealth program, Parker will use quantitative and qualitative indicators to measure the success. Specifically, Parker’s Nerken Center for Research will track the number of virtual patient encounters, patient visit time, clinician response time as a measure of access to care, prescription rates, treatment plan adherence, accuracy of diagnoses, rate of hospital admission, emergency room utilization, patient mortality, as well as patient demographics.
In addition, Parker will assess resident and provider satisfaction regarding the effectiveness of the telehealth program.
USING FCC AWARD FUNDS
“COVID-19 is particularly dangerous for the elderly and chronically ill patients we serve, who are most affected by the disease,” Breuer said. “Sadly, 8 out of 10 COVID-19 deaths in the U.S. have been in adults 65 years and older, and New York City and Queens have been disproportionately hard hit. In the interest of reducing the possible impact of COVID-19, we have dramatically reduced patient face-to-face encounters in the nursing home to protect our patients and staff.”
This funding will allow Parker’s patients access to necessary medical care in a safe environment, she added. In this time of social distancing, the availability of care via telehealth has become extremely important to reduce the spread of COVID-19, she said.
“This new grant will help strengthen Parker’s resources by expanding the availability of telecommunications services, information services and connected devices,” she explained. “Additional laptops, mobile devices and remote patient monitoring strategies will allow our doctors to monitor their patients from anywhere and is part of how Parker will provide better care to our residents affected by COVID-19.”
This expansion of technology will ensure Parker provides its residents with the highest level of continuity of care throughout these difficult times, Breuer added. Parker Jewish Institute for Health Care and Rehabilitation has earned the Center for Medicare & Medicaid Services 5-Star Quality Rating.
“Throughout the COVID-19 public health emergency, Parker has been at the forefront in strategic planning to mitigate the spread of infection,” Breuer said. “Throughout the pandemic, Parker has provided access to healthcare services via telehealth on a limited basis. We are thankful for the FCC’s support in expanding our telehealth services necessary to provide critical connected care services.”