Like many other moderately sized community hospitals with ambulatory clinics, Ellis Medicine in Schenectady, New York, is challenged with not only providing its patients and community expanded and alternative methods of access to primary and specialty care, but also ensuring that care is provided in the right setting.
Prior to the pandemic, Ellis Medicine was conducting telehealth only informally by telephone visits. There were significant opportunities for both telephone and video visits to be captured through telemedicine.
Telemedicine offers several benefits that position healthcare provider organizations to deliver care in a convenient, contemporary and sustainable manner, said Colleen Hammond, practice manager and manager of population health at Ellis Medicine.
She pointed to ease of access and continuity of care that meets consumer choices while transcending social determinants, resulting in engagement and satisfaction for patients, supplemental and alternate streams of revenue for providers and organizations for established patients, and the opportunity to attract new patients.
“With COVID-19 and unprecedented situations that may arise in the future, these objectives were not only catapulted to the forefront, but were also laden with the added benefits of safety and conservation of precious resources such as personal protective equipment (PPE),” Hammond noted.
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MEETING THE CHALLENGE
The unprecedented COVID-19 pandemic caused the federal government to greatly reduce regulatory barriers on the one hand, while federal agencies like the FCC provided funding to providers on the other. This significantly helped Ellis Medicine fast-track its strategic plan to offer telemedicine.
“After initially dabbling with Zoom, Microsoft Teams and FaceTime, Ellis Medicine chose Mend as its telemedicine platform for several reasons,” Hammond explained. “These reasons include: ability to launch through a browser versus an app; device and software diagnosis; low bandwidth consumption and scalability; tech support for patients; ability to integrate with patient portal; and ability to continue documenting within existing EHR while performing telemedicine.”
"Our offices started by offering routine scheduled appointments that could be easily conducted through telemedicine such as follow-ups, medication reviews and post-op."
Colleen Hammond, Ellis Medicine
Primary care and bariatrics were the first to successfully conduct video visits while behavioral health increased its telephone visits substantially. The ease of use and satisfaction for both providers and patients quickly drew the attention of colleagues from other specialties, Hammond said.
Currently, Ellis offers telemedicine services for primary care, behavioral health and all specialties, including bariatrics, cardiothoracic surgery, CHF clinic, dermatology, endocrinology, gynecology, infectious diseases, maternal-fetal medicine, neurology, nutrition, otorhinolaryngology, rehabilitation, surgery and social work.
“Our offices started by offering routine scheduled appointments that could be easily conducted through telemedicine such as follow-ups, medication reviews and post-op,” she said. “As the level of comfort and popularity grew among patients and providers, we expanded services to include pre-op appointments, sick and same-day appointments, annual wellness visits and new patients who needed to establish care.”
The clerical coordinators, practice managers, documentation specialists and coders played a significant role in adoption of telemedicine and its evolution, she added.
Currently, Ellis Medicine tracks metrics surrounding use of the Mend telemedicine technology. Over time, it likely will track engagement with repeat visits, growth with new patients, and satisfaction for providers and patients. There has been consideration for creating a task force dedicated to telemedicine.
The results so far? From March 23 through August 26: 6,929, video visits attended, 1,124 cancelled and 287 no-shows. And for telephone visits: 11,401 attended, 1,486 cancelled and 742 no-shows.
USING FCC AWARD FUNDS
Ellis Medicine was awarded $131,261 for a telehealth platform, laptops and telehealth equipment to provide COVID-19 symptom monitoring and testing referrals, to treat and monitor COVID-19 patients with a remote care treatment plan, and to treat other at-risk patients with chronic conditions.
“The FCC funds were a timely and much-needed lifeline for Ellis Medicine and its community,” Hammond said. “The FCC funds supported the purchase of equipment and licenses for the telemedicine platform. With the help of these funds we were able to expand care delivered to patients. We now have 80 providers set up with the Mend platform.”
This growth has allowed Ellis Medicine to offer patients and the community a wide range of telemedicine services, she added. It is rewarding to provide patients the opportunity to conduct telemedicine visits with their own primary care and specialty providers, improving continuity of care and patient-provider relationships, she remarked.
“Recently, we have expanded our telemedicine services to include same-day appointments, which are open to the public,” she said. “These appointments provide patients needing acute care the opportunity to schedule appointments on-demand at a time that is convenient for them. Through this initiative we hope to provide patients the care they need when they need it, reducing unnecessary emergency department utilization.”
With the uncertainties of the national health crisis, she concluded, securing a telehealth platform has better positioned Ellis Medicine to care for its community and the patients it serves.