Telemedicine innovation: Rural health system keeping more people alive at lower costs
In 2005, Tift Regional Health System began exploring telemedicine as a way to connect its physicians and specialists with patients in the rural area surrounding its Tifton, Georgia, home base.
At that time, telehealth technology largely consisted of a hub-and-spoke network, based out of large tertiary care centers or academic medical centers.
"We understood [telehealth] was the future and we needed to be a part of this technology that could get our patients to the specialists that they needed to see 200 or more miles away," said Jeff Robbins, MD, director of telehealth and neurodiagnostics at Tift Regional Medical Center.
The virtual visits idea was starting to be discussed in rural parts of the country. The Internet was slow, but the tech was getting close to making distant encounters possible.
"In the early days, every encounter was basically a telehealth network within itself," Robbins said. "The technology only allowed us to connect to one endpoint at a time. The technology didn't allow us to network to a new endpoint or customer without a lot of IT involvement. Internet was slow and the devices used to conduct a patient-to-provider encounter were primitive compared to what we have today."
These issues prevented Tift Regional from achieving the outcomes it knew were possible but staff understood, given its track record at other hospitals, that telehealth could play a very important part in delivering healthcare in the near future.
Tift at that point partnered with the Global Partnership for Telehealth, a nonprofit with a 12-year track record in developing and implementing sustainable, cost-effective telehealth programs.
The Global Partnership for Telehealth markets telehealth systems to hospitals and other medical facilities in 11 states. There are a variety of telemedicine technology vendors with varied offerings on the market. These include American Well, Avizia, Cisco Systems, HealthTap, InTouch Health, MDLive, SnapMD, TeleHealth Services and Tellus -- many of those are in the Healthcare IT News Buyers Guide: Comparing 11 top telehealth platforms.
Tift Regional Medical Center's virtual waiting room
GPT's network of caregivers and its technology gave Tift Regional the ability to connect to nursing homes, school clinics, emergency rooms, stroke teams, specialized wound care teams and advanced critical care teams hundreds of miles away from its rural location in South Georgia.
"I like to say the miracle of telehealth is that it gives us the ability to erase time and distance," Robbins said. "Our patients benefit with virtually no travel time or expenses, decreased time waiting for an appointment, reduced medical costs, and extra value to the patient encounter and extended access to consultations with specialists not offered in their area and usually hundreds of miles away."
The partnership with GPT also allows Tift Regional's employed physicians to increase revenue because they can see patients outside their area, reducing missed appointments, and giving them the tools to treat more patients over time and have better patient follow-ups that improve outcomes, which also cuts down on readmissions, he added.
Telehealth carts generally include a monitor, camera, keyboard and remote control. Peripherals give physicians the ability to monitor vital signs, use a digital stethoscope, and use high-definition cameras for specific types of care such as dermatology or wound care.
Telehealth has become a critical component in Tift Regional's ability to deliver quality healthcare, and the healthcare organization has seen success in using the technology.
"Telehealth has increased access to healthcare within our organization by making it easier for our patients to obtain clinical services," Robbins said. "It also allows our hospital to provide emergency services that we cannot always provide like advanced/emergency stroke care. We have also seen an increase in improved health outcomes."
Telehealth allows Tift Regional to get its patients seen, diagnosed and treated earlier. This leads to improved outcomes and less costly treatments, Robbins explained.
"Telehealth has allowed us to have advanced ICU support and that has reduced mortality rates, reduced complications and subsequent hospital stays," he added. "We are seeing a reduction in healthcare costs through home monitoring, which is lowering costly hospital visits. Our stroke program is reducing the high cost of transferring stroke and other emergencies."
And Tift Regional has used telehealth to address the shortage in healthcare providers by allowing its patient population to see specialists outside Tift's area, also enabling Tift's own specialists to serve more patients, he said.
Before telemedicine, a virtual encounter meant both the presenter and the provider had to switch between many different programs. This presented issues when programs failed and data didn't link up correctly.
"The provider can now see who is waiting to be seen in the virtual waiting room, and data entry has been streamlined to allow patient data and notes to be uploaded into our existing EHR," Robbins said. "And maybe the best improvement is the ability to switch programs, going from Pathways to the stethoscope then the cameras within the same encounter."
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