Telehealth heroes: meet the physician champions of video visits
Telehealth physician champions are innovative forward-thinkers who are willing to push the boundaries of traditional medicine. They develop protocols, lead the staffing and management of the telehealth practice, and analyze and grow the service to its full potential. In this article, four physician champions of telehealth share their take on what it’s like to run a telehealth program—including everything from physician buy-in to EMR integration.
Jason Knutson, MD, is the lead physician for Avera Health’s direct-to-consumer telehealth service, AveraNow. He was instrumental in not only managing AveraNow, but defining the clinical requirements for the telehealth partner and service.
“Five years ago, our health system started an Innovation Council to help us think outside the box and find new ways to improve healthcare,” he said. “Other industries have seen huge benefits through computers and smartphones. We thought healthcare could benefit in a similar way.“
In the summer of 2015, Avera launched AveraNow, and in its first 12 weeks the program saw 372 of its 2,500 enrollees have a telehealth visit. But it wasn’t consumer adoption that surprised Knutson. “We were hoping patients would like to use this platform, but I was surprised at the overall response from patients — the reviews have been fantastic,” he said. And while many telehealth skeptics think a high patient satisfaction correlates to a high prescription rate, that’s simply unfounded. “We developed strict criteria around antibiotic stewardship, and we do not give antibiotics unless we really think they are appropriate,” he explained. “Our antibiotic stewardship has improved very nicely over the course of a year, and patient satisfaction is still very high.”
Avera’s telehealth implementation included physician champions from its inception, but sometimes physicians aren’t brought in until after the service has been envisioned. This was true for Southwest Medical Associates, one of Nevada’s largest multi-specialty medical groups, which is also a wholly owned subsidiary of UnitedHealth Group and Optum. Eugene Somphone, MD, medical director of on-demand medicine at Southwest Medical, has successfully guided the medical group to enrolling more than 30,000 patients in telehealth and conducting more than 20,000 telehealth visits. According to Somphone, however, he was initially a bit skeptical.
“I was initially drawn into telemedicine, not by choice, but because our health plan decided to offer the service as an embedded benefit,” he said. “However, once I learned more, I immediately recognized the tremendous potential in terms of convenience, access and cost. I wanted to be on the forefront of this revolution in healthcare.”
Somphone wasn’t the only physician at Southwest Medical eager to adopt telehealth. “We’ve been able to demonstrate that this avenue of care is highly successful and rewarding, and now we have a waiting list of providers wanting to transition full time to telemedicine,” he said. With urgent care adoption surging, Somphone has now pivoted his focus and plans to advocate telemedicine to colleagues in other specialties like behavioral health and rheumatology, so they, too, can leverage telehealth.
Speaking of specialty care, Nemours Children’s Health System in Jacksonville, Fla., is using telehealth to deliver pediatric care in myriad creative ways. Shayan Vyas, MD, medical director of telehealth for Nemours, has been instrumental in building up Nemours’ telehealth program. “Telehealth represents the standard of care for medicine in the 21st century,” he said. “Pediatric telemedicine . . . allows our providers and patients to keep care within the patient’s medical home with convenience – something that is very important to our approach to telemedicine.”
In addition to its direct-to-consumer offering — which has allowed 68 percent of patients to receive care without having to visit a retail clinic, urgent care center or emergency room — Nemours also has a robust consultation-based telehealth program in place. Through its provider-to-provider telehealth service, Nemours is able to project pediatricians into partner hospitals for consultations, allow school nurses to consult with Nemours physicians and even consult with physicians on cruise ships. Nemours has also placed its providers on the Exchange, allowing patients across the state to see a Nemours physician.
“Telehealth isn’t just above convenience; it’s about providing and spreading the highest level of quality pediatric medical care,” Vyas said.
Vyas has also been the leading force behind telehealth EMR Integration at Nemours. “Our telemedicine strategy promotes continuity of care,” he said. “EMR integration has allowed for that continuity of care, and has even helped grow our telehealth program by 130 percent in the 2016.”
Will Daines, MD, medical director of Intermountain Connect at Intermountain Connect Care at Intermountain Healthcare, has also been a big proponent of telehealth EMR Integration. “We feel a strong sense of stewardship over the health of individual patients, and part of acting as a steward of someone’s health is maintaining a complete, accurate and up-to-date record of their health,” he said. “The care provided in telehealth programs should not be off in its own silo. We have worked very hard to create integration between our EMR and the records kept in our vended telehealth applications.”
EMR Integration is important for telehealth physician buy-in, especially considering how much time a physician spends with the EMR. To engage Intermountain physicians in telehealth, Daines has taken a transport approach that emphasizes open communication.
“When engaging with physicians, I feel it’s very important to listen more than you talk. Physicians possess a natural skepticism with regard to new technologies,” he related. “It is critical to be open and honest about the capabilities and limitations of telehealth, listen to physician concerns, thoughtfully consider how you will address those concerns and circle back to inform the physician how you plan to incorporate their feedback in your program. “
Each of these physician champions has a different approach and focus for their health system’s telehealth program, but the end goal is the same — to optimize the quality and efficiency of the care they provide their patients.