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Clearly it is not, we've been doing in-hospital telehealth programs well before COVID. Telestroke, TelePhyschiatry.  The question becomes where can we go from here.

FTA

However, what happens after COVID? Years ago, I looked at data from my own hospital, a national center of excellence for neurological care. In the span of a single year, we treated roughly 1000 patients, about 3 per day, transferred to us from other hospitals by ambulance or helicopter that were then discharged within 48 hours. We can’t do anything in 48 hours—so that means that these patients were thought to have more serious issues by the outside provider than they actually had on arrival. These transfers reflect uncertainty and fear from less-experienced community physicians. When in doubt, transfer. From a physician’s perspective, this is the safe move. But 2 hospitalizations and a medevac can push many Americans into bankruptcy. Unfortunately, a phone call is often not enough to reassure outside providers, patients, and families that the transfer is not medically necessary. We need to bond, to look in their eyes, and tell them it will be okay—and if the patient takes a turn for the worse, we’ll be there for them.

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I'd like to see us use telehealth for more hospital rounding. As an in-patient, waiting for you doctor to physically come by at the end of their day is really frustrating. Can we make clinicians more efficient with in-hosptial telehealth?

#healthcare #healthIT #cio #cmio #chime #himss

https://healthcarepittstop.com/in-hospital-telehealth-is-not-an-oxymoron-heres-why/

Transcript

 This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

  Today in health it, this story is in hospital. Telehealth is not an oxymoron. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current and engaged. VMware has been. A great sponsor of this week in Health it.

They have been committed to our mission of providing relevant content to health IT professionals since the start. They recently completed an executive study with MIT on the top Healthcare trends, shaping IT, resilience, covering how the pandemic drove unique transformation in healthcare. This is one of many resources they have for healthcare professionals for this.

And several other great content pieces. Check out vmware.com/go/healthcare. Alright, here's today's story. This is from a site called healthcare pitstop healthcare pitstop.com, and it is in hospital telehealth. It's not an oxymoron, and here's why. And they talk about in the current pandemic, it has renewed interest in telehealth and telemedicine.

We have talked about that on several occasions. The use of telehealth within the hospital during covid increased pretty significantly, mostly out of a need for safety. We didn't want to don and doff equipment. We were trying to save equipment as well. We wanted to provide as few direct contacts with those that had COVID-19 as possible.

So those were obvious. Let me give you some of the excerpts as it goes on. However, what happens after covid? Years ago, I looked at the data from my own hospital, a National Center of Excellence for neurological Care. In the span of a single year, we treated roughly a thousand patients, about three per day, transferred to us from other hospitals by ambulance or helicopter.

That were then discharged within 48 hours. We can't do anything in 48 hours, so that means that the patients were thought to have more serious issues by the outside provider than they actually had on arrival. These transfers reflect uncertainty and fear from less experienced community physicians. I.

When in doubt transfer From a physician's perspective, this is the safe move, but two hospitalizations in a medevac can push many Americans into bankruptcy. Unfortunately, a phone call is often not enough to reassure outside providers, patients, and families that the transfer is not medically necessary.

We need to bond to look into their eyes and tell them that it's going to be okay, and if the patient takes a turn for the worse, we'll be there for them. Alright, so that's a pretty powerful case study right there and some analytics to back it up. He goes on once in the hospital. A patient's journey often feels like a game of mousetrap, a disconnected series of steps with different doctors showing up at all hours.

Patients let alone, families often have no idea who's taking care of them. Now imagine replacing pagers and cell phones with video monitors everywhere. Families located thousands of miles away could participate and be brought up to speed on the next steps for their loved ones. The physician is down in the ED or clinic, no problem.

They can be in the room as quickly as it takes to place a phone call. This is not only better care, it's cost effective care. A while back, Viscu now part of Phillips Healthcare started providing a second set of staff members to look over the shoulders of doctors and nurses at their facilities. Although the cost of these deployments was high, up to a million dollars per room, hospital systems found savings.

In both the cost and quality of care. Banner Health, one of the leaders in this space has over 500 patients throughout the US being watched over from their command center here in Phoenix. Notably, even a one hour decrease in the average length of stay per patient translates into millions of dollars in savings.

For hospitals, considering all these benefits, why have hospitals been slow to adopt in-House telehealth? Historically, barriers have included both technical and financial issues. First, delivering video in aging buildings and hospitals has posed a challenge. There are thick walls, poor wifi, and privacy concerns.

Typically, a cart, think of it as a TV on wheels is deployed, but this is expensive and forces people, nurses, doctors, patients and families to change their behavior and gather around a cart, add an appointed time. Ideally, technology should support humans, not the other way around. Most video infrastructure.

That's the software piece of the solution is sold like a cell phone contract that is on a per minute or per person charge. This makes enrolling everyone in the hospital and 24 by seven patient monitoring expensive. However, these challenges are not insurmountable. How we charge for something can be negotiated.

I've met with a lot of smart engineers with help. I am now spending considerable time building these solutions at scale. Alright, here's my so what on this? Telehealth in hospital is not an oxymoron because it's part of the definition. The problem is we take the definition and we morph it to mean video visits to people who are offsite.

The reality is we've been doing teleconsults for years. We've done it around telestroke, we've done it around telepsychiatry. Telestroke cases, we would essentially have a center of excellence around stroke care, and we would extend those services to our more rural locations or those that did not have the scale or the population to support the investment in a full-blown, uh, stroke center.

Psychiatry was also an interesting use case in that, uh, a lot of our ED visits . Required psych evals before they could be admitted. And in those cases we did those via telehealth because those were, uh, a lot more efficient to do that way. None of the individual hospitals had enough cases to keep a single person busy, but all of the hospitals had enough cases to keep more than one person busy doing that via telehealth.

Anyway, it's part of. The definition. I think we, this is one of the areas we are going to get much more creative. This is an area where we can provide an awful lot of efficiency within the hospital itself and how they operate. Today. He talked about this a little bit, the physician who's down in the ED, but needs to be up in the patient room for a meeting.

That is a great use case. There are doctors that could do a significant amount of their rounds directly via telehealth. Depending on the specialty, depending on the circumstances, but they could show up in those, in those locations. I will also say this, the idea that we can't put technology that is reliable because of thick walls and whatnot, that is a concern around some use cases, but for the most part, a lot of the patient rooms.

Aren't near the rooms that have those thick walls and whatnot. We should be able to get wifi to those places, which takes away some of the technology concerns. The cost of a flat screen TV is pretty inexpensive these days. Cost of access points pretty inexpensive these days. The cost of the software it, there are a lot of different ways to get it.

You can get it on a price per minute kind of thing, but for the most part, you can now get . Uh, per user type pricing, which is more in line with how we would utilize these services. Plus, if you break out the components that are the video aspect of it, those are available for direct purchase to health systems.

So there's some of this that we have gotten beyond, but the one thing I want to mention here is we've gotta get beyond this. I, I've been in a hospital, my father-in-Law was in a hospital this past year. We've gotta get beyond this. Hey, the doctor's gonna be able to come in and see you today. Today's 24 hours.

That creates an awful lot of angst in people's minds, and this could be people who are already struggling and stress doesn't actually help the situation at all. It would be nice to get more efficient around our scheduling for rounds and people within the hospital. I understand that they're busy, but if it's more efficient to integrate telehealth to make that process work better.

Then that is one area we should be looking pretty closely at. All right, that's all for today. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com, or wherever you listen to podcasts. Apple, Google Overcast, Spotify, Stitcher.

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