The COVID-19 pandemic has helped push forward telemedicine initiatives and clinician engagement with new technologies, which Linda Reed, vice president and CIO of St. Joseph Health, plans to continue building upon post pandemic.
Prior to the pandemic, the Paterson, N.J.-based health system was not doing any practice-based video visits. They were ready to deploy the virtual capabilities for more than a year but had been delayed by some pushback from clinical personnel, Ms. Reed told Becker's Hospital Review.
The pandemic ultimately laid the groundwork for St. Joseph Health's telemedicine growth, increasing from zero visits to more than 2,500 in just a month. Ms. Reed credits the telemedicine expansion to the support of the physicians, who really got on board with using virtual platforms to deliver care.
"I think one of the takeaways from the pandemic is to continue to push harder on new technologies and not let some of that organizational pushback stop you," Ms. Reed said.
Here, Ms. Reed discusses plans to increase patient engagement with telemedicine and build the program post COVID-19 patient surge.
Editor's note: Responses have been lightly edited for clarity and length.
Question: What has your clinician and patient engagement experience been like since expanding telemedicine services?
Linda Reed: We have ramped up our telemedicine response since the pandemic started. We had more than 2,500 visits just in a month. This increase stems from our physicians really wanting to take care of their patients, whether using FaceTime, Zoom, our Cerner portal or any other telecommunication platforms. Our physicians are the ones who really got on board to make virtual care happen. While teaching our internal employees to use these platforms was one thing, teaching patients was a different story, which is why we need to boost engagement in the post-surge world.
Q: How do you plan to foster patient engagement with telemedicine in the post-surge world?
LR: Engagement really depends on the patient population. For example, our pediatric patients never really had any issue because they have younger parents; they know how to manipulate the technology and they all have smartphones. When we started looking at some of our more elderly patients, we noticed factors like they had flip phones instead of smartphones, and they don't know how to get onto the internet. We brainstormed some of these observations and came up with a few ideas to troubleshoot. The first is old-fashioned mailings, so just sending step-by-step telemedicine guides to patients in the mail. Once things get back to normal and it is safe to do so, we may also try having small group sessions onsite or in the community to talk to patients about virtual visits, how they work and the equipment needed to participate.
We're also considering setting up direct patient contact by appointing people who can call patients and offer technical support when needed as well as establishing some kind of grant funding to help meet patients' technology needs. We hope to create a fund for our community and patients to get them the technology they need for virtual visits if they don't have a smartphone or lack internet access.
Q: What do you need to do to continue supporting telemedicine growth post pandemic?
LR: If you look at the literature, there's a ton of information written about video visits supporting value-based care, patient convenience and more access, so you would think that telemedicine would have taken off three, four or five years ago, right? But it never did. That was largely because patients didn't realize they were available because the staffing in these practices and medical offices weren't comfortable with the technology. Because of this, they didn't let their patients know the option was available. Getting people comfortable with the technology will make it easier for them to use it more often. However, as of now, I think they've all used it, so it's one of those genies you can't flip back.
We're all going to see more increased remote traffic, whether from patient video visits or our remote work-from-home employees. We will need to boost cybersecurity practices to accommodate for that. We've all heard about Zoom bombing. HHS relaxed some of the HIPAA requirements and video visit telemedicine requirements to help expand access. Well, those waivers and relaxation will at some point go away. We won't be able to use FaceTime going forward, and we will have to go back to real platforms like Zoom for Healthcare, which has stronger security.
Q: From a health IT perspective, what are some lessons you've learned from the pandemic?
LR: One lesson I've learned is to push harder on deploying our new technologies. We were ready to deploy virtual visits a year and a half ago, but we got pushback from some of our clinical personnel. This can result in some organizational inertia, so I think one of the takeaways is to continue to push harder on new technologies and not let some of that organizational pushback stop you. We need to increase the IT IQ of the entire organization.
Q: What surprised you most about the pandemic?
LR: One of the biggest surprises, and it wasn't just for IT personnel but for all of us, was how fast the volume of COVID-19 patients grew. It was so exponential, and then the criticality of those patients ramped up so quickly, too. It wasn't like we went from two patients to another two patients; it went from two patients to 10 to 20 to 50. And then the ventilators did the same thing – it wasn't just two people on a ventilator, it went from like two patients to 20. Just how fast everything escalated caught everybody by surprise.
The other lesson learned that was kind of surprising was the reporting chaos, from a federal, state and local perspective. Everybody started wanting data. The federal government asked for one set of data, the state asked for another and so on. None of the definitions were the same. It got to the point where it was almost undoable because there was just so much data they wanted. Some people asked for critical care and others asked for intensive care unit, so do you include both or not? Reporting requirements were chaotic, which was hard to keep up with from an IT perspective. We learned how to spin up a good data set and be able to grab all the data you need.
Q: The pandemic accelerated telemedicine adoption across the globe. What other technologies do you think will become more mainstream in the healthcare space?
LR: I guarantee we will start looking into more remote monitoring tech. More and more patients wear wearables, whether it's an Apple Watch or Fitbit, and a lot of those devices will upload vital signs right into the cloud, which we can then grab. Artificial intelligence is also becoming huge, and I think in analytics, from an epidemiology perspective, we're going to see more and more of hotspot monitoring.
Electronic prescribing is another tech area I expect to get bigger and bigger. Before the pandemic, I think there were practitioners out there who weren't doing e-prescribing, but if patients can't get to the office, I think more physicians are going to have to do e-prescribing.
I think virtual reality and 3D printing will also really take off. It'll be interesting to see what kind of VR is created for this type of pandemic situation, and 3D printing in-house capabilities hospitals implement to help address equipment shortages.