Mayo Clinic, Thomas Jefferson transform telehealth and virtual care to redesign the patient experience
US hospital systems, including Thomas Jefferson University Hospital and the Mayo Clinic are leading the charge in a shake-up of telehealthcare to improve patient experience. Consolidation of remote programs, changing cultures from a focus on technology to "clinically focused, technology-enabled telehealth" and restructuring virtual health to reduce transfer rates are a few of the improvements being made. Doctors too, need to play their part, developing a "new skillset" including observation, communication and leadership.

Stephen Klasko, MD has shaken things up in his three-year tenure as CEO of Thomas Jefferson University Hospital.

That includes consolidating three organizations into one and injecting a more entrepreneurial spirit to the academic medical – and that has required bringing doctors up to speed on telehealth and virtual care technologies.

“We now require physicians to be telehealth-trained and to do at least one telehealth session per month in order to receive incentives,” Klasko explained. “Doctors need to be involved in redesigning the human experience, like providing mammogram results in just minutes instead of making a woman wait anxiously for four days.”

Thomas Jefferson is among the vanguard of hospital systems re-engineering telehealth and virtual care platforms to improve the patient experience. The Mayo Clinic, Ohio Health, and Hospital Corporation of America are also undertaking similar turn-around initiatives.

Mayo Clinic and HCA: From sprawl to success

Sometimes the zeal to create telehealth programs causes a tangle of competing efforts, as was the experience of Bart Demaerschalk, MD at the Mayo Clinic and Christopher Northam of HCA.

“Our departments were developing telehealth programs independently,” said Demaerschalk, medical director of telemedicine services at Mayo. “We now have a consolidated Connected Care program that provides one place to go for expertise in operations, compliance, legal and IT.”

Hospital Corporation of America, likewise, had to reengineer its sprawling telehealth program, which spans 382 sites in 20 states.

“We’ve transitioned from technology-focused telehealth to clinically focused, technology-enabled telehealth,” said Christopher Northam, HCA’s vice president of telehealth. Although telestroke and telebehavioral care are still the pillars of the HCA program, the network has widened to include remote home monitoring, rehab clinics and radiology centers.

HCA also linked the telehealth platform to its Meditech EHR. “Our enterprise data warehouse has over 28 petabytes of data,” said Ryan Richardson, director of HCA’s strategic analytics. “We’re able to cull actionable data from the warehouse, including telehealth volume by physician and service line. And we’re starting to analyze the length of a telehealth encounter with the quality of the outcomes.”

OhioHealth: Telemedicine no longer underutilized

When Chad Miller, MD, realized that many of the cases in OhioHealth’s telestroke program involved non-stroke neurological conditions like seizures and hypertensive emergencies, it became clear the resource was underutilized and ripe for improvement.

“We restructured our virtual health platform to enable clinicians to do remote workups and assess a wide range of neurological conditions,” said Miller, the system medical chief for neurocritical care at OhioHealth. “We were quickly able to reduce our transfer rate to tertiary facilities in half.”

Building on that significant achievement, in fact, OhioHealth plans to do more remote patient monitoring and chronic care management across its 12-hospital network.

Physicians need new skills

Doctors are the key piece to all the telehealth initiatives at HCA, Mayo, OhioHealth and Thomas Jefferson — and succeeding means equipping them with the technological chops to thrive using telemedicine and virtual care tools.

To that end, Klasko said that hospitals cannot afford to choose doctors on criteria like grade point average and, as such, he recommended that hospitals undertake modern behavioral and competency-based interviews.

“Thirty years ago doctors had an excellent grasp of biology, but now they need a new skill set,” Thomas Jefferson’s Klasko said.

Thomas Jefferson, for instance, has partnered with United Airlines to help physicians more effectively use simulators to get them ready for real-world care situations.

“We’re working hard to ensure that tomorrow’s physicians have the skills needed to make telehealth successful: observation, communication and leadership,” Klasko said. “Technology will eventually replace about 80 percent of what doctors now do.”

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