Jan 20 2021
Patient-Centered Care

How Collaboration Tools Support Healthcare Providers

Rapidly changing needs pushed healthcare providers into massive expansions of their telehealth systems.

Like many hospital systems, St. Luke’s University Health Network had been “dabbling” in the use of telehealth for several years, in the words of Dr. James Balshi, the network’s chief medical information officer. The technology supported specialty consults across St. Luke’s 12 hospitals and 300-plus care sites in Pennsylvania and New Jersey, but the entire system saw fewer than 10 telehealth sessions per day.

Then the COVID-19 pandemic arrived in early March, and the system — which serves a large population of commuters to New York City — began preparing for the worst. Within three days, St. Luke’s trained 1,900 employees to conduct remote visits using Microsoft Teams, which until then had been used primarily by the IT and marketing departments.

“It was a life raft for our organization,” says Balshi, noting that the system had more than 100,000 telehealth sessions in the two months following the expanded rollout of Teams. “We were lucky to have this tool in our belt and to be able to rapidly actualize it. Many times a day, we were communicating across the hospitals about modifying how we treated patients in real time. We couldn’t have done this if we hadn’t had the Teams infrastructure.”

As the pandemic progressed and it became clear that both patients and staff members were safer if they remained at home, St. Luke’s and hospitals across the country expanded their use of collaboration tools, such as Cisco Webex, Microsoft Teams and Zoom, to support virtual care efforts, physician consults and even day-to-day operations.

Hospital Scales Up Microsoft Teams to Support Telehealth

Like St. Luke’s, Stony Brook Medicine used Teams as part of its Microsoft Office 365 platform but hadn’t adopted it widely prior to March 2020, according to Dr. Gerald Kelly, the health system’s CIO. That quickly changed for the Long Island-based organization, which put Teams in place for a range of uses, including booking and conducting virtual care appointments as well as supporting the Incident Command Center, hosting employee townhall meetings and even offering mindfulness sessions to help employees manage stress.

Onboarding required more than just providing access to the platform, Kelly says. Employees needed to see how Teams could support collaboration, whether for document-sharing, secure texting, conducting internal meetings or connecting with patients.

“We had to reach a whole workforce that had never used telemedicine before. We had to train people from finance how to communicate virtually. We had to train HR how to work from home,” he says.

Similarly, WakeMed Health and Hospitals had been using Webex “sporadically,” primarily for communicating with external stakeholders, says Peter Marks, the organization’s vice president and CIO.

When the North Carolina-based hospital was shut down for everyone but COVID-19 patients, use of the collaboration tool went into “hyperdrive,” Marks says. WakeMed was fortunate that Webex accounts had already been created and that some of the system’s 11,000 employees had already used it.

“Like anything else, the technology was out there, but it was a sleeping giant until it was used,” he says. “It was a bit herky-jerky in the beginning, but training and time and ingenuity took care of things.”

With transformation occurring so quickly in response to COVID-19, healthcare organizations are preparing for what ICD analyst Wayne Kurtzman calls digital parity: the ability for all workers, not just knowledge workers, to be connected to the technology they need from any device. “A lot of people needed a reason to go digital, and this was the reason that changed attitudes and behaviors,” he says.

MORE FROM HEALTHTECH: See how mobile devices support virtual rounds and telehealth.

Zoom Aids Clinical Workflows for Telehealth

Butler Health System has operated a diagnostic telehealth program since the spring of 2017, connecting patients and care teams at four rural sites in western Pennsylvania with specialists based on the network’s two main hospital campuses.

This experience played a vital role in helping the system enable telehealth visits in patients’ homes — in just three days — using Zoom’s HIPAA-compliant product, says Cynthia Esser, the system’s director of emerging technologies. “Workflow is important, and we were able to use Zoom’s capabilities to support a virtual care environment to continue to care for our patients safely during the pandemic.”

Butler Health created a virtual video experience that was similar to an in-person office visit. Clinical support staff verify each patient’s information and help them prepare for the provider visit. The provider then diagnoses and treats the patient, and provides prescriptions, further testing or referrals if needed. Custom Zoom workflows have enabled office staff to schedule patient appointments on behalf of individual providers, allowing multiple appointments to be completed by different providers at the same time, while using Microsoft Outlook integration to access appointments through their email.

“We were able to come very close to mimicking an in-person visit,” Esser says. “If you don’t have that in the virtual world, then the patient is missing key parts of the process.”

Beginning mid-March and stretching into May — at a time when telehealth use peaked across the U.S. — Butler Health saw about 2,000 patients per week through Zoom, compared with only a handful before the pandemic. Part of the reason for the spike was safety, which patients wanted and providers needed, Esser says. Part of it also stemmed from the loosening of regulations by the Centers for Medicare and Medicaid Services on how telehealth could be used, coupled with expanded public and private insurance coverage of telehealth visits.

With restrictions lifted, many organizations felt free to explore new ways or providing care. “Any of that fog about whether it would be worth it to do a virtual visit rapidly dissipated,” says St. Luke’s Balshi. “Everyone who experienced this came away saying that it could work, that it is pretty close to being in a room with the patient.”

Cynthia Esser
We were able to come very close to mimicking an in-person visit. If you don’t have that in the virtual world, then the patient is missing key parts of the process.”

Cynthia Esser Director of Emerging Technologies, Butler Health System

Illustration by Traci Daberko

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