Telehealth effectiveness measured in two different US health systems. Some of our Readers are marketers like your Editor, who are always searching for references on program effectiveness. Healthcare IT News in recent days has presented two, one using Amwell and the other using Teladoc:
St. Luke’s University Health is a small health system with 14 hospitals and multiple clinics covering eastern Pennsylvania and western New Jersey. They were addressing several problems:
- Network coverage expansion and time to consult reduction
- Integration with EHR and multiple systems
- Maintaining high privacy standards
- Introducing behavioral telehealth for both patients and employees, especially during the Covid pandemic
The case study is primarily about the implementation of Amwell Psychiatric Care for 24/7 coverage and the SilverCloud Health platform, part of Amwell. This accelerated at the start of the pandemic. St. Luke’s instituted a Virtual Remote Monitoring Center (VRC) that monitored more than 6,000 patients supported by a 24/7 operations team.
With SilverCloud, they custom-built a support program for employees that included a self-paced program for stress, anxiety, and depression with support from a social worker and app-based 24/7 coaching interventions. If needed, the employee could be referred to an Employee Assistance Program or a St. Luke’s therapist.
For the mental health programs, using the PHQ-9, comparing results between in-person and virtual visits from July 2021 to March 2022, results were close to identical in 6-point reductions in both virtual (96%) and in-person (90%) populations. In overall telehealth visits, between March 2021 and March 2022, they had over 205,000 unique patients use telehealth. Another metric that telehealth affected was outpatient care. St. Luke’s reduced no-show rates from 14% to 6%. Article
CommonSpirit Health is the largest Catholic and second-largest non-profit health system in the US. The problem they were attempting to solve was primarily onboarding patients in crisis in the shortest possible time, well within the four hours recommended by the Joint Commission. They expanded their use of Teladoc in the CommonSpirit Telehealth Network to include behavioral health, instituting a.”round and respond” model to improve access to behavioral health specialists in several hospital emergency departments (EDs) and quickly assess patients as mild, moderate or severe based on patient risk. They also added services such as geropsychiatric and crisis intervention with medication-assisted treatment as consultation-liaison services. Results were:
- Decrease in length of stay, cost; increased satisfaction and expectations of care met
- 1,200 telebehavioral health consultations per month, through three states and across 25 hospitals
- Establishing a standard of care of response within 60 minutes to all ED consult requests, have actionable recommendations within 90 minutes, and an ED disposition plan within the first four hours
- 61% of cases seen within 30 minutes, 79% within 60 minutes with average response 42 minutes
- 65% rate for discharge recommendations and a 35% rate for transfer at specific locations.
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