As MedStar Health launched its telehealth response to the COVID-19 pandemic, hundreds of the health system’s caregivers first rose to the challenge of meeting a historic surge in demand for the existing MedStar eVisit urgent care, on-demand telehealth offering.
Leveraging an existing telehealth platform, the health system responded to volumes that jumped from an average of seven visits daily in February 2020 to more than 500 visits in a day within the first week of the COVID-19 response.
Next, as part of a health system that previously has delivered more than 4.9 million outpatient visits in a year, MedStar Health caregivers and patients had to address the world’s new reality that stay-at-home orders might lead to delays or cancellations for routine and nonurgent medical needs to stop the spread of COVID-19.
Also, patients had a continued need to reach out to their primary care physicians to get questions answered about COVID-19.
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While the health system previously had a platform available for clinicians to deliver scheduled outpatient video visits as needed, demand in February 2020 only required supporting about two scheduled video visits weekly. Suddenly, thousands of MedStar Health clinicians now needed an alternative pathway to care for patients who could not be seen in offices due to COVID-19 concerns.
To address this challenge at such an incredible scale and speed, within days the health system had to stand up a new telehealth system that offered rapid provider provisioning, onboarding and training, among other qualities.
Telemedicine technology and services vendor Bluestream Health has served MedStar Health since 2016. Initially, MedStar Health was very focused on business-to-business telehealth in its work with the vendor. From the end user’s perspective, Bluestream’s prior B2B use cases with MedStar Health leveraged a simple technology to serve as a front door for delivering critical health care.
Bluestream Health has been the infrastructure for the MedStar Acute Care Coordination Center, MAC3, which links emergency physicians and physician assistants to emergency department triage nurses to improve safety and efficiency, as well as to allow emergency consultation from MedStar Health urgent care centers and the MedStar Visiting Nurse Association staff in the field. Bluestream Health, the health system noted, never tried to change MedStar workflows.
“Bluestream brought a very agile video-to-video connection and ‘brokering engine,’ so we always envisioned doing more in the direct-to-consumer space together – and this was jumpstarted by the pandemic,” said Dr. Ethan Booker, medical director of the MedStar Health Telehealth Innovation Center and MedStar eVisit.
“As Bluestream has described it, its business-to-consumer offering is a lighter version of Bluestream that has been offered for free to small providers during the crisis. MedStar Health was its first enterprise direct-to-consumer customer.”
MedStar Health already had delivered tens of thousands of B2B telehealth sessions through Bluestream technology, and built several new use cases, so staff knew that the provisioning, onboarding and training cycle of a B2C use case would be fast enough to support scaling to thousands of providers within weeks.
The ability to rapidly upload the providers’ information into the telehealth system and then to provision it within the health system’s standard security approach was a key reason MedStar was successful. Bluestream was not trying to replicate MedStar’s provisioning, scheduling and billing processes in a separate system, Booker explained.
“The speed to onboard and train providers was just as powerful,” he added. “Rather than require a half-day training session to get providers up to speed, we were instead able to provide very concise training materials.”
The technology also did not require a great deal of training for patients, which is essential during a pandemic, Booker said.
“With some platforms, patients largely need to be contacted beforehand to ensure success via pre-visit encounters,” he noted. “This wasn’t feasible when we were scaling from two visits a week to more than 4,000 in a day. Based on our existing work with Bluestream, we had every reason to believe patients would successfully connect with little instruction. It is as easy as receiving a link via email or text, and a couple clicks to connect.”
The system is browser-based, not app-based, does not require a download for patients, and offers stability on a broad array of devices and operating systems, he added. The vendor also offers peer-to-peer encrypting in a browser, which is why one can securely connect quickly, he said.
There are many vendors of telemedicine technology and services on the health IT market today. Healthcare IT News recently published a comprehensive guide to telehealth vendors in the age of COVID-19. To access this special report, click here.
MEETING THE CHALLENGE
In recent years, MedStar Health’s telehealth team has gained tremendous technology and operational knowledge, so it was able to hit the ground running when the crisis came and the emergency eliminated previous barriers to telehealth adoption at this scale.
“Our MedStar Telehealth Innovation Center (MTIC) was established in March 2017 with the goal of supporting and coordinating telehealth activities across MedStar Health’s distributed care delivery network,” Booker explained.
“While MedStar Health had engaged in telehealth initiatives for many years prior, MTIC was established in response to requests from clinicians across the health system for expanded telehealth capabilities – and in recognition of the increasing role of telehealth in care delivery across the nation,” he added.
“Since that time, we have partnered with our clinical service lines and business entities that are interested in establishing and scaling telehealth throughout their practices, providing telehealth infrastructure, best practices, subject matter expertise, project implementation and programmatic operational support.”