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Remote Care: Turning Crisis into Opportunity

By Dhrumil Shah, CMIO, Compass Medical

Healthcare has never been considered an industry easy to disrupt or willing to embrace innovation. It took a global pandemic to change healthcare as we know it today and I am certain that we are only at the beginning of this change process curve, putting one disruption point behind us and a few more to come. We have been working hard over the last few decades, moving past what once was a ‘Sick Care’ and truly focusing on ‘Healthcare’, which promotes our communities’health and well-being. Yet, we failed to prepare adequately to face this pandemic and gave a response that one would consider less than optimal for the most expensive healthcare system in the world. Without a doubt, resilience and dedication to providing quality care have allowed us to get to where we are today despite all adversities we faced.

By virtualizing care and delivering innovations at home, we are building bridges which no health system can build physically.

What needs to change moving forward?

All of us will have many different ideas and perspectives around how to navigate a path forward, but one thing is clear that ‘Status Quo’ is now less desirable than ever. I am not saying that almost all care will need to be virtual & delivered to the patient’s home, but why not aim for it? It is only when we seek dreams we are able to create tomorrow’s success today. We all know that highly complex and advanced care will always require hospitals and medical facilities where patients will have to travel, but can’t we at least work on making HealthCare a little more ‘Caring’ and ‘Healthy’? Self-care equals better patient care and bedside standard of care saves more lives than any other medical interventions. Hospitality in the context of a hospital aims to make the patient’s experience positive. By virtualizing care and delivering innovations at home, we are building bridges which no health system can build physically.

Today, I am able to coordinate a video visit with a daughter in Florida and an elderly parent in my home state Massachusetts where I practice primary care, to go over End-of-Life Planning discussion and help assess medication compliance and home environment which might  prevent next fall &/or ER visit. My care team is able to engage with patients virtually in realtime at the most vulnerable points in their care, such as post-hospital discharge through TCM (Transition Care Management) program, monitoring and preventing the adverse outcome of chronic disease through RPM (Remote Physiological Monitoring) program, & engaging patients, post Emergency Room visit to improve access to care, address gaps in care or prevent further downstream utilization thus reducing total cost of care.

Compass Medical, where I practice as a primary care physician and function as Chief Medical Information Officer, is a physician-owned and led medical organization serving over eighty thousand patients across Southeastern Massachusetts. Just like many other healthcare organizations, we also faced the crisis head-on with a steep decline in office visits, rapid deployment of Telemedicine, and process disruptions around every aspect of care delivery given new safety and infection control measures needed to implement. Patients were avoiding essential in-person care and providers were beyond overwhelmed trying to manage clinical and operational volatility.

Crisis breeds Opportunities and Success breeds Complacency.

A group of our leadership team members and clinicians came together to seek new opportunities amid this crisis and we came out with what we call today ‘Connected Care Services Model’. We doubled down on CCM (Chronic Care Management) we implemented as a centralized service since 2016 and expanded by incorporating TCM (Transition Care Management) program enabled through real-time ADT (Admission Discharge Transfer) feeds. We recruited a pool of clinical staff and providers rapidly to deploy RPM (Remote Patient Monitoring) program and post Emergency Room discharge Telehealth follow-up the program. We increased our TCM utilization by 500% and created a new services model while our peers were either doing 100% virtual care or waiting for this pandemic to be over to go back to “Old Normal”.  

Our patients started embracing these new care delivery models rapidly. They appreciated working outside the box of medical buildings we so get hyperfocused on as our sole means to provide excellent quality care. Now the care was in patients’ hands or reaching out to them in times of their most vulnerable. Remote care is not just limited to providing necessary means to take care of patients in their homes, but also should enable every care team member to provide the highest efficiency of care possible. Remote work from home enabled us to continue many essential clinical and operational processes without major gaps in the workforce due to exposure or other such needed measures. We have a set of providers currently utilizing remote scribing services, including myself which allows for greater flexibility and efficiency by reducing EMR documentation burden.

Remote care or Telemedicine is not the next big thing. I firmly believe that remote care is an opportunity, but at the core, it is just another part of a comprehensive care delivery which we need to continue to enable through data and technology. We cannot wait for the crisis to be over to pave the path forward as our most high risk and vulnerable populations need us in healthcare today more than ever to provide new ways to handle old problems and work together to find solutions to new challenges we all face together.

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