Project Goals: Bringing COVID-19 Palliative Care Into the Home
“People want to be at home. They don’t want to go to the hospital.”
That was the goal of the The Arizona Palliative Care Telehealth Program for COVID-19: to treat people where they’re at through telehealth and to keep them out of the hospital.
The program was spearheaded by the Arizona Hospital and Healthcare Association (AzHHA), a statewide association of 75+ hospitals and healthcare organizations collectively building better healthcare and health for the patients, people and communities of Arizona.
Why Telehealth?
Like many largely rural states, COVID-19 cases were overwhelming the Arizona health care system and widening healthcare disparities. This program targeted their rural and underserved population— the most vulnerable people with poorer health and fewer resources. They were suffering from COVID in isolation, unable to manage their complex symptoms, and anxious about whether they would ever recover.
What is Palliative Care?
Palliative care, not be confused with hospice care, is more than end-of-life care. It’s an interdisciplinary specialty that focuses on whole-person care to improve the quality of life for people living with serious illnesses. It’s usually provided in parallel with curative treatments.
A typical palliative care candidate has 4 or more chronic conditions such as heart disease, cancer, stroke, diabetes, renal disease, Parkinson’s and Alzheimer’s disease. Over two-thirds of Medicare costs are related to treating these candidates.
How Does Palliative Care Improve Outcomes?
Palliative Care not only improves the quality of life and care satisfaction of patients and their families, but can also decrease costs. One palliative care study conducted by Mount Sinai’s Icahn School of Medicine and Dublin’s Trinity College showed that patients who received a palliative care visit within three days of being admitted to a hospital had an average savings of $3,237 per patient versus patients who did not receive palliative care.
In a highly fragmented care system like the US, Palliative Care also helps lower hospital admissions by giving patients the resources and extra support they need to manage their condition at home, which is the goal of the Arizona Telehealth Palliative Program. This could mean providing medication management changes, emotional support, clergy, faith-based support, coordinating among care team members.” It’s about giving people the many other aspects of support – logistical, mental, and spiritual, needed to live their lives better.
Core Problems to Developing AzHHA’s Telehealth Program
Time was of the essence. The AzHHA team knew that palliative care could play a huge role in helping isolated patients manage their COVID symptoms at home. They had seen successful telehealth palliative programs in other states and wanted to replicate that. However, they lacked the first hand experience and internal resources to quickly launch such a telehealth program. They started by identifying four key areas where they would need outside expertise:
Clinician Staffing – a ready-to-go team of Arizona-licensed palliative care physicians, nurses and medical assistants,
Telehealth Technology – a responsive, expert technology partner to ensure they had a robust platform that worked according to their processes,
Project Management – an experienced team to implement, manage, and monitor all aspects of the program from workflow design to post-launch data analysis,
Website Design and Marketing – an extended design arm to build and maintain the program website and to assist in the creation of website marketing materials.
The Solution
Out of the three other vendors AzHHA assessed, the VSee-This American Doc (TAD) team was the only vendor that offered an all-in-one telehealth staffing and technology solution.
“It was a pleasure working with the TAD-VSee team. They were proactive in moving the project forward and responsive to our needs, quickly rolling out modifications as our program needs changed.”
– Vicki Buchda, Vice President of Care Improvement
1. Recruit high quality, licensed telehealth staffing – worry free
Even before COVID, there was a growing shortage of palliative care specialists, which the COVID emergency further exacerbated. TAD recruited high quality palliative care physicians and nurses from its nationwide telehealth physician network. It made sure all clinicians were correctly credentialed and trained all clinicians on the telehealth technology. As the program rolled out, they also recruited Medical Assistants to engage patients for an efficient registration and onboarding that maximized physicians’ time.
2. Provide full service telehealth for a quick program launch – 2 months!
VSee designers used their intimate understanding of healthcare workflows and telehealth technology capabilities and limitations to quickly understand AzHHA clinician and admin needs. Over the course of 6 weeks, VSee worked closely with AzHHA to design a simple patient experience that would also allow providers to work as closely as possible to their usual workflows (minimizing the learning curve).
This involved creating clinical protocols, developing forms, designing the provider dashboard, and building the program landing page. The final solution included:
Automating the visit experience as much as possible with customized patient referral forms, HIPAA-compliant video and post-visit survey
Front desk hub for MAs and nurses to do quick patient coordination, efficient triage and screening of patients, and virtual passing to a physician.
Custom provider dashboard that centralized the functionalities and documentation needed to hold the consult, including the patient’s medical history, custom consultation notes template, and ability to send patient education materials.
Admin dashboard to display at-a-glance reports such as patient satisfaction and usage data. Regular monitoring and progress reports by the VSee-TAD team.
3. Flexibly make rapid program changes to meet patient needs
Soon after launching the program, it became clear that the initial PCP referral process was not meeting patients’ needs. It turned out that many of those who needed help were Covid Long Haulers who learned about the program through online support groups, so did not have a PCP to refer them into the telehealth program.
Once the problem was identified, the VSee-TAD team, worked quickly with AzHHA to create a new self-referral and triage process. The new forms and processes were designed and launched in just two weeks. They increased the number of patients who could be reached, improved the patient experience and enhanced care team performance. Key outcomes from this pivot:
- reduced no shows 30%
- fast tracked medical records in 25% of patients
- collected additional relevant context & details for better physician care
- reached 15% more patients through the self-referral process
4. Support marketing and outreach initiatives
The VSee-TAD team functioned as an extension of the AzHHS in-house marketing team, building and maintaining the official program website according to their branding and content requirements. Additional educational content and tools for patients were created in collaboration with the palliative care providers.
5. Go above and beyond
The TAD team truly believes in increasing access to healthcare. In addition to managing and monitoring the program, the TAD team initiated a partnership with the Area Agency for Aging to provide free housing and meals to patients, making this option available for any patient needing social assistance. It also secured a $50K Intel grant that provided remote patient monitoring devices for any patients in need.
6. End Result: High patient satisfaction
The project received 200+ referrals. With patient satisfaction averaging at 4.8 out of 5 with a rating of 5 being extremely satisfied. The following patient comment speaks to the program’s success:
“This is the first medical professional who has acknowledged my long COVID symptoms. I’ve had the virus for 8 months and had more than 40 dr [sic] consultations!!! So thank you” – de-identified self-referral patient
Key Outcomes
- Project implemented in 2 months
- Referred 200+ patients to the Palliative Care Telehealth COVID-19 Program
- Average patient satisfaction ration 4.8 out of 5 (extremely satisfied)
- Added new self-referral process and triage improvements in 2 weeks
- reduced no shows 30%
- fast tracked medical records in 25% of patients
- collected additional relevant context & details for better physician care
- referred 15% more patients through the self-referral process
Learn how VSee can help you make a difference with telehealth. Talk to us today!
