The Executive Suite: A new trend in virtual care: Provider collaboration

As we move into the third year of the pandemic, virtual care, or telehealth, has become a common way for healthcare providers to diagnose, treat, and communicate with patients. Healthcare systems in the future will need to deliver more accessible care. Collaborative and team-based care are interchangeable terms that define a scenario where patient-care coordination is utilized across different specializations and healthcare settings.

Many hospitals and organizations are working to connect clinicians via virtual collaboration. For example, “tele-ICUs”— the use of health information exchanged from a hospital clinical care unit to another location via electronic communications—enable as many as 1,500 patients to be monitored at once. A tele-ICU uses an offsite command center where physicians and nurses are connected with patients in far-flung ICUs through real-time audio, visual, and electronic technology.

Another example of virtual collaboration is the St. Luke’s University Health Network, with 12 hospitals and 300-plus care sites in Pennsylvania and New Jersey. St. Luke’s had been experimenting with telehealth for several years before the pandemic struck the U.S. in March 2020. The organization pivoted, and within three days, St. Luke’s had trained 1,900 employees to conduct remote visits using Microsoft Teams technology, which had previously been used primarily by its marketing and IT departments.

Microsoft Teams enables simple, secure collaboration and communication with chat, video, voice, and healthcare tools in a single hub that supports compliance with HIPAA, HITECH, and other regulations. Dr. James Balshi, the network’s chief medical information officer, told HealthTech Magazine it has been “a life raft for our organization” and noted that the system had more than 100,000 telehealth sessions in the two months following the expanded rollout of Teams.

And, he added:
“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.”

Butler Health System has operated a similar diagnostic telehealth program since 2017 to connect patients and care teams at four rural sites in western Pennsylvania, including specialists based on the network’s two main hospital campuses. At the start of the pandemic, the system enabled telehealth in patients’ homes using Zoom’s HIPAA-compliant product.

As Cynthia Esser, Butler Health’s director of emerging technologies, told HealthTech Magazine, “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.” From March 2020 through May, Butler used Zoom to create a virtual video experience that was similar to an in-person office visit. Clinicians verified patient information, and then the provider diagnosed and treated the patient, providing perceptions, testing or referrals if needed.

According to Philips, a health technology company, using a live collaboration platform, experienced sonographers can assist local counterparts remotely, while their colleagues can use the same platform to discuss patients’ medical status post ultrasound. Performance-guided procedures using virtual collaboration platforms allows clinicians to provide guidance and education to their peers.

And interventional physicians, who perform image-guided minimally invasive procedures, have also started to explore the use of virtual collaboration platforms to provide remote guidance and education. Philips’ Collaboration Live is a communications platform that lets ultrasound users communicate with remote users in real time, sharing talk, text, screen share, and video stream from the ultrasound equipment. In a study of 30 patients, 100 percent felt they had better access to healthcare via telehealth delivered through Collaboration Live.

Specialists can integrate a telemedicine program into their practice to develop creative solutions to address issues in the delivery of health services, and nurses, who, along with physician assistants, often serve as the primary care providers for patients in remote areas. Nurses are trained to work in a collaborative environment as part of a healthcare team and have extensive experience with direct patient care. Telemedicine allows nurses to connect patients with necessary specialists in a cost-effect, timely manner.

In a study conducted by BMS Health Services, 20 individuals from six healthcare quality improvement teams conducted collaborative tasks in virtual or face-to-face settings. The quality of collaborative task performances were measured, and questionnaires and interviews with participants were used to record participants’ experiences. Disadvantages included the difficulty that people had who were inexperienced using computers.

The Allure Group, a New York City-based network of six skilled nursing facilities, uses telehealth technology to provide 24/7 physician-led medical care. When an Allure resident requires support late in the evening, over the weekend, or on a holiday, Allure staff can contact a telehealth physician who will guide the staff via video to reach a diagnosis and order lab tests, avoiding a trip to the emergency room.

According to research from Frost & Sullivan, a growth strategy consulting and research firm, the opportunity for telehealth products and services to become a standard of care is exploding. Victor Camlek, healthcare principal analyst for that organization, believes virtual care and remote patient monitoring “will propel the overall market of telehealth,” as he said in a news release, and that the future lies with MHealth and personal emergency response (PER) systems.

“Further,” he added in the release, “patients will benefit if data from RPM is fully available to virtual visit providers. This trend will demonstrate the benefit of integrated services. The trauma resulting from the COVID-19 crisis will lead to a clear growth opportunity for one-stop virtual visit and RPM solutions."

Telehealth provides an effective platform for collaboration to improve healthcare quality. The power of virtual collaboration can make specialized care not only more accessible but also more affordable, and most importantly, it can improve the quality of care in a variety of healthcare settings.