Rapid Systemwide Implementation of Outpatient Telehealth in Response to the COVID-19 Pandemic.

EXECUTIVE SUMMARY: The COVID-19 pandemic, with its resultant social distancing, has disrupted the delivery of healthcare for both patients and providers. Fortunately, changes to legislation and regulation in response to the pandemic allowed Emory Healthcare to rapidly implement telehealth care. Beginning in early March 2020 and continuing through the initial 2-month implementation period (when data collection stopped), clinicians received telehealth training and certification. Standard workflows created by means of a hub-and-spoke operational model enabled rapid sharing and deployment of best practices throughout the system's physician group practice. Lean process huddles facilitated successful implementation. In total, 2,374 healthcare professionals, including 986 attending physicians, 416 residents and fellows, and 555 advanced practice providers, were trained and certified for telehealth; 53,751 new- and established-patient audio-video telehealth visits and 10,539 established-patient telephone visits were performed in 8 weeks for a total of 64,290 virtual visits. This initiative included a new COVID-19 virtual patient clinic that saw 705 patients in a 6-week period. A total of $14,662,967 was charged during this time; collection rates were similar to in-person visits. Initial patient satisfaction scores were equivalent to in-person visits. We conclude that rapid deployment of virtual visits can be accomplished through a structured, organized approach including training, certification, and Lean principles. A hub-and-spoke model enables bidirectional feedback and timely improvements, thus facilitating swifter implementation and a quick rise in patient volume. Financial sustainability is achievable, but to sustain that, telehealth requires the support of continued deregulation by legislative and regulatory bodies.

A Web-based program to ensure compliance of medical staff providers with mandated health care facility requirements.

BACKGROUND: We designed a Web-based program for educating medical staff providers on infection control and prevention measures and for ensuring that such providers comply with mandated immunizations, influenza vaccination, and tuberculin skin testing. METHODS: Our program was designed in a health care system employing approximately 2,699 medical staff providers and 9,700 other health care workers in 3 hospitals; a skilled nursing care facility; and a large, multisite, faculty practice plan. We developed a program for educating medical staff providers on infection control and antibiotic stewardship and ensuring compliance with institutional immunization, tuberculin skin testing, and influenza immunization requirements. A post-test required a 100% correct score to pass. The modules allowed access from any computer with Internet connectivity. RESULTS: In total, 2,666 of the 2,699 (98.8%) medical staff providers completed the program, and 76.4% of the 2,666 received influenza vaccination. CONCLUSION: Entering the data into an electronic database allowed for ease in monitoring compliance, and the requirement for successfully passing a post-test following the educational modules ensured that medical staff providers had read the material. Entry into the electronic database also allowed for analysis of reasons for varied compliance with influenza immunization that will be useful in focusing future educational efforts.