Enterprise Adoption of Telehealth: An Academic Medical Center's Experience Utilizing the Telehealth Service Implementation Model.

There are numerous challenges to developing and sustaining successful telehealth services and a paucity of guiding frameworks to inform telehealth strategy, design, and ongoing operations. The framework Telehealth Service Implementation Model (TSIM)™ was developed to provide a guiding telehealth framework that enables grassroots innovations and accounts for the many factors and domains necessary for successful telehealth service development, implementation, and sustainment. TSIM includes six phases: (1) Pipeline, (2) Strategy, (3) Development, (4) Implementation, (5) Operations, and (6) Continuous Quality Improvement. TSIM provides common terminology for improved team coordination, checkpoints, and milestones to facilitate scaling telehealth services, and a process to get stalled services back on track. TSIM provides an invaluable framework to assist organizations in developing a strategic vision for telehealth services, designing telehealth services enabled for success, and monitoring for high quality and high reliability.

Electronic Visits For Common Acute Conditions: Evaluation Of A Recently Established Program.

Asynchronous interactions between patients and providers through patient portals (called e-visits in this article) have the potential to increase access to care and reduce the time requirements for some office visits. We performed a retrospective chart review for nonemergent acute care of adults in the period December 2015-July 2017 at the Medical University of South Carolina. Most patients in the 1,565 e-visits were female (80.2 percent) and ages 18-44 (55.3 percent). Sinus problems (38.1 percent) were the most common complaint. There were some unresolved e-visits (6.4 percent), with patients ages sixty-five and older and those with diarrhea or skin problems having a higher likelihood of their e-visit being unresolved, compared to other groups. The majority (81.5 percent) of in-person follow-ups did not result in diagnosis changes. More than 90 percent of the 665 patients surveyed after an e-visit reported a positive experience. Most patients (92 percent) reported that the e-visit had replaced an in-person visit. Further evaluation of the factors associated with unresolved visits could guide the development of treatment algorithms that could improve the quality of care in, and the cost-effectiveness of, e-visits for acute common conditions.