Redefining Healthcare through technology

What are some of the pain points present in today’s virtual care segment of the healthcare industry?

There are many aspects to consider while discussing the virtual care industry and its challenges. While quality and efficient, seamless adoption in clinical workflow are the major factors, sustainability and value are also of equal importance. As the healthcare industry shifts from a fee-for-service model to a value-based model of payment, there is a different value proposition regarding how the virtual care industry proactively delivers care to reduce the cost and drive more patients to an outpatient setting than an acute one. We focus on ensuring quality through technology to deliver meaningful, financially profitable care and add value to the system.

It is of utmost importance that healthcare institutions create a better atmosphere with better access and higher-quality care for the patients and ease the burden on the workforce. But more often than not, the healthcare system is shorthanded. To top it off, the available clinicians hadn’t had much experience with technology-assisted medical procedures or telemedicine as they didn’t have access to them when they were in medical school. Renown Health has a comprehensive training program to not only onboard and implement the technology in such a way that it seamlessly integrates into the workflow but augments it to make it more efficient. The program ensures the clinical team and the patients receive appropriate support, which is crucial to driving success.

The final major issue confronting today’s virtual care segment of the healthcare industry is timeliness. With the aid of technology, things move faster than they used to with manual labor. At Renown Health, we strive to create the optimal healthcare ecosystem with the limited available resources and continue to make healthcare an interesting and exciting area for individuals to work in.

According to you, what kind of impact did the pandemic have on the virtual care industry, and what are some of the newer things that came in as part of it?

The pandemic effectively eliminated the stigma associated with technology and made space for innovation as social distancing compelled adoption. As technology took over the industry, there was a significant reduction in the workforce requirement, which allowed healthcare institutions to see patients from a capacity standpoint. There have been limitations around how we use technology effectively in the virtual care industry.

Virtual care shaped itself well due to the extended pandemic over the last 12–18 months. There have been many flashes in the pan during this period, like new products and pilots that didn’t have the expected outcome or value the developers desired. All of which pointed toward the need to focus on the roots of quality and sustainability. The major impact of sustainability is reimbursement, as in what kinds of services can be reimbursed with the evolution of wearable devices. Outcomes are better when you’re delivering care sustainably from a reimbursement standpoint.

The rules relating to it continue to evolve as the virtual care industry continues to grow. Previously, reimbursement for a virtual visit to a patient wasn’t possible when they were at home, but now it is. We are also considering augmented reality and performing some physical reality virtually using data and technology. When we look at the workforce, we’re particularly interested in how we can augment it using AI to reduce bedside burnout for nurses and create new roles for them. Virtual nursing combined with AI and data science helps to a great extent when it comes to the use of vitals and wearable devices or ambient monitoring devices. The pandemic, as it continues, has brought about significant development in the virtual care field.

How would you say your expertise and experience helped Renown Health navigate the industry’s struggles and contributed to its growth?

I have a background in public health with a focus on epidemiology and healthcare technology, as well as years of experience in the health system from the hospital, medical group, and insurance sides in data analytics and strategic planning. I was able to bring together the experiences of data analytics, finance, population health, and public health to consider where technology can truly make a difference and how to facilitate healthcare by leveraging technology as an enabler and not as the end-all solution. I was able to think about it from all those different perspectives, which turned out to be highly beneficial to Renown Health’s growth as it allowed us to create clinically relevant and meaningful interventions while leveraging technology to deliver them in ways we never thought possible before.

There are many types of care services that we brought in as part of virtual care, like mobile care and wearable devices. But from a population health perspective, it is imperative to ensure that every patient we care for is eligible or able to receive this type of care and that we are not creating further disparities between the various populations that we serve as a safety net hospital. So we leverage the data side for capturing success metrics, defining what success looks like, and validating the value. 

Furthermore, we continue to be more efficient with what we’re doing in technology or a hybrid future by using them in a way that is synergistic and creates scale efficiency. It was never a single person’s expertise that benefited the company; rather, it was a collaborative effort that propelled Renown Health to its current heights. We have a great team of technologists, coordinators, nursing staff, clinical staff, and leaders with diverse sets of experience and expertise that we collaborate with to build the strong institution that we are today.

What are the benefits of the telehealth services that Renown Health offers, and how are they different from traditional methods?

We are a safety net hospital, ranked as the seventh largest in the state of Nevada and 48th–51st in every physician access category across the board, including various specialties and affirmative action. We offer hub-and-spoke telemedicine to many different rural partners, from critical access hospitals and rural clinics to prison systems and tribal health communities, as well as our own rural clinics for specialty services in a hosted telemedicine model where the patients can go to their closest local clinic where they go for primary care that they received the referral from and then have a presenter who can use Bluetooth stethoscopes and exam cameras to stream high-definition video for our specialists to complete the consults remotely. We also do virtual visits, which involve connecting with patients directly from their mobile devices to their tablets or computer.

We provide primary care and urgent care for almost all of our specialties. But since peripheral devices like Bluetooth stethoscopes and exam cameras with trend presenters are not used while delivering virtual care directly to the patient, it is often challenging to ensure the right kind of care is given. We have adopted a few untraditional levels of care to provide for our patients. We have telesitters within the hospital, so monitoring patients who have an elevated risk for falls or physical altercations in the hospital setting can be easier for our staff. We also do remote monitoring on a post-discharge basis as well as from a chronic care management perspective. We even did some virtual triage during the pandemic; even though it is on hold for the time being, it is a service we’ve had for a long time.

Health at Home is another of the initiatives that we brought into practice: a continuous monitoring post-discharge model that we were using to take care of the patients, help prevent readmissions, and ensure that they were on the right trajectory toward recovery. We have contributed to increased access to high-quality, low-cost healthcare as we progress.

When the direct costs of programs are considered, the financial return on investment (ROI) isn’t ideal, bringing us back to sustainability. But as a closer look is taken from a population health perspective, it is making the system more accessible and controlling the cost for the patient simultaneously.

We at Renown Health address the gaps in access to quality care across the various disparate populations that we serve and find ways to address the healthcare deficit by using technology to deliver care more streamlined, purposeful, and meaningfully.

Do you have any words of advice for your peers on creating a seamless process in the virtual care industry?

The best piece of advice I can give anybody in the virtual care industry is to always keep the intended value in mind while monitoring and tracking the unintended consequences along the way. If the intended value is to create better access at a lower price point by leveraging technology and reducing burnout, then it is important to ensure that our implementation has the right impact. Sometimes, when the technology is implemented, the efficiency might not be seen on the scale or the improvement in quality that is expected. This can put the patients’ as well as clinicians’ lives in jeopardy, and they don’t deserve it, making it all the more important to keep the value that you intend to have in focus and use a team-based approach.

No technology will ever create the right solution on its own. It has to be a synergistic wheel between the technology, the people using it, and the processes in place for the technology and the delivery of care.

Last but not least, to sustain an industry like virtual care, it is essential to think outside the box while also knowing the value drivers and the acceptable limit of appropriateness. Innovations can often be dangerous, and that isn’t our goal at all, as the lives of patients are at stake. We must always return to ethics and the appropriate use of technology and data to ensure we’re doing things correctly and then find ways to drive positive, sustainable change.