When I worked for a healthcare system based in the Southeast, clinical data convinced me that telemedicine was the right choice for our hospitals. Since earning my Masters of Science in Engineering Management, industrial and management systems engineering, data has always been my weapon of choice.
You don’t meet many healthcare professionals with engineering backgrounds. At first glance the two fields don’t go together. It surprises me how often I rely on my engineering past to bring a fresh perspective to the present and future of healthcare—especially when it comes to considering whether a telemedicine program is right for your hospital.
Data convinced my colleagues that telemedicine was the right choice, too.
Where I worked, telemedicine wasn’t an easy sell. We needed a solution to manage nocturnist coverage. There was too much turnover, physician burnout and expense associated with delivering high quality care. This hospital system, like many, had three types of telemedicine detractors:
Naysayers: Often a clinician, this stakeholder doesn’t believe that a remote physician can deliver quality care. They say: What about bedside manner? Patients won’t like talking to a screen.
In-house Administrators: Both administrators and clinicians can advocate for establishing an internal telemedicine solution. Administrators believe that the hospital system can run a more efficient program—overlooking locums costs, recruiting challenges and provider turnover.
In-house Clinicians: Providers express concerns about patient coordination, nursing resources and quality. These clinicians worry that a loss of control will make managing the telemedicine providers a hassle. They don’t realize that Eagle is hyper-focused on working as a team member, assuring a smooth hand-off and providing the same quality care.
The detractors were a fraction of the executives and stakeholders evaluating the viability of introducing a telemedicine solution into the hospital system. Most team members liked the idea of telemedicine because it offered cost savings, expanded access to specialists and reduced transfers. Yet, I focused on the detractors with the goal of addressing all of their concerns.
I took a year’s worth of clinical data from Eagle—time from arrival in Emergency Department (ED) to admission, nurse satisfaction, physician response times and more. The data showed that the level of care was exactly the same with telemedicine as it was with the systems’ on-the-ground staff. This addressed the Naysayers’ concerns.
Those that supported telemedicine but wanted to develop our own program using local physicians, required a different approach. I worked through the analysis and the pro forma to show them that, though we might have been able to succeed from a quality and delivery of care perspective, we just didn’t have the economies of scale to provide a program with the same financial results as a telemedicine company, like Eagle.
Put that data next to the significant physician expenses we could save annually per facility, and the decision was a no-brainer. There was really no way anyone on the executive team could look at the data and legitimately counter the proposal to give telemedicine a go.
Today, all the hospitals in the system are enjoying the benefits of Eagle’s telenocturnist program. It helped that the system was one of the largest in the state. We had some bravado. We were ready to try new things. I also had a phenomenal mentor who helped me cultivate my talents as a leader and change agent.
I put that experience to work for rural patients.
As Eagle enters its second decade, I am working with Dr. Mac and our executive team to help Eagle accomplish new goals. While hospital leaders know that telemedicine is better than spending significant money on locum tenens physicians, there remains a misperception among many hospital leaders that: Telemedicine is still not as good as full-time employed local physicians.
It’s a headwind we often encounter in hospital presentations. Again, the clinical data proves otherwise:
Telemedicine physicians produce results equal to those of local providers—and, in this era of dwindling numbers of on-the-ground physicians, are certainly easier to find.
Working to counter the “vendor mentality”.
No matter how successfully we perform, there are naysayers that insist on viewing telemedicine as separate and apart from the onsite clinical team. To the contrary, we are part of a hospital’s medical staff. Eagle works best when we are fully integrated into patient care. Eagle providers work alongside the on-site staff for months even year. The telemedicine providers become familiar faces providing timely, critical support to hospital staff.
“We thought we might see a different face each time, but our Eagle team is a core group of three or four intensivists we see regularly. Nursing staff feels like they have a real camaraderie with them.”
Encouraging communication between telemedicine and onsite physicians is key. If a daytime physician is uncertain about the hand-off of a telemedicine patient at shift change, I might get a call.
My response? It’s a conversation that is best handled peer-to-peer, physician-to-physician. I connect the onsite and telemedicine physicians immediately. There is no need to funnel the communication through me. Good things generally happen for the hospital and the patient when the providers connect face-to-face.
Whenever a new team member is added, there is a period of adjustment. Telemedicine providers are new team members. There’s a learning curve for everyone involved when a hospital begins a telemedicine program—adds new team members. I’m finding new ways to speed it up.
I would welcome your comments on other ways our company can grow in 2020. Please contact me at jason.povio@eglhp.com.
