Telemedicine is Changing How Long-Term Care Facilities are Managed

Karen S. Rheuban MD, director and co-founder of the University of Virginia Center for Telehealth, spoke with the American Medical Association (AMA) recently and explained that since the arrival of COVID-19, they’ve had to transition their focus and compared this shift to a Blockbuster versus Netflix model: Instead of using telehealth services to increase access to just primary care and urgent care during normal business hours, it has taken on a much broader scope. Care is drastically improved through remote collaboration with dialysis centers, clinics and other specialty provider locations, 24/7. This applies to both inpatient and outpatient use. 

In August, Dr. Laurie Archbald-Pannone, a geriatric specialist and associate professor of medicine at the University of Virginia, shared their approach in developing a collaborative care model using telemedicine. Together with doctors, nurses, emergency responders and local public health experts, they studied how hospitals and academic medical centers can work successfully with LTC facilities. 

In addition to coordinating widespread testing, Dr. Archbald-Pannone explains, “We have improved their [patient] access to sub-specialty care with telemedicine, a great tool for patients.” 

To establish these collaborative virtual appointments, a nurse practitioner leads a telementoring training program for facility administrators and clinical teams, addressing any technical questions prior to the first appointment. 

“We helped arrange telemedicine visits with critical care doctors who used a virtual stethoscope to listen to heart and lung sounds remotely and connect in a real-time video chat with a resident, nurse and primary care physician. This kind of care, we discovered, is effective, efficient and much easier on the resident; instead of a trip to the hospital or doctor’s office, patients can receive treatment and talk to a physician from the nursing home.” 

Dr. Archbald-Pannone points out that telemedicine also helps to alleviate chronic staffing problems at LTCs. With greater access to doctors and timely treatment, patients recover quicker and require fewer transfers to larger facilities, again, reducing their risk of exposure. 

Telemedicine kits allow for real-time virtual consultations through an encrypted video-conferencing application, providing a continuum of care in a safe environment. Diagnostic data shared through HIPPA-compliant software allows specialists to make immediate care decisions.  

Other tools available in telemedicine kits include an electrocardiogram, electronic stethoscope, otoscope and an ultrasound device, all of which can be remotely controlled by specialists. A telemedicine kit can easily be carried to a patient’s room, or set up as a virtual walk-in clinic anywhere. 

The telemedicine kit needs to be easy to use, training should be simple and hands-on. In addition, the kit needs to be affordable and integrate with existing Internet connectivity and able to export patient data into existing medical record systems.

On the Aug. 10 episode of the AMA’s virtual daily update, medical leaders and experts tackled the very complicated issue of the cost associated with virtual innovation in treating patients. 

“They [care providers] think so much about the patient, but they forget that this lives within a world where you have to be able to afford it, or it has to be able to create that return on investment. Otherwise, it's not going to be adopted.”

Vice president of managed accounts at Moving Analytics Beth Andrews, illustrated the ROI succinctly:

“When you look at the area that we're in, in providing virtual cardiac rehab, currently patients are participating at under 20%. Our [virtual] programs are achieving over 80% participation.

When compounding the value of collaborative managed care available 24/7 in a low-risk environment, while at the same creating faster recovery times and more positive health outcomes and creating a positive ROI, it’s a resounding win-win.