Innovating telehealth during times of unprecedented change

Now more than ever, Medical City Healthcare is committed to delivering excellence in every aspect of care. Constantly evolving and improving, we collaborated with clinicians to adapt and develop innovative telehealth solutions to treat patients quickly, safely and with the goal of conserving Personal Protective Equipment (PPE) during the COVID-19 pandemic.

Medical City Healthcare has always set the bar and led the way in telehealth. We launched HCA Healthcare’s first virtual visit service, Medical City Virtual Care, in 2018. We have connected patients with higher levels of care through tele-stroke, tele-NICU and rural telehealth programs. Now, we are deploying more than 750 devices (laptops and iPads) to expand our telehealth network and meet the care demands caused by the COVID-19 outbreak.

Below are some highlights of how we’re using telehealth at Medical City Healthcare:

Medical City virtual care COVID-19 screening

Overview: As the first cases of COVID-19 were confirmed in North Texas, we launched a screening questionnaire based on CDC guidelines to help patients determine the most appropriate level of care for their health needs. More than 12,000 community members were screened via Medical City Virtual Care from March 11 – March 31.

Who does this benefit? This option allows North Texans to be screened from a smart phone or computer 24/7, enabling them to stay at home and prevent the spread of illness in their community or in the healthcare setting. Ensuring that patients seek the appropriate level of care also reduces the demands on our emergency departments, conserves limited tests, and saves PPE.

How does it work? Based on the screening results, patients are navigated to the appropriate care setting—virtual visit, urgent care, physician practice, or the ER—based on their symptoms.

Emergency consults

Overview: As soon as the Centers for Medicare & Medicaid Services announced that telehealth privileging requirements were waived, we began making plans to add to our existing telehealth infrastructure. All of our emergency department physicians and providers now have access to conduct virtual patient visits.

Who does this benefit? Virtual consultations benefit our providers and patients by reducing risk of COVID-19 exposure and conserving PPE while also maintaining ED throughput. This is a customized solution developed in partnership with our emergency room physicians to meet local workflow needs. Medical City Plano Emergency Department Director Michael Meek, MD, estimates that telehealth triage saves 2 staff members per patient from going into the room. That conservatively translates into 60 donning and doffing sessions per day–saving 420 sets of PPE per week, per facility.

How does it work? The emergency department triage nurse collects vitals and other data from the patient while the physician is teleconferencing using HIPAA-compliant software called VidyoConnect. The virtual triage enables the physician to better determine if admission or testing is required or if the patient can return home without further staff interaction.

Inpatient virtual rounding

Overview: Our inpatient telehealth solution enables physicians to virtually round on patients using VidyoConnect. More than 2,000 providers have been provisioned for video consults/rounding across our emergency department and inpatient settings.

Who does this benefit? Virtual rounding enables our staff to perform inpatient care using telehealth, increasing the number of patients on which staff can round. It also reduces exposure to both provider and patient and conserves PPE, while enabling patients to have access to hospitalists quickly.

How does it work? The inpatient providers utilize their own mobile device or workstation. Patient devices are issued by the facility IT department for use while within the hospital.

Practice-based and behavioral health telehealth

Overview: To better meet patient’s healthcare needs in a safe and effective way, our behavioral health centers and PSG practices have launched telehealth visits.

Who does it benefit? Telehealth practice visits benefit patients who may be immunocompromised, those who cannot be around others, certain behavioral health patients or those whose care qualifies for a virtual visit. These virtual visits enable practices to limit exposure to patients and providers.

How does it work? Depending on the patient and situation, our providers are using a mix of technology to virtually connect with patients through either a health portal or other bridge options. When a patient sets up a virtual visit, they will be given instructions on how to access their appointment.

Keeping patients connected

Overview: We greatly value the support that friends and loved ones provide during a patient’s hospital stay. Providing iPads or other devices to patients enables those who do not have a smartphone or tablet of their own to conduct video visits with friends and family members outside the hospital. Across North Texas, approximately 600 tablets have been deployed at all 16 hospitals to keep patients connected with their loved ones and caregivers.

Who does this benefit? Facilitating virtual family visits improves the patient’s emotional well-being, contributing to a better patient experience while also helping to ensure the health and safety of patients, caregivers, colleagues and our communities.

How does it work? Patients are provided a shared device with a pre-programmed WebEx Meetings account and invite loved ones to the video visit. Video visits are secure and free. A Medical City Healthcare chaplain recounted the difference a virtual blessing made for one new mother, whose family couldn’t be present prior to her baby’s surgery. “A smile from mom was enough to reveal that a connection had been made. Without this technology, this meaningful event would have gone unappreciated.”

Providing safe care to colleagues and patients

Overview: Through remote monitoring, we are able to provide ongoing care to Medical City Healthcare colleagues who are symptomatic or have been previously exposed to a patient with COVID-19. Patients who have been screened in a Medical City Healthcare facility and have been potentially exposed to COVID-19 can also benefit from remote monitoring.

Who does this benefit? Both symptomatic and asymptomatic colleagues and patients are able to take advantage of personal, consistent monitoring and care while limiting exposure to patients, staff and others through virtual monitoring.

How does it work? Colleagues and patients are screened through Employee Health or through the Emergency Department. The VivifyGo care team then monitors them and can intervene, when necessary, via secure text or phone call to manage care decisions.