Updates from Sierra Nevada Memorial Hospital and Hospital Foundation
One of the fastest pivots in medicine as a result of COVID-19 was the transition to telehealth. There was limited telehealth utilization in the community prior to COVID-19. Many physicians were reluctant to move in that direction because of unequitable reimbursement, cost, lack of knowledge on how it works, and a resistance to change in how they practice medicine.
Dignity Health Sierra Nevada Memorial Hospital’s (SNMH) first telehealth robot was purchased as part of SNMH Foundation’s Stroke of Luck campaign in 2008. Many think of telehealth as something only a small community hospital might need when in fact urban facilities have also moved in that direction. Why? Because in today’s health care world there are so many medical specialties of care that no one hospital can expertly cover all.
Developing a telehealth program in a hospital setting is very complex. Every specialty (e.g. cardiology, stroke, women and infant) must be set-up independent of each other. Work flows must be adapted for clinical practices. IT (information technology) including software, hardware, and wiring can be costly and difficult depending on the age of technology and of the facility. Contracts must be negotiated and managed with physician groups in the hospital, but also with physicians willing to take telehealth calls. Great care must be taken on how to manage health records and how billing will work across facilities. Most importantly, HIPPA (patient privacy) must be protected at all costs.
Telehealth offers significant value for patients. It is unrealistic to think a physician in a specialty such as neurology can be available on site 24/7. If a stroke patient is rushed to the hospital, for example, it is often more expedient to get a physician on the telehealth robot for a consultation. While the emergency room physicians are able to manage most stroke care, the use of the robot is ideal for a consultation or if there are complications.
So how does it feel to be a patient on the other end of a robot? While it sounds strange, it feels relatively natural. Most robots have a monitor and people say once the physician starts talking, it really just becomes a conversation between two people and whatever clinical staff are in the room. Robots can look very different and have different functions. In addition to a monitor, some have equipment that allow for tests to be taken and transmitted directly to the telehealth physician. Some robots have wheels and can be moved by the physician remotely while others need to be moved manually.
The most significant recent change is the use of telehealth in physician offices. As more and more community physicians and specialists have had to move to telehealth during COVID-19, they are discovering ways to make it work in their medical practice. It has added a new dimension to the competitive medical landscape. A truly patient-centric approach to care delivery will make use of telehealth as a tool to eliminate barriers to and hassles of receiving care. Many say, telehealth is here to stay.
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