The Center for Connected Care at the Mayo Clinic in Rochester, Minnesota, is focused on the resourcing and diffusion of digital health solutions in partnership with the Mayo Clinic practice, extending Mayo Clinic’s knowledge and expertise and increasing patient access to clinical care, even at a distance.
THE PROBLEM
These digital health solutions include an array of modalities that reflect the wide-ranging needs of patients: synchronous, real-time video telemedicine (including outpatient video visits and acute-care solutions like telemedicine for stroke and neonatology); asynchronous services (for example, secure-portal messaging and provider e-consults); and remote patient-monitoring solutions that blend technology and nursing-care coordination to improve patient disease self-management.
Today, more than one million people from all 50 states and 140 countries come to Mayo Clinic to receive care at sites in Minnesota, Arizona, Florida, Iowa and Wisconsin. In addition to providing specialty and primary care at destination medical campuses in Rochester, Minnesota; Jacksonville, Florida; and Phoenix, Arizona, the Mayo Clinic Health System services more than 50 communities in the Midwest. This community practice includes general acute care hospitals, rural health clinics, physician offices and critical access hospitals.
The more rural community practices do not have the consistent specialty care resources and access available at a destination medical site like the campus in Rochester, Minnesota.
PROPOSAL
Telemedicine has helped to bridge the access divide between the clinic’s rural and urban communities. The particular telemedicine solution depends on the need presented.
For example, a facility-to-facility telemedicine interaction connects a rural provider to a distant site specialist when specialty expertise is needed that is not otherwise available at the rural hospital or clinic. Community hospitals are able to access specialty and subspecialty providers at another site, facilitated through a video connection.
“Since the pandemic, the number of providers of many different specialties and clinical roles that we’ve oriented to digital care has increased exponentially.”
Dr. Steve Ommen, the Mayo Clinic
The specialist is able to connect remotely with the patient and local care team to provide a consult or guide a local physician through a specialized procedure. These types of interactions have been critical for extending Mayo Clinic’s expertise across a wide geography – and expanding the Mayo Clinic care team across sites to best meet the needs of each patient.
Alternatively, direct-to-patient video telemedicine is used to offer follow-up care at a distance. Many patients from the community practice might travel to Rochester for a specialty procedure. Following a procedure, a patient may wish to continue their follow-up care with that specialty care team, but travel time and accommodations can be burdensome for short follow-up appointments.
With a video visit, a patient is able to meet virtually with their specialty care team for follow-up care without the need to travel back for their follow-up appointment. The patient is able to access the video appointment through a secure connection facilitated by their online patient portal account. The patient can access this appointment from their personal device to reach their provider, located at a distance, in their office.
“Another use case might be our remote patient-monitoring program,” said Dr. Steve Ommen, medical director for the Center for Connected Care at the Mayo Clinic in Rochester, Minnesota. “Mayo Clinic has operated an RPM program since 2015. The program uses technology and a nursing-care coordination model to improve patient disease management, resulting in decreased readmission rates and increased patient satisfaction and self-efficacy.”
This program has been active across Mayo Clinic, having assisted patients in Minnesota, Wisconsin, Arizona and Florida in managing their chronic conditions. This is a tablet-based system through which Mayo Clinic provides vended technology with peripheral devices to track patient vital signs and physiologic data.
“Each day, patients’ vital signs and symptoms are monitored through twice-daily measurements of temperature, pulse oximetry, heart rate, blood pressure and weight, with optional peak flow and glucose measurements, depending on patients’ health history and risk factors,” Ommen explained. “Providers can order the RPM service to assist their patients with moderate-to-high risk chronic conditions.”
MARKETPLACE
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MEETING THE CHALLENGE
“Our digital care services have been leveraged by care teams made up of a variety of clinical roles, including physicians, mid-level healthcare providers, nursing, therapists, pharmacists, genetic counselors and others,” Ommen said.
“Any of these roles may be involved in the follow-up care,” he continued, “sometimes with the appropriate supervision of the treating physician, as part of the patient’s care team. Our follow-up care video visits and facility-to-facility encounters are fully integrated within our electronic health record, which also encompasses our billing and scheduling system, making the workflow much more convenient for providers without having to toggle between systems.”
From the patient perspective, the appointment is accessed through the patients’ secure portal, which feeds to their electronic health record.
RESULTS
The COVID pandemic has vastly accelerated the adoption of the provision of care via telemedicine, thus bringing the option for virtual care from a “nice-to-have” to a baseline expectation for both patients and providers, Ommen stated.
“Prior to the pandemic, we had innovative physicians who had begun to integrate virtual care into their practice, but it was far from an across-the-board adoption,” he said.
“Since the pandemic, the number of providers of many different specialties and clinical roles that we’ve oriented to digital care has increased exponentially, due in part to significant flexibility from government regulators as part of the pandemic response. This really allows us to do the right thing for our patients and their care.”
The volume of video interactions May Clinic supports on a daily basis greatly exceeds what it had done prior to the public health emergency, and signals a great patient desire to get their needed care conveniently and safely during this time, he added.
Due to this need, it really has been imperative that the technology used is scalable to meet this level of patient need, he noted. Virtual care is really not a nice additive any longer. It’s a must-have, and sometimes even an equivalent alternative to care that would have been provided face-to-face, he said.
USING FCC AWARD FUNDS
The FCC awarded Mayo Clinic $1,000,000 to implement video telehealth services and remote patient-monitoring across its Midwest presence of more than 50 communities in Iowa, Minnesota and Wisconsin, in order to minimize exposure and slow further spread of the COVID-19 virus and maintain patient care and monitoring standards.
“We are very grateful to have been awarded funds under the COVID-19 Telehealth Program,” Ommen remarked. “All funding has gone toward the purchase of connected devices to expand digital care in light of the pandemic. For Mayo Clinic, this is twofold.”
The funding helped to purchase additional equipment to outfit provider offices and workstations throughout the Mayo Clinic Health System community practices. The proces advances the ability for local providers to perform scheduled video visits with local patients who are in their homes. This allows patients and providers to observe social distancing practices during the pandemic without a delay in regular follow-up care.
“Additionally, some of the funds have been used for the purchase of additional peripheral devices for our complex care RPM program,” Ommen said. “As part of the pandemic response, Mayo Clinic’s Center for Connected Care stood up a specialized RPM program specifically designed to serve our patients who have tested positive for the COVID-19 virus. The FCC funding has gone, in part, toward the devices needed to expand our RPM patient capacity and allow COVID-19 patients to self-isolate safely at home while a dedicated care team continuously monitors their progress.”
Twitter: @SiwickiHealthIT
Email the writer: [email protected]
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