The move to mobile virtual visits was a natural evolution for Sioux Falls, S.D.-based Avera eCARE services, which has a long history of serving rural populations and harnessing telehealth technology to improve patient access to physicians and specialists.
Avera Health was founded about 115 years ago to provide rural and frontier medicine. “Our telemedicine platform grew out of the need to serve patients where they reside,” Donald Kosiak, MD, executive medical director at Avera eCARE Services, told Clinical Innovation + Technology.
Avera’s telemedicine programs initially focused on linking specialists with hard-to-reach populations. In the early 1990s, technology deployed at the clinic level helped remote patients access heart and lung doctors. But the technology was still primitive and the cost was too high to widely implement.
It took some time before Avera expanded into 24-7 programs. In 2004, the organization established its eICU CARE program, in which cameras in patient rooms at rural hospitals link to a critical care team. Now in 30 rural facilities, Avera eICU CARE has monitored more than 54,449 patients since its inception. Avera attributes the technology to saving the lives of 1,042 patients who were initially not predicted to leave the rural facility alive.
Then Avera began offering eEmergency and ePharmacy services in 2008 and 2009, in which rural physicians work with a team via two-way video technology to assist them with treating trauma, heart attacks, stroke and other critical conditions. Transfers avoided because of eEmergency have saved more than $14.6 million, according to Avera. Its ePharmacy program has processed more than 1.7 million orders, Kosiak said. “We have lots of robust data and experience.”
The next step in Avera’s telehealth journey is direct-to-consumer mobile platforms. It recently partnered with Verizon Enterprise Solutions, which is launching its virtual visits solution on June 25. This mobile-based technology is hosted on a HIPAA-enabled cloud that allows doctors and patients to link remotely.
Its launch into mobile telehealth required assurances of compliance with privacy regulations not just to avoid fines, but to gain the trust of the patient population. “As they become more comfortable, it’ll be easier for them to log into the platform and talk about their most private healthcare needs,” said Kosiak.
The platform, which operates on laptops, tablets or smartphones, connects patients with minor conditions to physicians. It will confirm patient’s eligibility and then collects co-pay. “Patients pay upfront at a cost that is much discounted compared to brick-and-mortar institutions,” he said.
A patient answers questions, then is connected to a physician elsewhere. With a mobile solution, patients are linked to where there is availability within Avera’s network. ”Maybe the rural clinic is busy, but the new family physician has an opening and you get routed through the evisit platform,” he said. “There are multiple ways to share technology when you have a medical group that is cohesive and shares resources back and forth.”
Medical data are securely stored in the system. So whenever a patient encounter occurs, the data from that visit get uploaded into the network’s EMR. When a remote physician visits with a patient for the first time, they have access to previous visit information, prescriptions and diagnoses.
Physicians are engaged and excited about the technology, Kosiak said. “Primary care physicians wanted to do more holistic medicine for many years, and as we figure out a mechanism to open access more, it’s a win-win-win.” He said they are setting standards so it’s not just about patients getting a prescription.
Kosiak said Avera is looking to expand telehealth to the hospitalist and long-term care space with a critical goal of preventing hospital transfers and “so families can avoid bundling up Grandma at 2am to seek care for a urinary tract infection."
“We look to be that virtual hospital,” he added.