Southwestern Health Resources in Dallas, Texas, is a clinically integrated network with 5,500 neighborhood service providers and more than 700,000 covered lives in North Texas. As a value-based care organization, it offers population health management for its moms and dad companies, Texas Health Resources and UT Southwestern Medical.
When the pandemic began, Southwestern was really concerned about its most at-risk members.
As client volumes plummeted, Southwestern also acknowledged an increased risk to quality enhancements due to the long-lasting effects of undiagnosed cancers and other disease progressions amongst individuals it serves.
” So we required to guarantee our neighborhood PCPs might link to clients who most needed them, as well as assistance outreach to all patients for preventive care,” stated Dr. Anthony Ziskind, senior executive officer of Southwestern Health Resources.
Telehealth would allow Southwestern’s neighborhood physicians to reach out to at-risk patients, determine their requirements, reassure them of their security if they required an in-person see, or connect with neighborhood partners to deliver care in their home.
In early March 2020, the Southwestern operations reaction team developed a network-wide command center to increase performance and provide patient outreach support to its provider network. The group rapidly focused recognized interactions channels with community providers– physician pod conferences, newsletters and more– on informing them in the use and compensation procedure for telehealth visits.
” The network has put out more than 200,000 targeted interactions to clients at threat of cardiac arrest and strokes, advising them to avoid postponing access to severe care.”
Dr. Anthony Ziskind, Southwestern Health Resources
As nearly all the companies in the network are on the same EHR and the Southwestern platform, the organization could guarantee the technology was incorporated with both their technology and center operations.
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SATISFYING THE CHALLENGE
All at once, Southwestern’s medical economics department applied sophisticated analytics and actuarial capabilities to claims and EHR information to identify senior, clinically intricate and otherwise at-risk patients, then provided those lists to physicians for outreach by means of telehealth. The organization also supplied each doctor with a list of their patients who had actually missed mammograms, colonoscopies or other important screenings due to the fact that of the pandemic.
Then, PCPs might get in touch with each individual by email or, if additional peace of mind was needed, by means of telehealth, to arrange their screenings.
” Clients were also notified to the choice of utilizing telehealth to connect with their providers,” Ziskind noted. “We released patient education details on our website to help with telehealth sees and launched targeted client interaction throughout the network by means of telephone to describe the alternative of care by telehealth.”
Building patients’ trust in telehealth and walking them through the procedure was necessary to developing volume, he included. The message to all patients remains threefold:
- It’s important to get the care you require.
- You have the option of telehealth to get care from the security of your house.
- We can help establish a relationship with a company for ongoing, personalized care.
” Other messages to clients included underscoring the value of telehealth as an equally high-quality alternative to in-person care and communicating about the vast array of treatment choices that are offered in this format,” he said. “Attending to insurance protection issues was also a large part of our messaging to assure clients that we have the ability to take care of them under many insurance strategies– alleviating cost-related fears.”
The work of the Southwestern operations reaction group rapidly enabled telemedicine across its community practices, with approximately 8,000 virtual visits each day throughout the network. Southwestern triggered around 500 independent practices in telehealth abilities in less than one month. The reaction group also collaborated check-in contacts us to at-risk patients, reaching 4,000 regular monthly client connections by May 2020.
” The network has put out more than 200,000 targeted communications to patients at danger of cardiac arrest and strokes, urging them to prevent postponing access to severe care,” Ziskind said. “Utilizing analytics from claims and EHR data, there has been extra outreach of 250,000 magnified messages to clients and members in high prevalence POSTAL CODE to amplify the prevention of COVID-19 infections in underserved communities, with a 2nd wave to all 700,000 network clients planned.”
Southwestern outreach allowed by data analytics and telehealth since July 2020 entailed:
- Education of at-risk and high-risk clients to avoid delays in intense care (170,000 outreach).
- Education of patients and members from high-prevalence ZIP codes (10,000 outreach) on managing the spread of COVID-19, and now network-wide (700,000 outreach prepared).
- Screening of COVID-19 clients for social factors of health (1,200 completed).
- Supplier and service provider partnered quality gap closure effort (underway).
SUGGESTIONS FOR OTHERS
” Population health management– and its core parts of care delivery development, client monitoring, advanced analytics and value-based payments– present a lifeline during the pandemic in part due to the versatility of providing an instant intervention of scaling telehealth and virtual care throughout our network,” Ziskind explained. “The technology was able to offer customized care remotely, the precise balance required in these circumstances.”
3 secrets to success, he noted, were:
- Wraparound support for suppliers to get up and running quickly in this brand-new model.
- Patient education and clear messaging on using the technology.
- Data analytics to stratify patients by risk and broaden engagement and target outreach efforts.