This is an extremely exciting time in the healthcare industry. Despite the troubled launch of the Health Insurance Exchanges, the Affordable Care Act,– as well as advancements in healthcare technology – has already begun to transform and evolve the healthcare landscape.
The Public Sector View recently had the opportunity to sit down with Ron Emerson, the Global Director for Healthcare at Polycom, to discuss these changes and the technologies facilitating them.
Prior to joining Polycom, Ron was the executive director of a telehealth network in the Northeastern United States that had about 350 sites. He served on the board of the American Telemedicine Association (ATA) and as the Chair of the ATA Industry Council. During his time in nursing, Ron worked in acute cardiopulmonary, field nursing facilities and home healthcare.
With his extensive experience in healthcare, we were excited to hear Ron’s perspective on the changing industry, and how he felt these changes would impact nursing, specifically. Here is what Ron had to say:
Ron Emerson: Nurses impact multiple areas of healthcare – everything from discharge planning and transition of care to wellness and prevention and education through direct patient care in the home or within the walls of a hospital. Utilization of distant technologies such as VTC that allow healthcare professionals to reach patients wherever they are located will become more and more key as we move more to population-based health.
The promise of VTC for nurses and other healthcare professionals is it’s more efficient to move information then it is to move people. By capitalizing on this promise nurses can quickly respond to a patient in their home who was recently discharged from the hospital; provide education to patients in their home on how to better manage their chronic disease or provide transition of care from the hospital to the home for patients by engaging all stakeholders regardless of location in high level intimate discharge planning through better care coordination.
As incentives change from fee for service to population based care, nurses as a key part of the care team will be instrumental in utilizing VTC to have more intimate high level interactions with patients to treat current problems or keep populations of people healthy.
PSV: What trends are we seeing in the healthcare space that make the empowerment of nurses and nurse practitioners more important today than ever before?
Ron Emerson: The movement to population health is the biggest driver. Healthcare organizations are now being incentivized to keep patients out of the hospital to manage cost. As a result, we need to reach patients where they spend most of their time which is their home or at work.
Nurses have historically been the primary healthcare professional to interact with patients in these key environments. Regardless if it’s acute care, chronic disease management or wellness and prevention nurses will be called on more because the incentives are aligned to use them more as a resource to provide these services in a proactive preventative manner then to respond in a reactive manner after the patient is in an acute state or prior to a patient having health issues at all.
PSV: We continue to hear about a need for increased collaboration between healthcare providers, payers and other members of the care group – as well as a need for more patient engagement. Why is this important today and where do telemedicine and VTC solutions fit into this?
Ron Emerson: A large percentage of medical errors are from a lack of communication. When care is coordinated better, we can drive better outcomes.
Patient-centered care and care coordination require bringing care providers, nurses, family members and the entire care team together. This can help ensure that all key components – not only medical, but also psychosocial and other necessary services – are delivered to the patient when they need it.
But what happens when the patient, nurse that will care from them and doctor’s office are all hours away from each other and everyone is distributed? Instead of everyone being on the phone, video can enable the interaction between these healthcare professionals and help increase care coordination. Video enables the nurse that will be going to the house to care for a patient, the doctor, the discharge planner in the hospital and the son of the patient – who has power of attorney – to all get together and meet face-to-face. By using VTC we can coordinate the patient’s care all the way across the care group. Everyone can meet over video to coordinate on care and interact.
Patient engagement is also becoming increasingly important. As a healthcare system, we’re moving away from a fee per service model. Things are changing and healthcare providers are going to be incentivized to keep their patients healthy and out of the hospital.
Approximately 80 percent of communication is visual. The ability to lay your eyes on someone without having to travel to the site and be in the same room with them allows the nurse or doctor to stay in touch and communicate with the patient. This is a way we can continue to keep our communication and collaboration with the patient high.
This patient interaction and engagement via video can be effective both for battling and managing chronic conditions, as well as helping to fight readmissions.
Because of their high cost over time, payers are extremely interested in managing chronic conditions, specifically. As we move towards incentivizing population health and keeping people healthy, we’ll see patients with chronic conditions – and at risk for chronic conditions – increasingly being communicated and collaborated with via video with the focus on keeping them healthy.
PSV: You mentioned readmission just now. What role can telemedicine solutions play in the discharge process, how can it fight readmission and why is that important in today’s healthcare environment?
Ron Emerson: There are a few different ways that telemedicine can help battle readmissions.
If a recently-released patient has a nurse or family member caring for them onsite, a primary doctor can come in over video and try to divert rehospitalizations. This also expedites the deliver of care.
We know that a lack of communication results in poor clinical outcomes. Using video, the discharge planner, primary care physician, care coordinator and other healthcare providers can be collaborating and communicating to ensure that all aspects of a patient’s care and recover are coordinated for the best possible outcomes..
Finally, we can use VTC solutions to make discharge instructions better. Instead of simply describing exercises and medications prior to discharge, healthcare providers can equip patients, nurses and home health aids with video instructions and other forms of media. These educational models provide higher detail and can be reviewed multiple times. Healthcare providers can even check to ensure the patient of caregiver watched the video discharge instructions.
The issue of readmissions is exceptionally important for healthcare providers and hospitals today because of 30 day readmit penalties – where Medicare and Medicaid essentially fine hospitals when patients with certain conditions are readmitted within 30 days of a previous discharge. With these penalties in place, healthcare providers now need to ensure that they transition care more effectively for better outcomes and decreased rehospitalizations.
Luckily, today’s collaboration solutions can connect healthcare providers and patients unlike any other time in history. We can do video on practically any device now – including computers, laptops and mobile devices – and we can include voice with the video in meetings. This means that people without video technology can participate via voice and aren’t cut out of the meetings. This technology is available today, and can start improving care coordination, enabling patient engagement and driving better outcomes immediately.
For additional information on how VTC solutions can help improve patient outcomes and decrease rehospitalizations, download the whitepaper, “Collaborative Video Solutions in Healthcare: Reducing Hospital Re-admissions and Improving Patient Care,” from our Resource Center.