multispecialty group medical practices, teaching hospital,
regional community clinics, affiliate hospitals and clinics,
behavioral health services, vision centers, pharmacies, and air
and ground transport services. We serve a Tri-State region,
with population of 600,000 patients. Our telemedicine clinical
services have grown to over 100 providers, in 33 specialty
areas. 31. A Safer Transition from the
Emergency Room: Using Telemedicine to
Reimagine the ER Visit
Through the years a strong infrastructure of technology, pro-
viders and staff has been built. Statistics that are monitored
include the number of appointments, the number of special-
ists, specialties, regional sites and locations. Our telemedicine
program is an essential component to our strengthening com-
mitment to ‘Care Close to Home’. Background: The week following ER discharge is often a
challenging time for patients; whether a result of continuing
symptoms, anxiety about symptom progression, inability to
access follow-up care, or questions related to treatment plan
or prescriptions. All have repercussions for patient safety,
care quality, and satisfaction with service. Patient-centric so-
lutions for continuity of care during this period are rare, re-
turn visits to the ER are not. With this in mind, Emergency
Medicine Consultants (EMC) has re-imagined the ER visit;
using telemedicine to transform the 3-hour ER visit into a
week-long patient relationship.
Developing a communication tool between key stakeholders
in the implementation of internal providers was imperative.
Methods: The action method of research was utilized to plan
the timeline and communication tool. This includes planning,
action, observation, reflection.
Results: A tool for implementation of telemedicine pro-
grams was developed. This electronic tool ensures that each
stakeholder in the process is notified of a new service line or
provider. A final notification is sent to all stakeholders when
all of the steps of the implementation have been completed
and it has final approval.
Conclusions: Our Clinical Telemedicine program at Gunder-
sen Health System has been successful because of the con-
sistent stream of communication between key members of
staff as well as the originating site. This has allowed for steady
growth and high patient satisfaction.
Matt Muller, MD
Emergency Medicine Consultants Ltd.
Methods: Through a partnership with CirrusMD, EMC pi-
loted offering 24/7 direct, continual patient access to emer-
gency physicians via a HIPPA-compliant, text-first virtual care
platform following discharge from the ER at no cost to the
patient. By the end of the pilot, the service is being offered to
30,000 patients a month at 12 hospitals in the Dallas-Ft
Worth metroplex.
Results: The Safe Transitions program is achieving the triple
aim: improved safety, service, and resource utilization. In the
first six months of the pilot, 2,700 follow-up virtual encoun-
ters were completed, involving almost 2,000 patients. Median
response time to initial patient inquiry by a physician was two
minutes, with median duration of patient encounters span-
ning 40 minutes. Nearly 80 percent of patients who registered
for the service used it, with 25 percent of patients on the
platform having multiple encounters over the 7-day period.
Resolution of patient issues occurred in 84 percent of en-
counters without brick-and-mortar referral, with additional
prescriptions written in 15 percent of encounters. Service
levels led 90 percent of surveyed patients to indicate that
having access to Safe Transitions “improved” their experience
with the health system, and 90 percent said they were more
likely to recommend the health system to friends and family
because of Safe Transitions.
Conclusions: Telemedicine following acute care episodes
improves access and continuity of care, care quality, and pa-
tient experience, while reducing avoidable utilization.
32. Reducing Hospital Readmissions
Through the MD24 Telemedicine Program
in Rural Areas
Linh Nguyen, MD, MMM
MD24 House Call
Background: Hospital readmission has been a problem in
the US Healthcare industry. In Arizona hospital readmission
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