Becker's Hospital Review

10 Executive Briefing Sponsored by: D uring the pandemic, out of necessity, the adoption and use of telehealth grew exponentially. Health systems that already had telehealth programs rapidly expanded these offerings, while other health systems sprinted to implement virtual care capabilities. This resulted in a dramatic uptick in providers trying to see patients online through any means possible, whether that be via a Facetime call or connecting through their EMR. But as a "new normal" for healthcare is emerging, it's becoming increasingly clear that not all video connections are created equal. Now, as health system leaders reassess their telehealth strategies and look to make virtual care a sustainable part of the care experience, they realize that simple video connections aren't enough to power seamless and easy care experiences for patients and providers alike. To understand how health systems are evolving their virtual care strategies and leveraging a telehealth platform to meet the needs of patients and providers beyond the pandemic, Amwell hosted a roundtable featuring five health system leaders during its 2021 Client Forum, which Becker's Hospital Review attended. Participants were: • John Callison, MD, vice president and chief medical information officer, University of Tennessee Medical Center in Knoxville • Sally Eckford, assistant vice president, virtual health, Wellstar Health System in Marietta, Ga. • David Kogan, vice president, Indiana University Health (IU Health) in Indianapolis • Eric Liston, administrator, Intermountain TeleHealth Services, Intermountain Healthcare in Salt Lake City • Teresa Neely, BSN, RN, senior vice president, chief ambulatory officer, chief nursing officer, ambulatory, University of Wisconsin Health (UW Health) in Madison These leaders represent large health systems with multiple hospitals, outpatient clinics, and urgent care centers, all requiring significant digital care coordination. The pandemic supercharged telehealth While most health systems had some form of telehealth in place prior to the pandemic, COVID-19 caused them to have to completely rethink their care delivery strategy and expand what was being done virtually. "Prior to the pandemic, Intermountain already had a pretty robust telemedicine program, and the pandemic put it on steroids and made everything go faster," Mr. Liston said. Similarly, UW Health had a robust telehealth program in place pre-COVID, said Ms. Neely. This program offered specialty care consults across UW's hospitals as well as on-demand care, an electronic intensive care unit and tele-stroke services. When the pandemic began, however, within a four- week period UW scaled its virtual platform across its inpatient and ambulatory system to support 1,700 providers. Likewise, for Wellstar Health System, the need to scale happened quickly, "As fast as COVID came, we reacted just as rapidly," Ms. Eckford said. Reacting meant educating providers on a range of things such as how to access Wellstar's virtual platform and how to conduct virtual "no touch" exams. To keep its physicians and medical staff updated on virtual health platform offerings, Wellstar created a Virtual Health Guidebook, a comprehensive manual with up-to-date information on trainings, and resources that could be accessible from any location. The situation was a bit different for UT Medical Center where they did not yet have a telehealth program until the pandemic hit. "We had thought about telehealth, but had not taken the first steps to implement it," Dr. Callison said. "COVID created a burning platform. I'm not sure how we would have accomplished what we did without having our providers being essentially forced to seek alternative options to continue managing their patients when in-person visits dropped off... I don't think telehealth at our institution would have been as successful without that burning platform." Beyond urgent care: During the pandemic, health systems relied on telehealth for numerous use cases Throughout the panel, each health system highlighted how COVID-19 caused them to expand the amount of use cases they were using virtual care for. A few examples: In April 2020, IU Health built a "hospital at home" program to serve COVID-19 patients after they were discharged from the hospital. Mr. Kogan said more than 800 patients have been assisted. Similarly, UW Health piloted using virtual care for patients who were discharged from the emergency department. To Dr. Callison's surprise, UT Medical Center's neurology and dementia clinic embraced the use of telehealth during the early days of the pandemic. "For a couple of months, they did no in- person visits; everything they did was via telehealth," Dr. Callison said. "They were doing dementia assessments, cognitive assessments, all remotely." He also described a radiation oncology use case where patients, instead of having to travel back to the tertiary hospital, could have images done closer to their home at satellite clinics. Ms. Neely described an in-hospital digital health use case as well. UW Health decided to have smaller rounding teams go into patients' rooms and then connect virtually with other team members outside of the room. All of these use cases underscore how virtual care is now being used to enable much more than urgent care visits and can improve patients' access to care, enhance the patient experience and increase operational efficiency across many specialties. Taking a platform approach to virtual care – health system leaders weigh in post-pandemic

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