When New York-based Westchester Medical Center Health Network (WMCHealth) decided in 2015 to launch a telehealth program across its 6,200-square-mile service area, the 10-hospital network opted to build it from scratch, investing more than $7 million in technology and infrastructure.
Today, its 5,000-square-foot eHealth Center includes 20 multi-media stations equipped with the latest patient-monitoring technology and software. Staffing it 24/7 are highly trained critical care physicians and nurses who specialize in trauma, ICU, neurology, stroke, behavioral health, and, soon cardiology, says Corey Scurlock, MD, Medical Director.
Referred to as the “core,” the eHealth Center augments care at hospitals and ambulances throughout WMCHealth’s network. And although it still relatively new, clinical leaders from as far away as South Korea and Australia have visited to see the innovative program up close, Scurlock says.
He lists the following as among the five most basic components of his program’s success:
- The telehealth program is staffed with nurses who have worked at WMCHealth for years: Many of those who staff the core have worked at the hospital for 10 years or longer, so they fully understand the policies, procedures and the politics of the units they’re supporting, says Corey Scurlock, MD, Medical Director of WMCHealth’s e-Health Program.
“They can speak the same language and understand how things are done on the unit,” he says. “It’s really beneficial to have those personal relationships, especially with our eICU program. The hardest part is getting everyone to agree on how we’re going to work together, what our best practices will be and how we’re going to communicate. It takes time, patience and the ability to work with your fellow colleagues.”
- It has strong clinical leadership on both sides of the camera: Scurlock staffs his program with physicians and clinicians who excel at communication. “I need people who can put their ideas out succinctly and build trust,” he says. “With telehealth, you have to be able to direct care in a crisis and quickly get the physicians, nurses and respiratory therapists on the other side of the camera to quickly buy into what you’re saying.”
- It shares performance metrics on a regular basis: Every quarter, clinical leaders receive a report card of their unit’s performance, such as the time it takes to connect a patient suspected of having a stroke with a neurologist, and the percentage of patients receiving prophylaxis for deep vein thrombosis or, for behavioral health, the number of appointment no-shows.
“It’s really important to get the teams engaged in process improvement and data,” Scurlock says.
- Unit leaders must visit the core every three months: Clinical leaders from units serviced by the eHealth Center must come to the core to view their report card data. This gives them a chance to explore the center and understand what goes on behind the camera. This often sparks ideas for improvement.
“They’re often surprised by what we can—and can’t—see,” Scurlock says. For example, one physician noticed how well the core doctors can zoom into a patient’s pupils and realized he could leverage this capability to have another set of eyes examine his trauma patients.
Another physician visiting the core noticed how difficult it was for the core physician to discern who was speaking when multiple physicians were in an exam room. This made him more likely to stay within view of the camera when speaking.
- It borrows best practices from clinical and business environments: Scurlock is a big fan of change management expert John Kotter, whose 8-Step Process for Leading Change is a blueprint for executives internationally. Kotter’s process involves urgency, alignment, strategic vision, short-term wins and sustained momentum.
For the eHealth program, alignment requires buy-in from physicians and nurses, while sustained momentum demands that teams be engaged in defining metrics for success, Scurlock says.
“It works,” he says. “But you have to continually build on it."
Scurlock will discuss the program, best practices and share their measures of success at the Telemed Leadership Forum 2018: ROI of Telehealth, hosted by URAC and Telemedicine Magazine.