Christopher Northam, vice president of telehealth at HCA Healthcare, and Gwen McCoy, AVP of telehealth at HCA Healthcare, discuss how the organization has enhanced its telehealth capabilities for a more efficient and safe way to care for all patients during COVID-19.

Problem: The unprecedented COVID-19 pandemic has made social distancing and isolating in our homes the new normal. As a result, people need new ways to access health care.

Solution: Expand HCA Healthcare’s telehealth capabilities to support the rapidly evolving challenges of our clinical staff to meet the needs of our patients in response to COVID-19.

Across HCA Healthcare, our telehealth capabilities are enabling a more efficient and safer way to deliver care. Fortunately we already had a strong foundation of using telehealth in our facilities. Our experience ranges from delivering life-saving care to stroke victims by connecting neurologists to emergency department (ER) physicians, to providing emergent psychiatry consultations to deploying remote monitoring for solid organ and bone marrow transplant patients, all via secure, bidirectional audio/video telehealth capabilities.

But, COVID-19 is more complex challenge. Patients’ symptoms are wide-ranging and the virus can be transmitted by those with no outward symptoms. That’s why we have been rapidly deploying telehealth capabilities in various formats to better serve all our patients, symptomatic or asymptomatic, and reduce potential exposure to COVID-19.

(Nashville, Tenn.) Dr. Lanny Holmes, a physician with TriStar Southern Hills Medical Center, was reluctant he would be able to provide the same level of care to his patients virtually. However, he has found joy in being able to treat his most delicate patients through telehealth during this time. Dr. Holmes continues to not only treat their medical needs, but provides the reassuring smile that they have become accustomed to.

There are three primary goals in using telehealth in response to COVID-19:

  • Limit potential exposure of our clinical teams
  • Limit potential exposure of patients
  • Continue to monitor and deliver treatment to both symptomatic and asymptomatic individuals

In the last three weeks, we have enabled multiple telehealth video and mobile applications to be used by 6,000+ providers in our outpatient and hospital-based clinics and added more than 2,000 telehealth endpoints in our hospitals. This is enabling physicians and nurses to utilize video and mobile solutions to stay connected in multiple formats (live video, text and remote monitoring) to treat both COVID-19 and non-COVID patients.

The ways we are using telehealth include:

Outpatient Clinics – Our Physician Services Group (PSG) has enabled telehealth across all of our physician clinics. Last week alone, our physicians conducted more than 13,000 telehealth primary care and specialty clinic visits with 24,000 appointments scheduled for this week. As we continue to ramp up, we are projecting 100,000 telehealth clinic visits will be completed in April. We’re also focused on ramping up telehealth services to support chronically-ill patients who are at a greater risk for contracting COVID-19, including cancer patients who would normally be seen at a Sarah Cannon clinic.

Patient and Employee monitoring – Given the nature of COVID-19, it’s important to continue close monitoring of persons under investigation, meaning those who have been screened in an HCA Healthcare facility for potential exposure to COVID-19.  We are also using the same remote monitoring to actively support HCA Healthcare colleagues who have potentially been exposed to COVID-19. Through Vivify Health’s remote patient monitoring (RPM) mobile app, the Care Assure nurse team can stay in routine contact with the patient and intervene, when necessary, via secure text or phone call to manage care decisions through the Vivify Health mobile app (Vivify Go). This capability allows for continuity of care for our patients and employees, even if an individual doesn’t show severe symptoms.

Inpatient treatment – For patients who require hospitalization, we are increasing the use of telehealth solutions to allow for care teams to see their patients for remote consultations, daily rounding and any specialty visit that does not require a physical exam. We can quickly and easily complete specialist visits (cardiology, oncology, critical care, etc.) utilizing our telehealth endpoints without adding risk to the patient or physician. These telehealth capabilities are helping reduce exposure to our entire care team, as well as preserving critical PPE in the hospital.

Urgent Care – Virtual urgent care visit capabilities have been deployed nationwide all of our CareNow clinics. This allows patients to consult with a physician via video chat, while staying home and avoiding potential exposure. This also helps reduce risk for physicians and other patients with conditions that do require in-person treatment.

Battling the COVID-19 pandemic requires organizations like HCA Healthcare to become agile problem solvers and quickly adopt new solutions. Telehealth is just one of the enabling capabilities we are deploying to both protect our front line caregivers and provide safe, effective care to the people we serve. By equipping all of our sites of care with telehealth capabilities, it enables our teams to continue to care like family.

(Plano, Texas) Dr. Sheena Bhuva with the Texas Back Institute using telehealth capabilities.
(Plano, Texas) Dr. Peter Derman, an orthopedic spine surgeon at the Texas Back Institute, uses telehealth to check on patients.
(Richmond, Va.) Dr. Alan Schulman with Neurological Associates says “hello” to a patient via telehealth.
Dr. Farshad Bozorgnia, with MountainView Medical Associates, checks in on patients using telehealth.

Nashville-based HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising 185 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding ERs, urgent care centers, and physician clinics, in 21 states and the United Kingdom. With its founding in 1968, HCA Healthcare created a new model for hospital care in the United States, using combined resources to strengthen hospitals, deliver patient-focused care and improve the practice of medicine. HCA Healthcare is a learning health system that uses its more than 35 million annual patient encounters to advance science, improve patient care and save lives.

Co-authors:

Christopher Northam
Christopher Northam, VP, Telehealth, HCA Healthcare
Gwen McCoy, AVP, Telehealth, HCA Healthcare