For the home health industry, 2020 was the year agencies unquestionably embraced telehealth. Amid the COVID-19 emergency, virtual visits have become a key tool utilized in the delivery of care.
One company, CommonSpirit Health at Home, has long recognized the value of telehealth.
Prior to the COVID-19 emergency, CommonSpirit Health at Home had plans to roll out a major telehealth pilot. The public health emergency kicked those plans into high gear, pushing the organization to implement telehealth much sooner.
To learn more, Home Health Care News sat down with Trisha Crissman, COO of CommonSpirit Health at Home’s home care and hospice division, for a recent Disrupt episode. Highlights from the conversation are below, edited for length and clarity.
HHCN: For our listeners who aren’t familiar with CommonSpirit Health at Home, tell us a little bit about the company.
Crissman: CommonSpirit Health at Home has been providing home-based health care for over 40 years through specialized home care, home infusion, hospice and medical transportation services across the country. We’re headquartered in Milford, Ohio, and we’re currently comprised of 70 locations across 13 states and nearly 3,000 employees.
In February 2019, CHI Health at Home transitioned to what we call now CommonSpirit Health at Home, as our two larger parent organizations aligned our ministries to form CommonSpirit Health. As a result of Catholic Health Initiatives and Dignity Health aligning, CommonSpirit Health became the largest nonprofit health care system in the country.
It currently operates more than 700 care sites in 142 hospitals across the country. The combined system has about 150,000 employees, and 25,000 physicians and advanced practice clinicians.
For most home-based care companies, the COVID-19 emergency has become the new normal, so to speak. What is CommonSpirit Health at Home experiencing on the ground, now almost 10 months in?
Patients and families have a heightened — and new — level of expectations for care in their home or their place of residence. We’re really seeing that they have become more accustomed to the role that technology plays in their care, which is refreshing. We’re seeing patients become more involved in their health and safety, and becoming more involved in opportunities to collaborate in their plan of care with providers. I think we’ll see this for quite a long time to come still, but we’re still having a difficult time and experiencing challenges related to accessing patients in congregate living environments.
I would also add that our clinicians are increasingly becoming more comfortable with the use of technology as well, understanding that remote patient monitoring and telehealth visits are powerful tools that can help keep our patients and our employees safe.
I’m really proud of the way that our teams have continued to say “yes” to their calling in this kind of new normal state. I think we’ve gotten beyond a place where we think it’s going to go back to normal. I think we’re kind of resolved that this is a new way of existing, and we’re continuing to lean into what’s happening across our country.
I’d also lastly add, in this new normal, our operators and our clinical leaders are responding more quickly to the day-to-day needs and requirements of the business.
What kind of results have you seen related to your telehealth efforts?
I would start off by saying that our rollout of telehealth solutions was incredibly rapid, but the preparation for it was really long. We’ve known all along, as an organization, that telehealth would be an important offering for the future. Our plan was to walk slowly into telehealth, with a plan to implement over the course of 18 months across all of our locations.
We were planning to do a pilot, work out the kinks over five months — and then COVID hit. So remarkably, my team did a phenomenal job responding. We altered our plan, skipped the pilot completely, and rolled out in 27 markets in literally two weeks.
Throughout this process, we’ve expanded our original inclusion criteria to allow for patients that did not want to have clinicians in their home due to COVID concerns. We’ve seen that we’ve had a really strong adoption of remote patient monitoring by both staff and patients. It’s taken us a little bit longer to adapt to the use of virtual visits. So we did spend a lot of time helping clinicians get comfortable with remote visits. We’re prepared for its kind of increased use as we see this resurgence.
Today, I would share that we’ve done over 3,700 virtual visits and have had 2,700 patients on remote patient monitoring since the beginning of the pandemic. This is just a little bit under a quarter of our overall home health census. From an outcomes standpoint, we’ve been able to decrease our in-person nursing visits and increase capacity to care for other patients — which is an outstanding byproduct.
Outcomes for our remote patient monitoring patients are better than those without remote patient monitoring, even though those patients have a higher acuity level, which is interesting to know. Related to patient satisfaction scores, our telehealth patients are 43% happier than those without telehealth. There’s some sort of ability to feel like you’re in control of your care and your environment.
We are constantly talking about this idea of the “cost of COVID-19.” What would you say has been the 2020 impact of the public health emergency on CommonSpirit Health at Home?
I would say the biggest impact that we have seen, of course, is our lost volume, particularly due to hospitals suspending elective surgeries back in the spring. The biggest impact was in states that did a statewide shutdown. In the states that did county-based shutdowns — for example in the Midwest, like Iowa and Nebraska — we didn’t see a significant impact in volumes as we did in other locations.
From a cost standpoint, we’ve seen increased spending for personal protective equipment (PPE), hazard pay, furloughs, lost productivity and costs due to workers being in quarantine.