Jointly Provided by the University of Virginia School of Medicine, School of Nursing and American Telemedicine Association
Accreditation & Designation Statement
In support of improving patient care, UVA Health Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
UVA Health Continuing Education designates this live activity for a maximum of 12.0 AMA PRA Category 1 Credits.
ANCC CONTACT HOURS
The University of Virginia School of Medicine and School of Nursing awards 12.0 contact hours for nurses who participate in this educational activity and complete the post activity evaluation.
Hours of Participation
UVA Health Continuing Education awards 12.0 hours of participation (consistent with the designated number of AMA PRA Category 1 Credit(s)™ or ANCC contact hours) to a participant who successfully completes this educational activity. UVA Health Continuing Education maintains a record of participation for six (6) years.
MOC II
Successful completion of this CME activity enables the participant to earn MOC points equivalent to the amount of CME credits claimed for the activity for a maximum of 12.0 MOC Part II (ABMS) points.
“Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 12.0 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.”
The views and opinions expressed in these research presentations are those of the speakers and do not necessarily reflect the views or positions of the ATA.
ATA2025 – Research AbstractsOral Presentations
A Decentralized Public Health Model for Substance Use Disorder Treatment via Connected Care
Julio Cespedes Jr., MBA, BS, Sophie Durham, PharmD, Christina Graham, Renia Dotson, MD, FACS, MPH MBA, Jonathan Hubanks, PharmD
Mississippi State Department of Health
Description: The Mississippi State Department of Health provides care statewide in 86 clinics. MSDH implemented universal Substance Use Disorder (SUD) digital screening linked to comprehensive evidence-based SUD medication assisted treatment delivered through remote telehealth providers. Preliminary outcomes indicate the model is as or more effective to similar in-person care, supporting access in treatment deserts.
Abstract: SUDs are alarmingly under-identified and under-treated. Larger cohorts of mild, moderate cases are unidentified and without intervention despite the well-established efficacy of brief screening, motivational, and treatment methods (i.e., Screening, Brief Intervention, and Referral to Treatment, SBIRT) conducive to implementation in medical clinics. The Mississippi State Department of Health (MSDH) reported an estimated 564,490 people over age 18 needed SUD treatment, but 70/82 counties are geographic mental health shortage areas, seventh in nation in mental health care deserts. MSDH designed an identification-to-treatment care pathway using EHR digital health tools and integrated telehealth capabilities. Patients receiving care for any reason at all 86 MSDH clinics are screened for SUD. Scores are automatically risk stratified and generate EHR messages directing clinical teams to appropriate score-based interventions. Nearly 1% of the state’s population was screened for SUD. Abstinence from alcohol or illegal drugs improved by 58.3% in treatment via telehealth in 48 different clinics representing 47/82 unique counties in the state. Connected care enabled decentralized addiction medicine treatment to the entirety of Mississippi via a limited clinical workforce. Preliminary treatment outcomes and comparative measures indicate the model is as or more effective to similar in-person care.
Classification of Research: Clinical Effectiveness
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: Abstinence from alcohol or illegal drugs improved by 58.3% for MSDH patients at 6 month follow up compared to national average improvement of 38.7%. Mental health outcomes included a 30.8% reduction in depression; a 6.7% reduction in anxiety; a 45.5% reduction in trouble understanding, concentrating, or remembering; and a 50% reduction in trouble controlling violent behavior. 0% of patients were using opioids or other stimulants compared to 25% and 12.5% respectively at intake. Other drug use outcomes included a 40% reduction in alcohol use and a 50% reduction in cannabis use.
Conclusions: A significant population of Mississippians have alcohol and drug use patterns with risk of negative health and psychosocial outcomes. SBIRT can be operationally difficult to implement, but the MSDH technology-enabled SBIRT screening model is notable as all care is fully integrated into existing clinic care delivery pathways. Technology ensures fidelity for the entire SBIRT procedure and monitors each care step across a state-wide network of clinics. Connected care enabled decentralized addiction medicine treatment to the entirety of Mississippi via a limited clinical workforce. Preliminary treatment outcomes and comparative measures indicate the model is as or more effective to similar in-person care.
Advancing Pediatric Care: Developing an Integrated EHR RPM Solution for Improved Patient Experience and Outcomes
Description: We've enhanced our strategies for implementing and scaling pediatric Remote Patient Monitoring (RPM) through a unified care team and patient experience. Creating and implementing a comprehensive RPM solution integrated with Boston Children’s electronic health record (EHR) enhances care quality, streamlines workflows for the care team, and improves the patient experience.
Abstract: Previous research has highlighted system-level challenges hospitals face when not having a centralized, operational team to implement and scale RPM programs. As a pioneer pediatric institution deploying RPM, this case study describes a standardized framework for implementing and scaling pediatric RPM enterprise-wide. Through this structured approach, we can enhance clinical and patient workflows and reduce the time it takes to launch new programs. To achieve financially sustainable, equitable, and scalable RPM programs, we first needed a unified process for integrating connected devices that capture physiologic data (e.g., weight, blood pressure, spirometry) with the hospital's EHR. Leveraging a device partner for infrastructure to support device logistics, management, and data integration, we can ensure that patients and care teams stay within the hospital's EHR ecosystem. This design creates a consistent end-user experience, improving buy-in and adoption. Measurable outcomes include reduced hospital utilization through shorter lengths of stay, reduction of readmissions & ED visits pre-RPM/post-RPM support.
Classification of Research: Measurement Framework & Tools
Classification of Research – Other:
Method: Descriptive
Method- Other: Case Study
Results: Developing a standardized RPM implementation framework that enhances workflows and reduces the time to launch through a unified process, we have identified at least a threefold increase in use case viability. Launching first with our cardiac nutrition program, measurable outcomes described in this case study include reduced hospital utilization through shorter lengths of stay, reduced readmissions, and fewer ED visits pre-RPM/post-RPM support. An additional five clinical programs are on the roadmap for future implementations.
Conclusions: The implementation framework we designed enables us to adapt quickly to various pediatric settings, significantly reducing the time required to implement and scale RPM programs. While this case study highlights the effectiveness of standardizing the implementation process, it also identifies opportunities and challenges for future consideration that could enhance our program offerings. To lessen the administrative burden before enrolling patients in the RPM program, we plan to explore and test artificial intelligence capabilities for obtaining insurance prior authorization for RPM services.
An Implementation Science Perspective on Primary Care Providers’ Telehealth Utilization
Whitney Garney, Kristen Garcia, Kala Reindel, Rachana Talekar, Sara Kent, Trey Armstrong, Carly McCord, Rae Adams
Texas A&M University
Description: A mixed methods implementation science study assessed telehealth utilization among primary care providers. Providers rated telehealth as useful and acceptable. They considered technology reliability and lack of formal training to be deterrents to utilization and believed telehealth was helpful for some visit types, but not equivalent to in-person care.
Abstract: Purpose: The Telehealth Institute at Texas A&M Health Science Center (TAMHSC) conducted an implementation science study to understand utilization telehealth in primary care. Methods: A mixed methods study using the Consolidated Framework for Implementation Science and Telehealth Usability Questionnaire assessed telehealth utilization among providers in three TAMHSC clinics using an online survey (n=40) and follow-up interviews (n=6) Results: Survey results showed that most providers reported utilizing telehealth for patient care. Most providers agreed or strongly agreed that telehealth was useful to improve access and save travel time. They reported satisfaction with telehealth for patient acceptability, continued use, and comfort. However, providers were less confident in reliability of technologies and didn’t believe that telehealth was equivalent to face-to-face visits. Providers reported limited formal telehealth training. In interviews, providers said telehealth was most appropriate for acute issues, chronic disease management, behavioral health, and follow-up care. They were not comfortable using telehealth for physicals, urgent care, or with special populations like children or older adults due to environmental or social aspects that influence a patient’s condition. Providers identified equity issues among patients with limited broadband access or low technology literacy. Providers suggested creating protocols, continuing education, or workshops to increase confidence with technology.
Classification of Research: Clinician Experience
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: The highest ranked telehealth domains were usefulness and acceptability. Providers had mixed feelings about reliability of telehealth technology, and didn’t believe that telehealth was equivalent to face-to-face visits. Interviewees said telehealth was most appropriate for acute issues, chronic disease management, behavioral health, and follow-up care. They weren’t comfortable using telehealth for physicals, urgent care, or with special populations like children and older adults. Providers noted equity issues for rural patients with limited broadband access or low technology literacy. Only half of providers had formal telehealth training. They suggested providing protocols, continuing education, or workshops to increase confidence with telehealth platforms.
Conclusions: Telehealth is a relevant, useful tool to expand access to primary care. However, telehealth technologies and training need to be improved in order for primary care providers to expand utilization. Specifically, telehealth platforms must be improved to assess the whole patient, which would allow providers to understand environmental and social attributes to care which aren’t easily captured with current technology. Further exploration into how to best use telehealth for special populations like children and older adults is required. Structural issues like broadband access and health technology literacy must be addressed to improve equity in the provision of telehealth services.
Bridging the Gap in Standardized Telehealth Integration for Chronic Cardiac Care: AHA Pilot Initiative for Quality Metric Development
Sruthi Cherkur, Carly Beastrom, Gary Myers
American Heart Association
Description: There is a gap in clinical guidance for the integration of telehealth for management of chronic cardiac diseases. The American Heart Association (AHA) seeks to bridge this gap through a pilot quality metric testing initiative with a cohort of 31 outpatient clinics to contribute to the development of quality standards.
Abstract: Following growth in response to COVID-19, telehealth is increasingly utilized to care for diseases not traditionally managed virtually. This rapid expansion, while increasing access to care, has resulted in significant variation in care delivery in part due to lack of clinical guidance on appropriate integration of telehealth. This demonstrates a need for evidence-based quality recommendations for the consistent delivery of high-quality telehealth care. The AHA aims to address this through an initiative to pilot quality metrics across 31 outpatient clinics delivering telehealth to chronic cardiac disease patients. These metrics are rooted in the Four Domain Model of Virtual Care and Value framework, spanning Equity, Economic, Experiential, and Functional domains.1 This framework is critical for measuring quality and standardization. Quarterly data gathered from participating clinics will be assessed for data trends, clinical value, and feasibility and iteratively refined through clinic feedback to establish a final set of metrics. Additionally, participating clinics will gather regularly as a cohort to discuss common challenges as they navigate this data collection process and share improvement strategies. Insights from this pilot metric testing will lead to the development of much needed standards along with valuable implementation use cases to benefit the field.
Classification of Research: Measurement Frameworks & Tools
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: With pilot metric development completed in Q3 2024, data collection infrastructure will be built within the AHA’s Quality Certification Tool Platform in Q4 2024. Clinics report quarterly data beginning in Q1 2025. Pilot metrics include % of accepted telehealth visits, % of telehealth visits including preparatory resources, % completed telehealth visits, % of satisfaction questionnaires provided, and % of patients reporting satisfaction with telehealth. Disease-specific metrics include assessing blood pressure and blood glucose control rates, LDL-C target levels, and statin and beta blocker adherence for in-person visits only versus those with at least one telehealth touchpoint.
Conclusions: Data from this metric testing environment will provide valuable insights into current telehealth integration and opportunities for standardization. Additionally, leveraging this data within the initiative’s learning collaborative environment will support productive engagement in solving for common challenges and developing quality improvement solutions. These solutions will serve as important use cases for other outpatient clinics seeking to better standardize their virtual care delivery models for these diseases, benefiting the field as a whole. Furthermore, this pilot metric testing process and data collection environment could serve as a blueprint for future AHA initiatives aiming to test metrics within a learning collaborative.
1Demaerschalk BM, Hollander JE, Krupinski E, et al. Quality Frameworks for Virtual Care: Expert Panel Recommendations. Mayo Clin Proc Innov Qual Outcomes. 2022;7(1):31-44. doi:10.1016/j.mayocpiqo.2022.12.001
Building Foundational Telemedicine Skills: A Core Training Curriculum for Graduate Medical Learners
1Weill Cornell Medicine, New York-Presbyterian Hospital and 2New York-Presbyterian Hospital, Columbia University Irving Medical Center
Description: We describe the development of a novel curriculum in telemedicine fundamentals geared to the needs of physician graduate medical learners that is being implemented in a large hospital system. Course content, structure, and learner assessment of both the course itself and of their changing telemedicine knowledge are discussed.
Abstract: Telemedicine has become part of standard medical care. Although the medical principles remain the same, a unique skill set is required for this type of care. Graduate Medical Education (GME) programs generally lack formalized training in telemedicine competencies, a disservice to GME learners. We describe a novel telemedicine training program for residents from all specialties reflective of American Association of Medical Colleges (AAMC) and Accreditation Council for Graduate Medical Education (ACGME) recommendations. The program was created to train residents in a 2,600 bed, 7 hospital system. Learners spanned all specialties, primarily in GME year 1 or 2. The course was taught by faculty who practice telemedicine care. Part 1 of the course contained 5 asynchronous modules teaching essential telemedicine skills. Part 2 was conducted in person and consisted of two standardized patient encounters each followed by a faculty-lead group debrief using the PEARLS (scene setting, reactions, description, analysis and application) method. Content was specialty agnostic. While on site for simulated encounters, QR coded digital posters helped learners physically navigate and linked content from the asynchronous modules to the simulated cases. Pre and post survey questionaries were completed with assurances that no grading or administrative response would be linked to answers.
Classification of Research:
Classification of Research – Other: Education
Method: Observational
Method- Other:
Results: There were 277 participants in the initial iteration, 90% in GME year 1 or 2. Surveys used a 5-part confidence measure from “not at all confident” to “very confident”. Pre and post surveys were completed by 161 participants, 92.5% and 98.8% respectively reported part 1 and part 2 helpful. In-person sessions were reported valuable for history-taking and physical examination by 96.9% of respondents. Confidence improved across the majority of questions but remained consistent in constructing a professional visit environment and obtaining medical history, with a decrease in extreme confidence. All course quality measures received a greater than 80% positive response.
Conclusions: This work has several limitations. Our course was designed for first-year residents, but including residents from other years may have influenced our findings. We report here pooled survey responses; in future work we hope to link pre and post survey responses for individual learners. We are intrigued by the difference in levels of confidence between competencies. We are evaluating how this should affect future course refinements and wonder if at least in some cases, learners' confidence levels may diminish as their knowledge about the intricacies of telemedicine increases.
Can eConsults reduce commercial health spending?
Sarah Berk, Mairin Mancino, Caroline Pearson
Peterson Center on Healthcare
Description: eConsults enable timely communication between clinicians and specialists, improving access, lowering costs, and enhancing care quality. A pilot by the Peterson Center on Healthcare and ARBCBS demonstrated $195 monthly savings per patient but highlighted low adoption. Lessons from this initiative can guide broader eConsult implementation in commercial insurance settings.
Abstract: Arkansas was chosen for the pilot due to its rural nature, specialist access challenges, and experience in CMS primary care transformation programs. Partnering with Arkansas BlueCross BlueShield ensured access to commercially insured patients across participating primary care sites. The pilot included eight independent physician groups and 19 health system practices, providing seed funding for eConsult training and integration into workflows. Reimbursement was offered to both primary care and specialty providers to encourage participation. Independent practices received $40 per eConsult for primary care physicians (PCPs), while health system physicians earned 0.5 relative value units (RVUs) per eConsult for both requesting PCPs and responding specialists. This RVU credit ensured the activity met productivity standards within the health system. The funding and reimbursement structure aimed to promote adoption of eConsults, address barriers to integration, and optimize care delivery in underserved areas. Lessons from this pilot highlight the importance of tailored incentives and workflow integration to encourage eConsult utilization and improve access to specialist expertise in rural, commercially insured populations.
Classification of Research: Cost Analyses
Classification of Research – Other:
Method: Cost Analysis
Method- Other:
Results: The evaluation showed that eConsults reduced costs by an average of $195 per patient compared to those without an eConsult. Savings were driven by lower specialty care costs, with eConsults costing $50 versus $159-$419 for in-person visits. Patients who received an eConsult saved $184 on specialty visits. Emergency department visits were similar across both groups, indicating eConsults did not impact access or increase adverse events. These results align with findings from other studies.
Conclusions: The Arkansas eConsult pilot highlighted challenges in adoption, with two independent practices driving most utilization. Strong leadership buy-in and engagement at these practices emphasized eConsults' value in enhancing patient care. Leaders also set usage targets and monitored progress. The pilot demonstrated eConsults’ potential to reduce costs without compromising quality, offering insights into opportunities and challenges for deploying promising technologies to improve health care system efficiency and affordability.
Clinician and health care staff perspectives on digital navigation and coaching for patients
Manuel Rebol, Sara Belay, Akshay Krishnan, Camille Jefferson, Neal Sikka, Colton Hood
George Washington University
Description: Digital health literacy (DHL) involves having the knowledge and confidence to find, understand, and use online health information to make informed decisions. Low DHL leads to poor patient health outcomes and increased health care costs. Our study aimed to better understand clinician perspectives on improving DHL during patient encounters.
Abstracts: Clinicians face the daily challenge of addressing the complex clinical and social needs of their patients. DHL is an invaluable tool for empowering patients to navigate community-based, social, and clinical resources as well to be more engaged in their help, especially through effective use of their patient portal. To holistically serve patients, clinicians can share knowledge about digital health resources (DHR). Marked as a “super social determinant of health”, DHL allows patients to learn how to find reliable health information, communicate with providers, schedule appointments, and become more engaged in medical management with effects that last beyond the visit. Our purpose was to gauge the current digital literacy of clinicians and staff, to understand barriers to helping patients with DHL, and to improve their ability to provide brief coaching interventions. After IRB approval, we recruited clinicians and staff to complete a survey on DHL. Participants completed a baseline validated eHealth Literacy Scale (eHEALS) instrument and our 5-question Mobile Phone Patient Assistance Questionnaire (MPPAQ). After 6 months, they watched 3 self-selected videos on patient portals and digital skills before retaking the MPPAQ. Participants received a $10 gift card incentive for completion.
Classification of Research: Clinician Experience
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: We recruited 197 participants from an urban Academic Medical Center (125) and local FQHC (63) (188 completed the presurvey, age: μ=40.4, σ=12.9; 53 male, 135 female). 179 participants completed the baseline eHEALS assessment of which 97% exceeded the threshold score of 26 on the 40-point scale, indicating high DHL. 67 participants (age: μ=38.9, σ=12.5) completed a 1 year follow up by watching DHL educational videos. After watching, participants felt significantly (p<0.05, for all 5 MPPAQ questions) more comfortable in assisting patients with their smartphones. 80% (49/61) of participants believe that a dedicated resource is key to improving DHL.
Conclusions: A brief educational intervention using DHL videos can help clinicians and staff feel better equipped to assist patients with DHL during their visit. Participants had high eHEALS scores, but training may still be needed to boost their confidence in helping patients. Additionally, 80% supported the idea of a dedicated resource, highlighting the challenge of balancing coaching with patient care. The expansion of DHC can render a clinic visit as an opportunity for patients to leave more engaged in their own health. Currently, our team is implementing and evaluating the use of dedicated digital health coaches in various clinical environments. Research funded by Qualcomm Wireless Reach.
Concept Analysis of Health Equity: Implications for Telehealth and Reducing Healthcare Disparities in Nigeria
Charles Umeh
University of South Florida
Description: This study analyzes the concept of health equity, focusing on its role in addressing health care disparities through telehealth in Nigeria. Using the Social Determinants of Health framework, it explores how telehealth can bridge gaps between rural and urban areas, while addressing challenges like internet access and digital literacy.
Abstract: Purpose: This study investigates the concept of health equity in relation to telehealth interventions in Nigeria. It aims to reduce health care disparities between rural and urban populations by exploring how telehealth can improve access while addressing challenges like internet access, digital literacy, and cultural competence. Methods: Using a concept analysis approach, the study distinguishes health equity from related terms like health equality and social justice. The Social Determinants of Health (SDOH) framework is employed to identify key factors influencing health outcomes, such as economic stability, education, health care access, and the built environment. The analysis synthesizes findings from relevant literature on telehealth and health care disparities. Results: The study finds that telehealth can help bridge health care gaps, especially in underserved communities. However, it also highlights the risk of reinforcing existing inequalities if telehealth programs are not adapted to the needs of vulnerable populations. Tailored solutions are essential to ensure inclusivity. Conclusion: This concept analysis provides a framework for designing telehealth interventions that promote health equity. Through addressing technological, educational, and cultural barriers, telehealth can be an effective tool for improving health care access in Nigeria’s rural and urban regions, ensuring equitable outcomes for all.
Classification of Research:
Classification of Research – Other: Conceptual analysis
Method:
Method- Other: Concept Analysis
Results: The study emphasizes that achieving health equity in Nigeria is critical, particularly in bridging the gap between rural and urban health care access. It highlights that rural populations often face significant barriers, including lower health literacy and lack of infrastructure, which exacerbate health care disparities. Research indicates that telehealth can increase access to services, with a notable potential for improvement if barriers such as digital literacy and internet accessibility are addressed. It further reveals that interventions tailored to the unique needs of disadvantaged populations can enhance health outcomes, promoting equitable health care access across diverse socio-economic contexts.
Conclusions: The study concludes that promoting health equity through telehealth is essential for reducing health care disparities in Nigeria, particularly between rural and urban areas. It underscores the necessity of tailoring telehealth interventions to address the unique barriers faced by disadvantaged populations, ensuring equitable access to health care. The findings are relevant for nursing and public health, highlighting the role of social determinants in health outcomes. Further research is needed to explore effective strategies for implementing and evaluating telehealth programs, focusing on community engagement and addressing infrastructure challenges to enhance health equity and improve overall health outcomes in underserved populations.
Cost-Effectiveness Analysis of Telehealth and In-Person Primary Care Visits for People Living with Alzheimer’s Disease-Related Disorders in the State of Nevada
Yonsu Kim,1 Jay J Shen,1 Ian Choe,2 Jerry Reeves,3 David Byun,4 Lulia Ioanitoaia-Chaudhry,5 Leora Frimer,6 Pengfeng Jin,6 Maryam Tabrizi,6 Hee-Taik Kang,7 Jae Woo Lee, 8 Claire Sieun Lee,9 Tae-Ha Chung,10 Yena Hwang,11 Ian Park,11 Hayden Leung,12 Jenna Park,12, Ji Won Yoo12
1School of Public Health, University of Nevada, Las Vegas, Nevada; 2Optum West, United Health Group, Las Vegas, Nevada; 3Comagine Health, Las Vegas, Nevada; 4Department of Medicine, William Bee Ririe Hospital, Ely, Nevada; 5Geriatric Education Center, Veterans Affairs, North Las Vegas, Nevada; 6Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada School of Medicine, Las Vegas, Nevada; 7Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, S. Korea; 8Department of Family Medicine, College of Medicine, Chungbuk National University Hospital, Cheongju, S. Korea; 9Department of Internal Medicine, School of Medicine at University of Nevada, Las Vegas, Nevada; 10Department of Family Medicine, Yonsei University, Wonju College of Medicine, Wonju, S Korea; 11Department of Medicine, University of Nevada School of Medicine, Las Vegas, Nevada; and 12Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, Nevada
Description: The aim of this study is to compare the cost effectiveness of primary care delivery in person versus via telehealth for those patients living with ADRD (Alzheimer-Disease Related Disorders) in the State of Nevada.
Abstract: The State of Nevada is considered a provider shortage area (192.6 per 100,000 residents vs. the U.S. average of 232). Compounding the provider shortage is the aging population and the attendant care burden especially for Alzheimer's Disease R Dementia (ADRD). Telehealth has been proposed and examined as one solution, due to its time-conserving characteristics for providers, support staff, patients, and caregivers alike. Using claims data, we have identified 91 telehealth patients with ADRD with demographically matched control patients with ADRD who were seen only in in-person settings. ER visits and hospitalization rates for both groups were analyzed, which show the mean annual rates of ER visits and hospitalizations for the telehealth group are 1.52 and 1.22, whereas those for the in-person group were 2.24 and 2.71, respectively. Additionally, Incremental Cost-Effectiveness Ratio (ICER) of teleheath visits was estimated for different demographic subgroups, based on the cost of travel and attendant loss of labor productivity loss during travel time for caregivers. The results shows the highest cost saving for those living with ADRD in rural areas (USD 320.93) versus urban residents (USD 19.35), suggesting the marked difference between rural and urban settings for the care burden associated with ADRD patients.
Classification of Research: Cost Analyses
Classification of Research – Other:
Method: Cost Analysis
Method- Other:
Results: The results show the mean annual rates of ER visits and hospitalizations for the telehealth group are 1.52 and 1.22, whereas those for the in-person group were 2.24 and 2.71, respectively. Incremental Cost-Effectiveness Ratio (ICER) of teleheath visits was estimated for different demographic subgroups, which demonstrate the highest cost saving for those living with ADRD in rural areas (USD 320.93) versus urban residents (USD 19.35), reflecting the cost of travel and attendant travel time equating loss of labor productivity for caregivers.
Conclusions: Cost effective analysis demonstrates telehealth can be effective in reducing costs associated with travel and attendant productivity loss for caregivers for those patients with Alzheimer's Disease Related Disorders living in rural settings.
Enhancing Telehealth through Patient-Centered Insights: A Collaborative Approach Leveraging National Research Council Survey (NRC) results to Improve Standardized Care
Laura Kimmich, Emily St Germain, Brianna Lotze
U.C. San Diego Health
Description: Telehealth has become an increasingly popular mode of health care delivery. Patient satisfaction and likelihood to recommend telehealth services have declined in our institution from 86.6% in 2023 to 84.2% in 2024. Our purpose was to leverage NRC surveys to identify areas of opportunity to improve patient experience for Ambulatory Telehealth.
Abstract: The usual Telehealth surveys is limited to two questions, but with the collaboration of our Patient Experience Team, and by leveraging NRC opt-in patients, we launched a focused survey asking on telehealth experience questions and we welcomed additional feedback. We utilized the NRC subset of UC San Diego Health (UCSDH) patients who have opted into additional experience surveys to ask about several themes related to communication around telehealth visits. Out of 1,818 respondents, 36% reported receiving a pre-visit phone call to prepare them for the visit. 7% of respondents indicated they were never informed of a delay. Of those who received the call, 81% rated the phone call extremely or very helpful. We also identified that a variety of modes are being used to inform patients of delays, such as: text messaging, phone call, and electronic medical record messaging.
Classification of Research: Patient Experience.
Classification of Research – Other: Clinical Effectiveness and Quality Improvement
Method: Survey/Qualitative
Method- Other:
Results: Our analysis revealed several improvement opportunities, such as pre-appointment preparation and communication platforms patients prefer. Currently, staff members make several calls throughout the day to communicate with patients, and most calls are not answered, indicating that there may be more effective ways to communicate. The survey also revealed that we should add all available communication options to our standard work for staff should one type of attempt fail. We also identified that the variety of modes used to contact patients also made it less likely for them to pick up if not informed by staff prior to appointment.
Conclusions: By leveraging NRC survey data, we gathered direct patient feedback that will support changes made to continue to enhance patient experience. Continued collaboration with the Patient Experience Team is crucial in identifying opportunities for improving Patients’ experience with ambulatory telehealth. Next steps including implementation of more robust standard work based on the above findings in the coming months.
Exploring Telemedicine Integration in ART Clinics in Lusaka, Zambia: Insights, Reflections, and Shared Experiences
Amanda Moonga,1 Morgan Chabala,1 Dr. Wilson Mbewe,2 Bella Siangonya,3 Nikita Toppin Dera,3 Joseph Daka,1 Dr. Dominic Mack3
1Morehouse School of Medicine, Lusaka, Zambia; 2 Ministry of Health, Kanyama First Level Hospital, Lusaka, Zambia; and 3Morehouse School of Medicine, National Center for Primary Healthcare, Atlanta, Georgia
Description: As the global health care landscape evolves, the integration of telemedicine into Antiretroviral Therapy (ART) clinics stands as a progressive initiative aimed at enhancing accessibility and effectiveness in the delivery of ART services. Morehouse School of Medicine (MSM) implements a hub and spoke model within ART clinics in Lusaka, Zambia.
Abstracts: As the global health care landscape evolves, the integration of telemedicine into ART clinics stands as a progressive initiative aimed at enhancing accessibility and effectiveness in the delivery of ART services. MSM implements a hub and spoke model within ART clinics in Lusaka: Chawama, Chilenje, Kanyama, and Matero including University Teaching Hospital. MSM, in collaboration with local partners and MOH, initiated a telemedicine program in June 2021, across one tertiary hospital, four hubs and 13 spoke sites in Lusaka subdistricts. Selection of spoke sites and services was done through analysis of Ministry of health (MOH) information system reports and other factors such as Technology infrastructure, electricity availability and road network reliability. Since inception until December 2023, has served 7000+ recipients of care with a remarkable 5% missed appointment below the 10% national target.
Classification of Research: Clinical Outcomes
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: Services selected to be offered via telemedicine have proven to have improved patient outcomes as compared to in-person facility visits. The program successfully integrated telemedicine by overcoming challenges with technological infrastructure and electrical availability through collaborating with local contractors and mobile network providers. Another challenge encountered was low digital literacy among health care providers and RoCs, and concerns related to data security and patient confidentiality. The program trained 80+ health care providers and 30 support staff through 400+ mentorships, building more competent and reliable teams including buy-in from key stakeholders.
Conclusions: The insights highlight the benefits of collaborative efforts in the integration of Telemedicine in the ART clinic including the role of data in streamlining the programs focus areas. These experiences provide valuable lessons for practitioners, policymakers, and researchers, in the integration of telemedicine in ART Clinics and showcasing telemedicine's potential in bridging health care gaps and advancing digital technology in HIV care.
Extending and Sustaining Neonatal Critical Care: A Dedicated Full-Time TeleNeo Critical Care Program’s Success
Stephen Minton MD,1,2 Erin Zinkhan, MD,1,2 Stevie Rowe, MD,1 Rosemary Valencia, MSN,1 Michelle Halgren, MHA,1 Jason Cox, MHA,1 Julie Martinez, MSN,1 Nicholas Carr, DO,1,2 Elizabeth O’Brien, MD,1,2
1Intermountain Health and 2University of Utah
Description: This study assesses the growth of the TeleNeo Critical Care (TNCC) service, expanded in 2022 to reduce in-unit demands and improve neonatal care access. Over two years, TNCC call volume grew by 118%, with sustained rapid response times and effective transfer prevention for complex cases, despite expanded support services offered.
Abstract: In 2022, the TNCC program was launched to enhance neonatal telehealth by reducing connection times, minimizing transfers, and increasing support across approximately 70 delivery sites. This study evaluates the sustainment and growth of the TNCC program over two years. Key metrics—call volume, urgency, connection times, nursery level, patient disposition, and level of care required—were tracked. To determine whether a case was classified as standard of care or complex care, we developed an algorithm for TNCC cases that help us determine transport avoided. Complex cases were defined by multiple TNCC consults, increased respiratory support, or IV access. Median LOS was evaluated as a balance measure.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: TNCC supported 895 patients in year one and 1,029 in year two. Emergent resuscitation accounted for 603 calls (23%); 481 calls (18%) involved transport facilitation. Connection times for emergency cases were unchanged. Additionally, 25% of cases required complex care managed by TNCC, preventing transfers. For facilities without a NICU, the median length of stay was 11 hours longer for complex consults, yet transport to higher levels of care was avoided. The TNCC program demonstrated substantial growth and maintained high service quality across its expanded network.
Conclusions: The TNCC program achieved substantial growth in its second year, maintaining efficient connection times, reducing telehealth burdens on in-unit neonatologists, and providing comprehensive support across an expanded network of sites. The successful scale-up in year two indicates that further expansion of TNCC can be pursued while sustaining quality and operational efficiency.
Implementation of a Tele-critical Care Program in Two Rural Mississippi Hospitals
Center for Telehealth, University of Mississippi Medical Center
Description: Rural hospitals in Mississippi are essential for providing health care to underserved communities but face significant challenges, including limited access to specialized care, lower patient volumes, and financial constraints. Here we present a Tele-critical Care Program provided remotely to support two rural Mississippi hospitals.
Abstract: Limited access to specialized care, such as critical care, can result in delays for critically ill patients at rural hospitals, worsening outcomes and straining local health care systems. Tele-critical care (Tele-ICU) addresses these challenges by connecting rural hospitals with critical care specialists through remote monitoring and communication technologies, allowing intensivists to support local physicians and improve patient care. Despite being in use for over two decades, Tele-ICUs are more common in urban hospitals, with rural hospitals, particularly in the South, having lower adoption rates. To address this gap, we developed and implemented a Tele-Critical Care Program (TCCP) in two rural hospitals in Mississippi. These hospitals were chosen based on a needs assessment and strong support from hospital administration, nursing, and providers. Critical care physicians, licensed in Mississippi, provided virtual support via EMR access and an external vendor portal connected to mobile carts. Workflow adjustments were made for remote rounding in the Emergency Department and Med/Surg units. From November 2023 to October 2024, one hospital received 227 consults, while the second received 248 consults from March to October 2024.
Classification of Research: Access to Care
Classification of Research – Other:
Method:
Method- Other: Financial outcomes
Results: Financial analysis at two hospitals revealed that from November 2023 to May 2024, the TCCP generated a $278,821 financial impact for one rural hospital. The key benefit was keeping patients local and utilizing the swing-bed unit, increasing length of stay by 3 days. From April to August 2024, the TCCP had a $366,548 impact at another rural hospital, a referral center, which saw a 68% retention rate of patients locally, increasing reimbursement capture.
Conclusions: Implementing a TCCP in rural hospitals can significantly enhance local health care providers' ability to deliver high-quality care. By enabling real-time expert support, the program reduces unnecessary transfers, optimizes care, and improves clinical outcomes for rural and underserved patients. As demonstrated, the TCCP is also a cost-effective model for extending specialized care to rural populations, ensuring health care systems can meet growing community needs. The program can be scaled to other Health Professional Shortage Areas, further addressing the health care disparity on a broader level.
Mayo Clinic Center for Digital Health Case Study: Development of a Post Acute Medical Remote Monitoring (RPM)
Angela Leuenberger, Ali Marty Rodningen, RPM, RN
Mayo Clinic
Description: Mayo Clinic Center for Digital Health Case Study: Development of a Post Acute Medical Remote Monitoring (RPM) program to provide transitional care for patients after hospitalization, regardless of diagnosis. This program was designed by partnering clinical remote monitoring nurse expertise with business process knowledge.
Abstract: RPM programs have traditionally targeted specific diagnoses, limiting accessibility for diverse patient populations. This Post-Acute Medical RPM Program shifts to an inclusive, diagnosis-agnostic model, enhancing the continuity of care from hospitalization to primary care. Designed for a broad range of patients, this program provides tailored support over 7–14 days, focusing on symptom management and vital sign monitoring to promote recovery and prevent readmissions. Patients complete digital symptom assessments and vital sign monitoring, with frequency tapering as they progress. Key to the program’s success is the 24/7 availability of registered nurses, who provide timely assessments and coordinate care as needed. This model ensures patients receive immediate support, fostering confidence in managing their health and connecting them seamlessly with their primary care team. By removing diagnosis-specific restrictions, this program widens access, promoting equity and inclusion in transitional care. It addresses the critical post-hospitalization period, empowering patients to achieve stability and self-management while reducing health care utilization and system burden. This case study describes how clinical remote patient monitoring nursing partnered with business process team to create a general pathway to monitor patients post hospital discharge.
Classification of Research: Measurement Frameworks & Tools
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: This Post-Acute Medical RPM Program is still in its early phases of implementation across site and regional practices. It has supported 15 patients to date, with 0% of those patients experiencing a hospital readmission. Patient satisfaction scores were high, with 95% of participants reporting they felt safe on the program. Nurses identified and addressed acute concerns in xx% of cases, effectively preventing adverse outcomes.
Conclusions: A diagnosis-agnostic Post-Acute Medical RPM Program enhances transitional care by providing vital sign and symptom management and timely support. The program empowers patients while decreasing health care utilization and promoting recovery. It addresses gaps in post-hospital care, ensuring accessibility and equity for diverse patient populations, and demonstrates a sustainable, scalable model for improving outcomes across health systems.
More than Just a Video Call: The Secret Ingredients of Tele-SNF Success
Brittany Armstrong, Leeva Matthew, Bryan McCarty, Radhika Malhotra, Jonathan Berkowitz, Melissa Hatcher, Pablo Duque Posso
Northwell Health
Description: This study examines the critical success factors of Northwell Health’s Tele-SNF program through a comparison of emergency department admission rates before and after process improvement interventions. These interventions emphasized the importance of team building, partnerships, staff education, and early intervention over specific physician consulting models to advance effective virtual patient care.
Abstract: The care models for telehealth in skilled nursing facilities (SNFs) vary across programs. The Northwell Emergency Telehealth Services' (NETS) Tele-SNF program is a telehealth program staffed with Emergency Medicine physicians. The model focuses on collaboration with the bedside nurse to effectively evaluate and treat the patient. Our study challenges the notion that effective Tele-SNF care is determined only by the model. Instead, we posit that program efficacy hinges on a comprehensive approach, focusing on process improvement, quality reviews of each case, strong SNF partnerships, and targeted staff education. In September 2023, NETS assumed care of the virtual SNF program from an e-ICU service at Orzac Center for Rehabilitation. Recognizing the opportunity for improvement, our team implemented a comprehensive education program for the Orzac nursing staff. This program included: In-service training on Tele-SNF consultation, explaining program operations and consultation request procedures. Simulation exercises involving role-playing patient encounters and physical exam training. Medical education sessions, with a focus on sepsis awareness, discussing early warning signs and timely interventions. This education was delivered through a series of in-person visits and video calls with leadership and frontline clinical team. We also used this opportunity to understand their workflows and adjust our processes accordingly.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Observational
Method- Other:
Results: Following the transition from an ICU physician providing care to an Emergency Medicine physician, we observed a rise in ED admissions after one year. However, after introducing targeted staff education on early warning signs and appropriate telehealth utilization, informed by quality reviews completed by an internal medicine physician. The ED admission rates dropped significantly from 35% to 20%.
Conclusions: Our findings suggest that the success of virtual SNF programs is multifaceted, extending beyond the mere provision of remote physician consultations. Key elements include building a cohesive telehealth team with a focus on quality and process improvement, fostering strong partnerships with SNF leadership and staff, implementing comprehensive staff education programs, and emphasizing early intervention protocols. These factors collectively contribute to reduced ED admissions and improved patient care within the SNF setting. This research underscores the importance of a holistic approach to virtual SNF care, providing valuable insights for health care organizations seeking to optimize their telehealth initiatives in long-term care environments.
Musculoskeletal Physicians and Physical Therapists Evaluating Patients in the Same Virtual Visit: Survey Study Shows High Patient Satisfaction, Engagement, and Health Literacy
Mary I. O’Connor, MD, Carolyn Chudy, DO, Kaitlyn Cooney Peters, NP, Megan Ribaudo, LCSW, Carrie McCulloch, MD, Jared Aguilar, DPT, Trista Taylor, MPA, Ryan A. Grant, MD, MS, MBA
Vori Health
Description: Survey research on patients' experiences with an innovative telemedicine model in which both an musculoskeletal (MSK) Physician/Nurse Practitioner and Physical Therapist evaluate patients in the same virtual visit shows high levels of patient satisfaction with 92% of patients reporting high levels of understanding their medical condition and treatment (health literacy).
Abstract: Patients undergoing evaluation for MSK concerns are often seen by a physician and physical therapist in the in-person setting in a sequential manner. This process typically delays the onset of physical therapy treatment and creates the risk of inadequate clinical collaboration between physician and physical therapist. To address these issues, we redesigned our initial patient evaluation to a group visit with both a specialty trained musculoskeletal physician and physical therapist together with the patient in the virtual encounter (“MD+ PT visit”). Objective: To gain insights from patients on their experience with this innovative virtual MD + PT visit format for initial evaluation of musculoskeletal concerns. Methods: An electronic 7-question survey was sent to 750 patients who completed an MD+PT visit asking them to comment on prior MSK evaluations and their experience with the MD+PT format.
Classification of Research: Patient Experience
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: 195 patients (26%) responded to the survey. Most patients had prior MSK experience with a physician or nurse practitioner (88%) or physical therapist (76%) with nearly all such encounters in the in-person setting. Only 3% reported a prior MD+PT visit. Patients agreed that the MD+PT virtual evaluation saved them time (93%) and permitted them to promptly start their treatment plan (91%). Overall, 87.5% rated the MD+PT visit as enjoyable and 92% responded that it increased their confidence with understanding their medical condition and how to start treating it, namely in their health literacy related to their MSK condition.
Conclusions: Our early experience with evaluation of MSK patients by both a MSK-specialty trained physician and physical therapist is the same virtual visit resulted in patients reporting a very positive experience and high health literacy related to their MSK condition.
Perceptions of Virtual Eye Care (VEC) among Patients during to Post-COVID
Shalini Shah, BA, Laura Huertas, MPH, Giselle Ricur MD1
University of Miami Bascom Palmer Eye Institute, Miami, FL
Description: This observational study examined patient perceptions of virtual eye care (VEC) appointments during and after the COVID-19 pandemic. An online survey was conducted over three years, and statistical analyses were used to determine if the factors patients considered most important when selecting virtual care appointments changed from 2022 to 2024.
Abstract: Since the COVID-19 pandemic, the role of technology in health care delivery has expanded, with telemedicine providing unique benefits for both patients and providers. While much of patient care has returned to in-person settings, virtual care options remain relevant, especially within the field of ophthalmology. This study aimed to assess patient perceptions of VEC during the last years of the pandemic 2022 through 2024. We gathered demographic information and opinions on virtual health care through an online survey distributed once a year. Assuming the groups from each year are independent, we analyzed the data of 1,703 respondents by using logistic regression models that adjusted for demographic covariates (age group, gender, race/ethnicity, and highest education level) to examine changes in patient priorities over three years when choosing virtual appointments. Findings indicate that patients’ preferences for virtual care have shifted in this time. Each year respondents showed higher odds of viewing reduced travel distances (OR=1.38, 95% CI [1.20, 1.58], p<0.001), reduced wait times (OR=1.29, 95% CI [1.09, 1.53], p=0.003), and enough time spent with providers (OR=1.60, 95% CI [1.37, 1.86], p<0.001) as the most important advantages of virtual care. This data suggests that VEC remains a relevant alternative for patients since the pandemic.
Classification of Research: Patient Experience
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: Among the 1,703 respondents, the majority were over 60 years old (73.6%), female (62.3%), White (65.3%), and had a post-secondary degree (84.7%). Most respondents had not considered having VEC appointments (60.8%), even though few were not interested in VEC services (11.7%). From 2022 to 2024, the odds of selecting time with provider (OR=1.60, 95% CI [1.37, 1.86], p<0.001), travel distance (OR=1.38, 95% CI [1.20, 1.58], p<0.001), and wait times (OR=1.29, 95% CI [1.09, 1.53], p=0.003) as key benefits of virtual care significantly increased each year. Other factors, such as time off work, showed no statistically significant change over the years.
Conclusions: Since the COVID-19 pandemic, patients' priorities regarding virtual care have shifted, with increased emphasis on reducing travel and in-person wait times, as well as enhancing time spent with health care providers. Moving forward, prioritizing telehealth and time with patients may help improve patient retention rates. It is important to note that our sample had a higher representation of highly educated, White, female respondents, which could influence the generalizability of these findings. Further research is needed to evaluate whether these perceived benefits are being effectively achieved in virtual practice and to investigate additional ways to promote telehealth utilization for ophthalmic care.
Predicting Clinical Response for Patients with Depression Treated via an Asynchronous Telemedicine Platform
Dr. Gabriella Farkas,2 Dr. Neil Parikh,1 Dr. Kristen Miranda,2 Dmitriy Gorenshteyn,1 Jeff Larson,1 Brett Ashton,1 Chelsea Orcutt,1 Lizzie Murdoch, 1
1Thirty Madison and 2KMG
Description: This study investigates the ability to predict clinical response in patients with depression receiving treatment through an asynchronous telemedicine platform. Utilizing machine learning models and patient data, we aim to identify predictors of treatment response, enabling personalized interventions and improved outcomes.
Abstract: This retrospective study examined patients who independently sought care for moderate to moderately severe depression via the asynchronous telemedicine platform, Nurx. These patients received ongoing medication management by primary care providers, overseen by consulting psychiatrists. Intake involved a comprehensive dynamic medical questionnaire including standardized assessments like the Patient Health Questionnaire-9 (PHQ-9) and Rapid Mood Screener (RMS). Follow-up data was collected at scheduled intervals; data from 4-weeks and 8-weeks of elapsed treatment were used for this analysis. The study focused on adult patients initiating treatment between July 2023 and July 2024, presenting with moderate to moderately severe depression scores (PHQ-9 score of 10-19) who completed the 4-week check-in questionnaire. Clinical response, defined as a score reduction of 50% or more, was assessed at 4 and 8 weeks. A predictive model was built to forecast clinical response at 8 weeks, with a target area under the curve (AUC) test of >0.7. This model leveraged patient-reported data from both intake and 4-week check-in questionnaires, incorporating a range of information including demographic, medical history, treatment history, and patient-reported clinical data.
Classification of Research: Clinical Outcomes.
Classification of Research – Other:
Method:
Method- Other: Retrospective
Results: There were 6,500 patients who completed the 4-week check-in and 81% of them (5,289 patients) completed the 8-week. Clinical response was achieved by 68% of patients at 4-weeks and 77% at 8-weeks. Notably, of the 163 patients reporting not taking medication at 4-weeks, nearly half (48%) achieved clinical response, indicative of the placebo effect that may occur - among other factors - with access to mental health services. Factors associated with clinical non-response at week 8 were “no change” in reported mental state at week 4, patient-reported medication non-adherence at week 4, and younger age. The model AUC was predictive (>.70).
Conclusions: This study demonstrates the effectiveness of asynchronous telemedicine for treating moderate to moderately severe depression, with the majority of patients achieving clinical response as quickly as 4 weeks. While the data presented here highlight the placebo effect in mental health, which is well-known in the literature, medication adherence at 4 weeks is a strong predictor of clinical response at 8 weeks. Personalized treatment plans and targeted intervention using the predictors identified in this study would help optimize the effectiveness of asynchronous telemedicine for depression management. Further research is warranted to validate the model and explore potential impacts of tailored interventions.
Scaling Interactive Care Plans: Advancing Patient-Centered Care Through Digital Innovation in a Multi-Site Academic Medical Center
Laura Christopherson, Angela Leuenberger
Mayo Clinic
Description: This session will present the deployment model for scaling an Interactive Care Plans program and the value assessment methods utilized to evaluate clinical impact and operational effectiveness. We will discuss best practices for program design, deployment, operations support, and adoption. Additionally, the presentation will cover challenges encountered, solutions implemented, and key lessons learned in deploying Interactive Care Plans (ICPs) across a complex health care system.
Abstract: As health care systems evolve, scalable and patient-centered virtual care models are essential for improving outcomes and operational efficiency. Traditional care models often struggle to effectively engage patients in managing chronic conditions or acute health events, leading to gaps in care and increased provider burden. ICPs offer a solution by automating the delivery of patient education and health data collection, enabling care teams to prioritize patients needing immediate intervention and support. This presentation highlights the deployment of an ICPs program across a multi-site academic medical center. ICPs empower patients to actively participate in their care by providing personalized education, collecting patient-reported health data, and delivering timely guidance. Designed to support chronic disease management and acute care recovery, ICPs streamline care coordination and improve patient outcomes. The program integrates seamlessly with existing health IT systems to ensure efficiency and scalability across diverse care settings.
Results: With over 25 care pathways implemented and 26,000 patients enrolled, results were mixed related to care team and patient engagement. Through observations, the level of engagement and support from care team proponents drove patient engagement levels. A key finding is that adequate patient engagement levels are a pre-requisite to achieving health outcomes and care team efficiencies through streamlined clinical workflows when managing patient populations experiencing a health condition or health event.
Conclusions: The deployment of a scalable Interactive Care Plans program demonstrates significant potential in transforming patient-centered care across diverse health systems. ICPs have the potential to drive patient engagement, improve health outcomes, and optimize care team workflows when implemented effectively. Key success factors include strategic deployment planning, use of value assessment frameworks to drive prioritization, seamless technology integration, continuous stakeholder engagement, and robust outcomes assessment. This model offers a roadmap for other health care systems seeking to implement scalable, digital care pathways.
State Licensure Policy is Associated with Outpatient Telehealth Use in Medicare Beneficiaries
J. Priyanka Vakkalanka, PhD, Tracy Young, MS, Fred Ullrich, MS, Marcia Ward, PhD, Knute Carter, PhD, Eliezer Santos Leon, MS, Kim Merchant, MA, Nicholas M. Mohr, MD, MS
University of Iowa
Description: State medical licensure policy has been cited as a significant barrier to telehealth adoption, and state licensure policies changed significantly around COVID-19. In this study, we evaluated outpatient telehealth use in Medicare beneficiaries to understand how in-state and out-of-state telehealth visits varied by state-level physician licensure policies.
Abstract: Methods: We conducted a quasi-experimental study in a 5% sample of age-qualifying Medicare fee-for-service beneficiaries between 2018-2022. Our primary exposure was time-varying state-level licensure policy, and our primary outcome was total outpatient telehealth visits (any-TH), in-state telehealth visits (IS-TH), and out-of-state telehealth visits (OS-TH). Results: We included 1,682,501 Medicare beneficiaries with 141,199,029 outpatient visits (3,229,736 [2%] of which were delivered by telehealth). State-level participation in the Interstate Medical Licensure Compact (IMLC) was associated with an increase in any-TH utilization (aOR: 1.10; 95%CI: 1.07-1.13) and OOS-TH (aOR: 2.24; 95%CI: 2.09-2.40) but was not associated with IS-TH (aOR: 0.98; 95%CI: 0.96-1.01) in the pre-COVID (Jan 2018-Feb 2020) era. In the COVID-19 era (March 2020-Dec 2022), we observed an increase in any-TH by IMLC participation (aOR: 1.07; 95%CI: 1.06-1.08) and COVID-19 policy relaxations (aOR:1.08; 95%CI: 1.07-1.08). While these findings were consistent with IS-TH utilization, we observed a decrease in OOS-TH by IMLC participation (aOR: 0.74; 95%CI: 0.72-0.75) and COVID-19 policy relaxations (aOR: 0.83;95%CI: 0.81-0.85), potentially attributed to the rise in IS-TH visits.
Classification of Research: Regulatory & Policy Research
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: In the pre-COVID-19 era (Jan 2018-Feb 2020), IMLC participation was associated with an increase in any-TH utilization (aOR: 1.10; 95%CI: 1.07-1.13) and OOS-TH (aOR: 2.24; 95%CI: 2.09-2.40) but was not associated with IS-TH (aOR: 0.98; 95%CI: 0.96-1.01). In the COVID-19 era (Mar 2020-Dec 2022), we observed an increase in any-TH by IMLC participation (aOR: 1.07; 95%CI: 1.06-1.08) and COVID-19 policy relaxations (aOR: 1.08; 95%CI: 1.07-1.08).
Conclusions: We found that licensure policies are associated with telehealth adoption, highlighting the potential for strategic policy changes to improve health care access and delivery. Variability in IS- and OOS-TH utilization may indicate that while local policies can improve telehealth access, interstate barriers still exist. Our findings underscore the necessity for ongoing evaluation of licensure policies and their effects on telehealth utilization. As telehealth continues to evolve, understanding the implications of policy changes will be crucial for ensuring effective access to care.
Telehealth and Post-Stroke Gender-Based Care Patterns
This was made possible by the HRSA of the US DHHS as part of the National Telehealth Centers of Excellence Award (U66RH31459). The contents are those of the author(s) and do not necessarily represent the official views of HRSA, HHS or the US Government.
Description: While post-stroke follow-up care reduces secondary stroke risk, its uptake remains low. Telehealth may be a convenient care option for stroke follow-up care. This study uses the Arkansas All Payer Claims Database (APCD) to measure telehealth uptake and secondary stroke rates among stroke patients through the COVID-19 pandemic era.
Abstract: We utilized data from the Arkansas All Payer Claims Database (APCD) for care between the years 2016 to 2023 (i.e., four years before and four years during the 2020 Covid-19 pandemic). Patients with at least one ICD-9 or ICD-10 diagnosis code for an ischemic or hemorrhagic stroke were included. Annual unique patients with at least one telehealth visit were identified using CPT and place of service codes while annual unique patients with a secondary stroke were identified using ICD-9 or ICD-10 codes. We then used regression analysis to assess patterns of telehealth uptake and secondary stroke by gender (i.e., male versus female) and insurance (i.e., Medicaid versus commercial) in the pandemic era versus prior to the pandemic era.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: Overall, between 2020 and 2023, women with Medicaid utilized telehealth 3.32 percentage points more often than between 2016 and 2019 (95% CI: 1.04 to 5.61, p=0.012), while men with Medicaid utilized telehealth 3.30 percentage points more often (95% CI: 0.86 to 5.73, p<0.01). The pandemic era was also associated with fewer secondary strokes: women with Medicaid saw 7.32 percentage points fewer secondary strokes (95% CI: 13.55 to 1.11, p=0.03), while men with Medicaid saw 5.90 percentage points fewer secondary strokes (95% CI: 11.20 to 0.60, p<0.03).
Conclusions: This descriptive analysis finds that telehealth utilization rates were similar across genders and that its use coincides with a decrease in secondary stroke rates among stroke patients in Arkansas. While this potential link is promising, there are several limitations to this study including potential internal validity challenges given that this research is only associative in nature and potential external validity challenges given that it utilizes data from a single state. That said, these findings provide a foundation to further explore the role that telehealth may play in decreasing the risk for a secondary stroke among stroke patients.
Telehealth Post-Pandemic: A Roadmap for Michigan
Bree Holtz, PhD,1 Charles Doarn, MBA,2 Lorraine Buis, PhD3
1Michigan State University, 2University of Cincinnati, and 3University of Michigan
Description: The “Telehealth Post-Pandemic: A Roadmap for Michigan” Think Tank gathered health care providers, patient advocates, policymakers, and telehealth experts to address post-pandemic telehealth challenges. Sponsored by AHRQ, the event focused on creating strategies for sustainable, equitable telehealth. Outcomes included a roadmap prioritizing research on clinical services, policy, and patient engagement.
Abstract: The “Telehealth Post-Pandemic: A Roadmap for Michigan” conference brought together a diverse range of stakeholders, including health care providers, patient advocates, policymakers, and telehealth experts, to collaboratively address the challenges and opportunities for telehealth in a post-pandemic world. Sponsored by the Agency for Healthcare Research and Quality (AHRQ), this Think Tank centered on creating actionable strategies that ensure telehealth's sustainability, equity, and scalability. Michigan’s diversity provided a unique context to explore telehealth’s potential to bridge health care gaps in both rural and urban areas. A primary focus was on advancing research to address health care inequities, particularly in underserved and rural communities. Discussions also emphasized the role of interdisciplinary research in measuring clinical outcomes, patient engagement, and the ethical use of telehealth technologies. This event catalyzed shaping the future research agenda in telehealth.
Classification of Research: Regulatory & Policy Research
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: The event's research discussions identified seven critical categories where future telehealth studies should focus. These include examining telehealth’s impact on clinical services, administrative uses, and education and training for both health care providers and patients. The discussions also highlighted the importance of studying telehealth policy implications, technological innovations, patient experiences, and ethical considerations shaping telehealth's future. These areas provide a roadmap for research in telehealth, emphasizing the need for interdisciplinary collaboration to ensure telehealth continues to evolve and address challenges both old and new.
Conclusions: The roadmap for telehealth research offers a model other states can adapt to address specific telehealth challenges. By prioritizing research in clinical services, policy, patient experiences, and technological innovation, we provide actionable insights relevant beyond Michigan. As states refine their telehealth strategies, this roadmap guides tailored research and implementation for diverse populations and health care environments. Ongoing collaboration across states will be essential to ensure telehealth grows as a scalable, equitable health care solution. This collection of papers will be available open access through the Journal of Telemedicine and eHealth.
Telehealth Program Launched to Expand Retention in HIV Care
Jennifer Belfry, DNP, MSN, APRN, FNP-BC, AAHIVS,1 Dr. Christopher Hall, MD, MS, AAHIVS,2 Jennifer Pena, MD, AAHIVS1
1QCarePlus and 2AvitaCare Solutions
Description: According to 2022 CDC data, nearly 552,000 people living with HIV were not retained in HIV care in 2022 (CDC Surveillance Data 2022). An innovative telehealth HIV program aims to expand access to HIV care to PLWH in the U.S. who are not retained in HIV care.
Abstract: Background: According to 2022 CDC data, for every 100 people living with HIV (PLWH) in the U.S.,47 were retained in HIV care, and 57 were virally suppressed, leaving nearly 552,000 PLWH not retained in HIV care in 2022 (CDC Surveillance Data 2022). Historically, certain populations have experienced health disparities in accessing HIV care, including racial and ethnic minorities, gender identity minorities, and people living in rural communities. An innovative telehealth HIV program aims to expand access to HIV care to PLWH in the U.S. who are not retained in HIV care. Purpose: The purpose of this review is to demonstrate the successes and challenges of the Q Care Link telehealth program in reaching high-priority Ending the HIV Epidemic (EHE) groups in the first year of practice. A secondary aim is to explore the development of telehealth platform innovations to improve HIV retention in care. Methods: Data were collected via chart review of the electronic medical records of HIV encounters from June 1, 2023, to July 15, 2024, for the first 100 patients enrolling in the telehealth[KW1] program (n=100). Data were deidentified and aggregated. Data analysis was completed using standard statistical processes.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: Conclusions: Program participants identified as 98% cisgender male, 1% cisgender female, and 1% transgender woman. The average age was 35.4 years of age. The patient cohort included 24% of patients identifying as Hispanic/Latinx and 42% as African American/Black. A full 28% of patients were newly diagnosed with HIV when seeking PrEP telehealth care, while 26% were referred to the program by community-based partners or other telehealth programs, and 46% of patients self-enrolled without referral from an outside source. Clinical outcomes of the program include improved viral suppression rates, and HIV retention in care at six months of 87%.
Conclusions: The Q Care Link telehealth program proved successful at delivering HIV care to priority EHE groups and retaining those patients in HIV care. Platform innovations included automated three or six months follow-up lab ordering, visit scheduling, and health survey via continuous patient engagement. The limitation of this review is that the program attracted only cisgender men, while patients born female were not represented in the data.
Centers for Disease Control and Prevention. Diagnoses, Deaths, and Prevalence of HIV in the United States and 6 Territories and Freely Associated States, 2022. HIV Surveillance Report 2024; 35.
The Development, Implementation, and Release of a National Telehealth Data Warehouse
Jason C. Goldwater,1 Yael M. Harris, PhD,1 Yunxi Zhang, PhD,2 Gregory S. Hall,2 Saurabh Chandra, MD2
1Laurel Health Advisors and 2University of Mississippi Medical Center
Description: This presentation outlines creating and deploying a National Telehealth Data Warehouse. It discusses data integration strategies, technological frameworks, and challenges faced. Attendees will learn how this data warehouse enables comprehensive research into telehealth practices and improves telehealth analytics, policy development, and nationwide telehealth analysis.
Abstract: Through a grant provided by the Health Resources and Services Administration (HRSA) to serve as a Telehealth Center of Excellence, the University of Mississippi Medical Center contracted with Laurel Health Advisors to develop a National Telehealth Data Warehouse. This is a transformative initiative aimed at revolutionizing telehealth data collection and analysis. Attendees will learn about the innovative technologies and data integration frameworks employed to aggregate large volumes of telehealth data from diverse health care settings. The process of harmonizing data across disparate electronic health records (EHRs) and telehealth platforms is highlighted, showcasing interoperability solutions and secure data management practices. We will share insights into the challenges encountered, including data privacy considerations, standardization complexities, and the evolving telehealth landscape. The session will also outline collaboration with key stakeholders, such as policymakers, health care providers, and IT experts, to ensure the data warehouse meets national standards and supports public health research and evidence-based policy development. The outcomes include improved telehealth quality assessment capabilities and support for research studies examining telehealth’s impact on health care access, cost, and outcomes. Attendees will walk away understanding the significance of this data warehouse and its potential for advancing telehealth practices across the United States.
Classification of Research: Information Technology
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: The development of the National Telehealth Data Warehouse will lead to data aggregation from multiple telehealth providers nationwide. Early analyses from the initial data feeds revealed significant trends in telehealth utilization, patient outcomes, and disparities in access, guiding policymakers and health care providers. Furthermore, secure data-sharing protocols have facilitated collaboration among researchers, driving evidence-based advancements in telehealth.
Conclusions: The National Telehealth Data Warehouse marks a telehealth research and policy development milestone. It provides a comprehensive, standardized data repository that systematically evaluates telehealth’s impact on health care delivery and outcomes. This initiative lays a foundation for improved evidence-based policy decisions and fosters innovative research partnerships, setting the stage for a more data-driven approach to telehealth optimization nationwide.
The Telerobotic Ultrasound Clinic Model: Toward a More Equitable and Affordable Future of Medical Imaging in Rural and Remote Communities
Sierra Leonard, Brent Burbridge,1 Chad Hammond,1 Ivar Mendez,1 Scott J. Adams1
College of Medicine, University of Saskatchewan
Description: The telerobotic ultrasound program leverages robotic technology to perform diagnostic imaging in rural and remote communities. Sonographers manipulate an ultrasound transducer from a distant site, providing access to essential imaging services for patients in underserved regions without the need for long-distance travel.
Abstract: The study aimed to assess the feasibility and effectiveness of deploying telerobotic ultrasound systems in three remote northern communities and one rural southern community in Saskatchewan, Canada. These communities lacked regular access to sonographers and faced significant barriers to ultrasound services due to geographic isolation and the burden of travel. As part of the telerobotic ultrasound program, sonographers remotely operated a robotic arm to perform various ultrasound examinations, which were interpreted by radiologists at an academic medical center. Overall, telerobotic ultrasound improved access to essential diagnostic services in remote regions. Telerobotic ultrasound decreased transportation costs and the carbon footprint of medical imaging through reducing the need for rural and remote patients to travel long distances for diagnostic imaging. It also reduced sonographer staffing requirements, and improved health care access in underserved areas. The implementation of telerobotic ultrasound eliminated the need for on-site sonographers in these regions, which can be costly and difficult to recruit and retain. This model may also decrease the burden on health care resources in urban centers by decentralizing certain diagnostic services.
Classification of Research: Access to Care
Classification of Research – Other:
Method: The study aimed to assess the feasibility and effectiveness of deploying telerobotic ultrasound systems in three remote northern communities and one rural southern community in Saskatchewan, Canada. These communities lacked regular access to sonographers and faced significant barriers to ultrasound services due to geographic isolation and the burden of travel. As part of the telerobotic ultrasound program, sonographers remotely operated a robotic arm to perform various ultrasound examinations, which were interpreted by radiologists at an academic medical center. Overall, telerobotic ultrasound improved access to essential diagnostic services in remote regions. Telerobotic ultrasound decreased transportation costs and the carbon footprint of medical imaging through reducing the need for rural and remote patients to travel long distances for diagnostic imaging. It also reduced sonographer staffing requirements, and improved health care access in underserved areas. The implementation of telerobotic ultrasound eliminated the need for on-site sonographers in these regions, which can be costly and difficult to recruit and retain. This model may also decrease the burden on health care resources in urban centers by decentralizing certain diagnostic services.
Method- Other:
Results: A total of 475 telerobotic ultrasound exams were conducted. These included abdominal, obstetrical (first, second, and third trimester), pelvic, and renal exams. The average duration (standard deviation) of exams was 17.8 (7.7) minutes. Ninety-seven percent of exams were reported to have good communication between the on-site assistant and off-site sonographer. Patient surveys indicated strong satisfaction, with 98% expressing willingness to undergo telerobotic ultrasound again in the future. Challenges identified included technical issues related to bandwidth and probe manipulation, adequate assessment of detailed fetal anatomy for second trimester obstetrical exams, and coordination between remote clinics and the sonographer site.
Conclusions: The telerobotic ultrasound program has the potential to significantly impact health care delivery in rural and remote communities by reducing disparities in access to essential diagnostic imaging. By providing telerobotic ultrasound services locally, patients can receive timely diagnoses, leading to earlier interventions and better health outcomes. This model aligns with health equity goals for serving rural and remote communities. Furthermore, the project highlights the potential for telerobotic technology to be scaled across health care systems, improving efficiency, reducing costs, and ensuring that high-quality care is accessible to all, regardless of geographic location.
Transforming Specialty Access: E-Consult Implementation in an Academic Medical Center and FQHC Partnership
David Saxon,1,2 Devin Miller,2 Linda Oberst-Walsh,2,3 Mayra Loera De Luna,2 Stephanie Grim,2 John F. Thomas2,4
1Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes University of Colorado School of Medicine, Aurora, Colorado, USA; 2Peer Mentored Care Collaborative, University of Colorado School of Medicine, Aurora, Colorado, USA; 3Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; and 4Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA.
Description: Access to specialty care at Federally Qualified Health Centers (FQHCs) is limited by wait times, geography, and resource constraints. An “external pivot” electronic consult (e-consult) program was introduced, allowing FQHC providers to send e-consults to specialists at an academic center, improving timely access to expert care.
Abstract: A novel e-consult program was implemented to improve specialty care access for FQHC patients by allowing providers to send electronic consultations to academic medical center specialists, addressing barriers like long wait times and geographic challenges. The top specialty areas addressed through the program have been endocrinology, rheumatology, neurology, cardiology, and urology, in descending order of consultation volume. In total, 180 providers have utilized the e-consult system across 21 specialties resulting in 1,252 completed e-consults since program inception. Variation in adoption rates across FQHCs reflects differences in patient population needs, provider engagement, clinic size, and other site-specific facilitators and barriers. Nevertheless, the program’s reach across diverse regions highlights its flexibility and capacity to adapt to different settings.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: A total of 180 FQHC providers have used the e-consult system, delivering 1,252 e-consults across 21 specialties since its inception. The top specialties utilized have been endocrinology, rheumatology, neurology, cardiology, and urology. The most active FQHC (Salud Family Health Centers) has had 93 providers submit 851 e-consults. The number of e-consults ordered by any single provider ranged from 1 to 60 with a median of 3. After initial growth of the program, there was a decline in e-consult use likely related to FQHC provider turnover and need for more specific continued engagement between academic medical center specialists and FQHC providers.
Conclusions: An e-consult program, designed to enhance specialty care access for patients at FQHCs, has made a significant impact by linking FQHC providers with specialists at an academic medical center. By leveraging e-consults, this innovative program has facilitated timely, expert advice for primary care providers, particularly in specialties that are often difficult to access for underserved populations. Sustained, focused efforts over time are essential following the implementation of such a program.
Using RE-AIM to Evaluate a Virtual-Only Specialty Care Program
Peter Gardella, Cortney Belton, Jillian Harvey, Caitlin Koob, Ryan Kruis, Jimmy McElligott, Emily Warr
1Medical University of South Carolina
Description: We utilize the RE-AIM framework to describe a virtual-only specialty program’s development, implementation, and outcomes. Multiple data sources are utilized, including electronic medical records, telehealth data, and patient surveys. Business Intelligence Tools are used for program-level dashboards to increase leadership’s access to real-time data trends and facilitate quality improvement.
Abstract: Patient populations across South Carolina often face greater difficulty accessing in-person care, resulting in delays and poor health outcomes. In South Carolina, 41 out of 46 counties are designated to have some health professional shortage area. As a result, South Carolinians face challenges accessing specialty care, averaging 3-6 month wait for in-person specialty care. To overcome the access issues, a virtual specialty service line was developed and implemented to increase access to specialty providers and offer an alternative to in-person specialty care. The innovative model provides 100% virtual care in high-demand specialties and primary care across the state. The Virtual Specialty program provides virtual access to providers, while also coordinating local referrals for in-person lab work, imaging, and pharmaceuticals based on the patient’s proximity. The program goals include reducing wait times for patients to establish care with a specialty provider; and increasing access to specialty care across South Carolina, including rural and underserved zip codes. The program includes Direct-to-Consumer: endocrinology, Rheumatology, Neurology, Pulmonology, Benign Hematology, Sleep Medicine, and Primary Care for new and returning patients.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: Reach: From October 1, 2023, to October 23, 2024, 13,216 Virtual Specialty visits occurred, for 10,215 patients. Effectiveness: New visit appointment wait times have been reduced to less than 8 days for all programs. Patient experience ratings are consistently higher for the 100% virtual practice compared to hybrid in-person/virtual care. Adoption: Endocrinology was consistently the highest volume service each month, followed by Rheumatology. Implementation: The program went through a 4 phase implementation process. Maintenance: Returning patients made up 58% of the visits. The Virtual Specialty patients reside across the entire state, saving considerable time and travel costs for the patients.
Conclusions: Initial lessons learned include the challenge of establishing a highly accessible digital front door while also leveraging Electronic Health Record tools. In addition, current South Carolina regulation limitations on prescribing schedule 2 and 3 medications create barriers to care. Virtual Specialty service will continue to expand through innovative partnerships with divisions of MUSC, collaboration with additional specialty departments and providers, coordination with trusted affiliated organizations, successful continuity of care with in-person needs, and ensuring a patient-centric approach. Navigating in-person needs across the state will require referral relationships in many communities and with the local MUSC providers.
Utilizing the EPIS framework to inform the expansion of a novel virtual nursing model within a large health system
Caitlin Koob,1 Jillian Harvey,1 Ryan Kruis,1 Jimmy McElligott,1 Peter Gardella,1 Emily Warr,1 Dee Ford
Medical University of South Carolina
Description: The Virtual Nursing (VRN) program involves an innovative care delivery model, leveraging teams of remote, virtual nurses to support bedside nurses in providing care via technology. VRNs offset time-consuming tasks, including documentation, care plan management, and video calls for patient/family education, while bedside nurses allocate more time to patient care.
Abstract: Purpose: To describe the implementation and expansion of a VRN model within a large health care system. Methods: The Exploration, Preparation, Implementation, and Sustainment framework is applied to evaluate VRN. Data sources include patient information and provider efficiency within electronic health records (EHR) and program tracking within REDCap. Outcomes include VRN utilization, service units/outcomes, and patient satisfaction. Service units describe VRN support. A standardized survey captures patients’ experience with admission, discharge, and communication with nurses. Descriptive statistics were examined. Results: Exploration/Preparation: VRN aims to alleviate strained nursing-to-patient ratios and support retention. Financial investments and nursing leadership engagement were critical. Implementation: From 10/2023-10/2024, VRN served 6,521 patients. VRN provided 20,924 service units, including admission tasks (41%), care plan management (42%), education (45%), quality surveillance (51%), documentation (25%), and discharge tasks (6%). VRN care was largely completed within EHR, with 22% requiring video. Additionally, 63.6% of services were requested by the unit, rather than initiated by VRN. Sustainability: Quality metrics have improved across VRN units within 6-months. Patients’ report improved experiences in all areas across VRN units. In FY2025, VRN will expand from five to 32 units systemwide. Conclusions: VRN may improve health care access, quality, and patient outcomes, while alleviating provider stress.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: From October 2023-October 2024, 6,521 patients were served by VRN. VRN provided 20,924 service units, averaging 3.2 units per patient. VRN services included admission tasks (41%), care plan management (42%), education (45%), quality surveillance (51%), documentation (25%), and discharge tasks (6%). VRN care was largely completed within EHR, and 22% of VRN service units required video. Additionally, nearly two-thirds (63.6%) of VRN services were requested by the floor unit, rather than initiated by VRN (36.4%). Additionally, patients’ report improved experiences in admission, discharge, and communication with nurses across all VRN units. In FY2025, VRN will expand from five to 32 units systemwide.
Conclusions: National efforts to address gaps related to health care access, quality, and workforce have elicited little success, often encouraging providers to relocate to meet widespread, unmet needs among patients and providers. Technology provides opportunity to improve health care access and quality, while also reducing the burden placed on providers that often leads to burnout. Preliminary findings suggest VRN may provide a strategic first step to improving health care access, quality, patient outcomes and satisfaction, while alleviating stressors within the health care workforce. Ongoing evaluation will examine the impact of VRN on patient outcomes, nurses’ perspectives of burnout and job satisfaction, and system-level cost savings.
Poster Presentations
A College of Pharmacy Tele-Based Approach to Addressing Health Equity
Raven Jackson PharmD, Maya Lacey PharmD Student, Daezha Brooks PharmD
Xavier University of Louisiana College of Pharmacy
Description: The objective of this research is to define a stepwise approach to developing a sustainable academic telehealth center that advances pharmacy practice while addressing health equity in rural areas.
Abstract: Using technology to assist with patient care dates back to the late 1800s and has since progressed in functionality and capability. Health care providers and organizations have long been aware of the benefits and importance of telehealth delivery models, even though the use of these services has been historically low. Telehealth has recently met the need for socially distant care given the COVID-19 pandemic, while also opening avenues for expanded care offerings and opportunities for reimbursement. This expansion is keenly important to pharmacy practice and the provision of patient centered medication-related information. Rural residents are often at a health care disadvantage due to their location, poverty rates, and lack of available health-related information. Many colleges of pharmacy have long been providing (and training students on) pharmacist-led health care services, such as Medication Therapy Management (MTM), but the scope and reach has been limited. The Xavier University Telehealth Center (XUTC) was developed to identify and address barriers to implementing a sustainable MTM program in an academic setting.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: In Progress
Conclusions: In Progress
A Decade of Telementoring: Analysis of Missouri's Dermatology ECHO Program 2015-2024
Dr. Mirna Becevic
University of Missouri, Columbia, MO/Missouri Telemedicine Network/SHOW-ME ECHO
Description: This analysis examines Missouri's Dermatology ECHO program's decade-long evolution from pilot to established telementoring platform. It demonstrates its impact on rural health care access through quantitative analysis of participation metrics, geographic reach, and engagement patterns across Missouri counties from 2015 to 2024.
Abstract: Project ECHO (Extension for Community Healthcare Outcomes) addresses rural health care disparities through telementoring, yet longitudinal analyses of specialty-specific ECHO programs remain limited. This study examined ten years of participation data from Missouri's Dermatology ECHO program (2015-2024), analyzing program reach, engagement patterns, and geographical impact. We retrospectively analyzed program data, including attendance records, session frequencies, geographic distribution, and facilitator-to-attendee ratios. The program demonstrated significant growth from 8 participants across four counties in 2015 to a peak of 125 participants spanning 35 counties in 2021, with a current stable engagement of 76 participants across 23 counties. Over the decade, the program delivered 2,474 total instructional hours through 216 sessions, maintaining a consistent core of 5-11 facilitators. Program evolution showed distinct phases: initial rapid growth (2015-2016), steady expansion (2017-2019), peak utilization during COVID-19 (2020-2021), and recent stabilization (2022-2024). Analysis revealed optimization of program delivery, transitioning from 35-39 annual sessions in early years to 13-19 focused sessions in recent years while maintaining engagement and expanding geographic reach. This comprehensive evaluation demonstrates the program's successful evolution from pilot to sustainable platform, offering insights for implementing and scaling specialty-focused telementoring initiatives.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: Analysis revealed four distinct program phases over the decade. Initial growth showed a 650% participation increase (2015-2016), followed by steady expansion averaging 85 participants (2017-2019). Peak engagement during COVID-19 reached 125 participants across 35 counties (2021), representing maximum geographic penetration. Recent stabilization maintained 76-89 participants annually (2022-2024). The program delivered 2,474 total instructional hours through 216 sessions, with consistent facilitator engagement (5-11 members). Geographic reach expanded from 4 to 23 counties, demonstrating sustained rural impact. Session delivery evolved from 35-39 to 13-19 annual sessions, optimizing resource utilization while maintaining engagement.
Conclusions: This decade-long analysis demonstrates the successful evolution and sustainability of a specialty-focused ECHO program. The transition from rapid growth to stable engagement, coupled with optimized session delivery and expanded geographic reach, provides a model for telementoring program development. The sustained coverage across rural counties validates ECHO's effectiveness in expanding specialty care access. Analysis of participation patterns and program optimization strategies offers valuable insights for health care organizations implementing similar telementoring initiatives. Future research should examine this sustainable model's clinical outcomes, patient impact, and cost-effectiveness for addressing specialty care disparities in rural communities.
A Review of the Benefits and Difficulties of Teledermatology
Description: A scoping review of the literature on the advantages and limitations of teledermatology.
Abstract: Background: Telemedicine is an innovative use of technology that has transformed the medical system. For specialties such as dermatology that rely heavily on synthesizing visual information, telemedicine has proven to be useful. Although many advantages using teledermatology have been identified, limitations remain. Objectives: To determine current benefits and drawbacks of using telemedicine within the field of dermatology. Methods: A scoping review of the literature on the advantages and limitations of teledermatology was performed. Data was collected from Pubmed and Google Scholar. Several areas were investigated including telemedicine’s impact on accessibility, patient care quality, diagnostic reliability, security risks and reimbursement. Results: A total of 6 broad categories were used to organize and collect data. Categories included patient care quality and experience, health care accessibility, privacy, technology limitations, insurance and policy. Current advantages and disadvantages were investigated and grouped appropriately for each subject of interest. Conclusions: Teledermatology in many ways proves to be beneficial through expanding health care accessibility and continuity of care. Additional studies are needed in order to predict how patient care will be impacted as technology continues to evolve.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: A total of six broad categories were used to organize and collect data. Categories included patient care quality and experience, health care accessibility, privacy, technology limitations, insurance and policy. Current advantages and disadvantages were investigated and grouped appropriately for each subject of interest.
Conclusions: Teledermatology in many ways proves to be beneficial through expanding health care accessibility and continuity of care. Additional studies are needed in order to predict how patient care will be impacted as technology continues to evolve.
A Single Institution Experience in the Use of Telehealth for Postoperative Visits among Emergency General Surgery (EGS) Patients
Description: To improve patients’ experience and compliance with follow-up after emergency surgery, we decided to provide telehealth-directed postoperative visits for our patient population. We describe our experience with telehealth postop visits.
Abstract: Individuals who undergo emergent abdominal surgery may find themselves significantly distanced from their residences; therefore, follow-up care for this patient population may encounter numerous challenges, such as geographical distance, financial burdens, and limited access to health care providers (HCPs). These challenges frequently hinder patient adherence to postoperative follow-up consultations following an emergent surgical procedure. As a response, we have opted to implement telehealth services to mitigate these difficulties in the postoperative management of this patient population. The objective of this study was to articulate our experiences in integrating telehealth for postoperative follow-up among patients undergoing emergency general surgery (EGS). We conducted a retrospective analysis of patients who underwent urgent surgical procedures (including laparoscopic/robotic cholecystectomy, robotic ventral or inguinal hernia repair, and laparoscopic/robotic appendectomy) from January 2021 to May 2024, all of whom participated in a telehealth postoperative visit within the specified study timeframe. All patients who met the criteria for the above procedures were allowed to participate in a telehealth postoperative visit during the study period. However, they could decline and choose an in-person visit instead.
Classification of Research: Clinician Experience
Classification of Research – Other:
Method: Descriptive
Method- Other: Retrospective Chart Review
Results: A total of 116 patients had postoperative visits via telehealth, utilizing audio and audiovisual methods. 75 patients (64.6%) were female, 60 patients (51.7%) were Black, and 56 patients (48%) possessed private insurance. The mean age of patients was 41 years (sd: 14), while the median age was 36 years. The average interval from surgery to the follow-up visit was 16 days (sd: 5), with a median of 15 days. 28 patients (24%) resided in areas designated as health care provider shortage areas, and 47 patients (41%) lived in rural locations. 79 patients (68%) completed their telehealth visits during this period
Conclusions: This research demonstrates that Telehealth constitutes a significant modality that can be effectively incorporated into traditional health care delivery. This integration facilitates the ability of rural patients to overcome geographic and logistical impediments while still receiving high-quality medical care. Future research will compare health care utilization and clinical outcomes between Telehealth patients and those who do not utilize this service.
A systematic review of digital health interventions present in US clinical practice guidelines.
Tulsi Mehta,1 Mehul Mankad, MD2
1Virginia Commonwealth University and 2Duke Department of Psychiatry and Behavioral Sciences
Description: There is a discrepancy between the digital health interventions outlined in clinical practice guidelines and the extent to which we currently utilize digital health to treat chronic conditions. This study demonstrates the need for evidence-based digital health approaches to chronic disease management.
Abstract: Clinical practice guidelines (CPGs) facilitate integration of research findings into clinical practice and promote the translation of peer-reviewed evidence into strategies for health outcome improvement. Chronic diseases represent a substantial concern in the United States, and addressing this burden requires innovation. This study aims to identify best practices regarding digital health approaches within the most representative CPGs for the ten most common chronic illnesses present in the United States population. Each CPG was screened using pre-determined search terms and true recommendations and suggestions regarding digital health technologies in the treatment of chronic conditions were extracted from the data. Seven CPGs did not return results consistent with inclusion of digital health technology in standard practice. Results showed a total of four recommendations and six suggestions from the mood disorders, diabetes, and coronary atherosclerosis CPGs. Five of these ten findings referenced telehealth interventions, and two referenced digital monitoring. Embedding evidence-based digital health approaches to chronic disease could become a standard component of the health care arsenal and deliver greater impact than has been realized to date. CPG review committees should systematically consider the growing evidence for digital health technology and update guidelines accordingly.
Classification of Research: Information Technology
Classification of Research – Other:
Method:
Method- Other: Systematic Review
Results: Seventy-four clinical practice guidelines (CPGs) were identified that address the standard of care for chronic conditions in the U.S. From this pool, 10 CPGs were chosen for further examination based on our inclusion and exclusion criteria. All 10 CPGs made some reference to digital health. Specifically, three CPGs—focused on mood disorders, diabetes, and coronary atherosclerosis—provided recommendations and suggestions for integrating digital health practices into treatment. These included four recommendations and six suggestions.
Conclusions: As the majority of clinical guidelines are curated by professional societies and governmental groups, the onus falls on those entities to select guideline authors knowledgeable in the growing literature applying digital health technology to chronic disease. Additionally, guidelines should address the impact of technology on the treatment of chronic disease with clear and concise recommendations regarding inclusion or exclusion of novel approaches to disease management. Embedding evidence-based digital health approaches to chronic disease management could become a standard component of the health care arsenal and deliver greater impact than has been realized to date.
An AI-based Physician Assistant for Virtual Primary Care
Geoffrey W. Rutledge
HealthTap
Description: We document the effectiveness of a generative AI-based virtual physician assistant that conducts pre-visit interviews, writes draft clinical notes, calculates differential diagnoses, and suggests questions for the patient to ask their doctor. This demonstrates the remarkable ability of an AI-based agent to help doctors within the workflow of virtual visits.
Abstract: We describe “Dr. A.I.”, a virtual physician assistant that uses generative AI (GPT-4) to conduct a pre-visit patient interview and to create a draft clinical note for the physician prior to a scheduled virtual video consultation. We document the effectiveness of Dr. A.I. by measuring the concordance of the actual diagnosis made by the doctor with the generated differential diagnosis list. The doctors' first diagnosis was on the AI-generated differential in 87.9% of cases, and the doctor's diagnosis was the first AI diagnosis in 62.1% of cases. The doctors' second diagnosis (when present) was found on the AI differential in 80.4% of cases. This application demonstrates the practical health care capabilities of a large language model to improve efficiency of doctor visits while also addressing safety concerns for the use of generative AI in the workflow of patient care.
Classification of Research: Clinician Experience
Classification of Research – Other:
Method: Observational
Method- Other:
Results: Among 124 visits for which the patient completed the Dr. A.I. interview, Dr. A.I. recorded from 1 to 12 diagnoses, with 35% (44/124) of the cases having 1–3 diagnoses and 54% (67/124) having exactly 10 diagnoses. The rates that the doctors' diagnoses appeared anywhere on the AI-generated lists were, for the first diagnosis: 87.9%, for the doctors' second diagnosis: 80.4%, and for the 3rd–7th diagnoses: 45.5%. The doctors' first diagnoses appeared as the top AI diagnosis in 62.1% of cases.
Conclusions: The questions asked and the diagnoses generated by a GPT-4 based patient interview correspond with a high degree of accuracy to the diagnoses assessed by doctors who evaluated the patients without knowledge of the AI assessment. It is possible to use generative AI based on the largest foundation models to engage patients in a medically relevant dialog that identifies the likely causes of a patient's medical symptoms.
Rutledge, GW. Diagnostic accuracy of GPT‐4 on common clinical scenarios and challenging cases. Learning Health Systems 8, no. 3 (2024): e10438. Rutledge, GW. Doctors' diagnostic accuracy with and without diagnostic decision support. AMIA 2020 Virtual CIC.
Application of Implementation Science Methods to Advance Reach of Innovative Telehealth Modalities
Emily Johnson, Ryan Kruis, Rebecca Verdin, Elana Wells, Kathryn King, Dee Ford, Katherine Sterba
Medical University of South Carolina
Description: Telehealth programs are increasing rapidly to meet dynamic health care needs, coupled with increased challenges for how to best implement and sustain these programs. This study complied four dissemination and implementation (D&I) telehealth program evaluations to create a telehealth D&I toolkit that can be utilized to guide telehealth implementation evaluation.
Abstract: Purpose: Telehealth modalities for health care delivery are increasing at a rapid pace to meet changing health care demands. Coupled with recent growth are challenges for how to best disseminate new telehealth practices, define barriers and facilitators to telehealth implementation outcomes, and characterize strategies for optimal delivery of quality telehealth services. Implementation science principles can guide a systematic process for these evaluations. This study presents an overview of a telehealth implementation toolkit, created to guide telehealth program implementation evaluation. Methods: Using four dissemination and implementation (D&I) telehealth research projects in different settings, our team in the Telehealth Center of Excellence compiled lessons learned to guide interprofessional telehealth teams to conduct dynamic evaluations of D&I processes and outcomes in telehealth programs. These evaluations were utilized to develop and publish a telehealth D&I methods toolkit. Results: The toolkit sections are based on steps in a D&I research project and include key questions for the D&I team, telehealth specific examples, and case study exemplars to demonstrate toolkit application. Principles of using previous telehealth observations to frame the research question, engaging multiple stakeholders involved in the delivery of a telehealth service, mapping an appropriate conceptual model to guide research, and using mixed methods are emphasized.
Classification of Research: Measurement Frameworks & Tools
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: Case study examples from four different settings are highlighted in each telehealth D&I toolkit section to demonstrate the D&I evaluation steps including identifying a study question, determining D&I study design, defining implementation outcomes, selecting a study framework, designing a measurement plan and identifying implementation strategies. These case studies are based on evaluations from telehealth programs providing care for perinatal anxiety and substance abuse, diabetes remote patient monitoring, school-based asthma care, and child trauma focused behavioral therapy.
Conclusions: The application of D&I principles to telehealth research, as described in the telehealth D&I toolkit, can promote a better understanding of processes, outcomes and determinants to improve implementation, scalability, and sustainability of telehealth programs. The steps and examples provided in this toolkit can be utilized and adapted to fit a variety of settings to guide ongoing and future evaluation of telehealth implementation.
Johnson EE, Sterba K. (2023). Implementation Science Telehealth Toolkit. MUSC Telehealth Center of Excellence. http://www.telehealthcoe.org
Bridging Healthcare Gaps for Pregnant Adolescents During the Perinatal Period: A Telehealth Opportunity in Mississippi
Description: This study explores telemedicine's role in caring for adolescent mothers during the perinatal period in Mississippi. This descriptive analysis includes 6,741 pregnant teenagers from the University of Mississippi Medical Center (UMMC). By examining patient demographics and telehealth usage, this study seeks to highlight gaps in health care access during the perinatal period.
Abstract: Telemedicine has emerged as an innovation to address gaps in health care accessibility, particularly benefiting rural and underserved communities. Mississippi faces high rates of infant mortality and teen pregnancy, exacerbated by socioeconomic challenges and limited health care access. Adolescent mothers face increased risks for maternal and fetal heath issues, including hypertensive disorders and preterm births, alongside increased rates of depression and anxiety. Mississippi’s predominantly rural landscape (79.3%) is associated with elevated teen pregnancy rates and barriers to perinatal education and routine care. While existing studies often emphasize pregnancy prevention, this study explores utilization of telemedicine in supporting adolescent mothers during the perinatal period, seeking to improve maternal and fetal outcomes. Data were collected from de-identified patient records using the UMMC Patient Cohort Explorer (PCE), linked to UMMC's Research Data Warehouse. The analysis included records from pregnant individuals aged 13 to 19 who received care at UMMC from January 1, 2013, to September 30, 2024. A descriptive analysis was conducted using PCE filter presets, applying principles of inclusion and exclusion to identify telehealth utilization patterns. Demographic and health care utilization data for 6,741 pregnant teenagers across 46,156 encounters were extracted for analysis.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: Among 6,741 pregnant teenagers at UMMC, 71.7% were African American, 21.1% Caucasian, 6.5% Other, and 0.7% Unknown. 4.8% of patients reported Hispanic or Latino ethnicity. Tobacco use was reported for 10.5% of patients. Most patients had Medicaid (79.1%), with 12.2% private insurance, 8.1% self-pay, and 0.6% “other”. Of these, 3.56% (241 pregnant teenagers) received care exclusively via telehealth, with 61.4% seen after January 1, 2020. The racial and ethnic distribution of telehealth users mirrored the overall sample, but tobacco use was higher at 17.1%. Most telehealth users were self-pay (67.3%), while 29.3% had Medicaid, indicating a shift in payor status.
Conclusions: Since 2013, 3.58% of pregnant teenagers at UMMC utilized telemedicine. The higher prevalence of tobacco use among telehealth users emphasizes the need for integrated cessation programs to mitigate maternal and fetal health risks. With Medicaid and self-pay patients comprising 96.6% of telehealth users, links between payor status and medium of communication warrant further investigation. This study suggests telemedicine can improve health care access for pregnant adolescents in Mississippi. Limitations included restricted data on chief complaints and pregnancy outcomes. Future research should explore patient motivations, satisfaction, and health outcomes to enhance telemedicine’s impact on perinatal care.
We have included the following scientific references. Please note, the following authors are NOT associated with this project: Ely, D. M., & Driscoll, A. K. (2024). Infant Mortality in the United States, 2022: Data From the Period Linked Birth/Infant Death File. National Vital Statistics Reports, 73(5). https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-05.pdf/Health Resources and Services Administration, Maternal and Child Health Bureau. (2024). III.B. Overview of the State—Mississippi—2023. U.S. Department of Health and Human Services. Retrieved October 25, 2024, from https://mchb.tvisdata.hrsa.gov/Narratives/Overview/e59e4cdd-ba68-40a0-a586-a0050f64b7c5
Jeon, N., Kent-Marvick, J., Sanders, J. N., Hanson, H., & Simonsen, S. E. (2024). Comparing maternal factors associated with postpartum depression between primiparous adolescents and adults: A large retrospective cohort study. Birth (Berkeley, Calif.), 51(1), 218–228. https://doi.org/10.1111/birt.12785
University of Mississippi Medical Center, Center for Informatics and Analytics. (2020). Patient Cohort Explorer. figshare. Software.
Zhang, Y., Lal, L. S., Lin, Y.-Y., Swint, J. M., Zhang, Y., Summers, R. L., Jones, B. F., Chandra, S., & Ladner, M. E. (2024). Tele-Mental Health Service: Unveiling the Disparity and Impact on Healthcare Access and Expenditures during the COVID-19 Pandemic in Mississippi. International Journal of Environmental Research and Public Health, 21(7), Article 7. https://doi.org/10.3390/ijerph21070819
Charisma™ Virtual Social Training: A Novel Approach to Measuring & Improving Social Cognitive Competencies and Remote Accessibility
Maria Johnson, Aaron M. Tate, Kathleen Tate, Sarah A. Laane, Zhengsi Chang, Sandra Bond Chapman
University of Texas at Dallas
Description: Utilizing an immersive digital health platform that combines live, strategy-based social coaching with dynamic roleplay offers a novel approach different from traditional therapy. Charisma™ proves to be an effective, research-supported social skill training that can be accessed from school, home, and clinical settings.
Abstract: This study evaluated the impact of 10 hours of Charisma Virtual Social Training (Charisma-VST) on social cognitive competencies in 9- to 17-year-olds with social challenges. The research compared outcomes between in-person and remote training formats and examined differences between participants with and without an autism diagnosis. Assessments were conducted during session one (pre-training) and session 10 (post-training), involving social inferencing, attribution and self-schema. Research clinicians engaged participants in four social interactions that took place in an immersive, interactive virtual learning environment (VLE). These interactions were recorded, transcribed and analyzed to dynamically measure five social-cognitive constructs: strategic social attention (SA), discourse (DISC), theory of mind (TOM), expressive reasoning (ER), and transformative, resilient thinking (TRA). Sessions two through nine focused on teaching nine social-cognitive strategies aimed at enhancing frontal lobe connections and critical thinking. Within the VLE, research clinicians acted as both “faux friend” avatars and social coaches. The “faux friend” avatars engaged participants in conversations, modeled prosocial responses, and provided diverse opportunities to practice social-cognitive strategies across varied personalities and contexts. As interaction complexity increased, social coaches guided participants to apply strategy-driven responses within the safe, virtual setting. Intermittent top-down coaching emphasized gist reasoning and fostered social resiliency between interactions.
Results: Results revealed significant improvements in measures of emotion recognition (t = 2.36, p < 0.05, Cohen’s d = 0.76), social inferencing (t = 7.67, p < 0.001, Cohen’s d = 1.37), and in non-standardized measures of social attribution (t = 2.57, p < 0.05, Cohen’s d = 0.54) and subjective social self-schemata (t = 6.05, p < 0.001, Cohen’s d = 1.13). Participants with and without autism made comparable gains across training locations. Additionally, the mean social competency scores from observational data in the VLE showed a statistically significant increase across the five social-cognitive constructs.
Conclusions: Overall, the immersive and interactive nature of CHARISMA-VST, alongside its adaptability and accessibility, makes it a powerful tool for social cognitive training. Clinicians and providers can customize scenarios to readily engage students and harness experiential learning. Additionally, utilizing a dynamic measurement of observed social-competencies within a VLE provides a new avenue for measuring social deficits and growth. These encouraging findings provide some of the first evidence that strategic, virtual social coaching improves one of the most important aspects of human behavior—social skills and human connectedness in youth with a range of social competency challenges.
Clinically- Supported Direct to Consumer (DTC) Visits Improve Patient Access and Business Continuity during Emergency Operations
Medical University of South Carolina, Charleston, SC
Description: During natural disasters, health care systems often respond with global changes to appointment schedules, such as cancellations and rescheduling, to reduce patient and provider travel in unsafe conditions. Clinically supported Direct to Consumer (DTC) telehealth models, using video visits, can be a vital tool in business continuity during emergency operations.
Abstract: Continuity of Operations Planning (COOP) is an essential element of Emergency Operations to ensure business continuity during a disaster. MUSC is located on the East Coast with frequent natural disaster impacts which forces the cancellation of thousands of patient appointments. Our core ambulatory COOP is to immediately begin rescheduling. This has many negative impacts on patient access including delays in care, patients lost-to-follow up, no-shows, and subsequently “bumped” patient appointments. Since COVID, MUSC has invested in a support structure for ambulatory video visits, which reached nearly 200,000 visits in FY2024. These visits are performed by 1,200+ providers across 500+ primary and specialty care clinics. Key to this growth has been the centralized telehealth support (TCS) team comprised of 15 CMAs who provide an additional layer of appointment readiness through virtual rooming and connectivity support. Nine of the 15 CMAs live outside South Carolina and can still offer operational support during disasters. During emergency operations for Tropical Storm Debbie, business continuity occurred during the disaster, rather than after, by converting appointments to virtual, where feasible. The infrastructure and the centralized support allowed for a smooth conversion to virtual visits to maintain patient access without compromising safety and minimally impacting expected revenues.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Observational
Method- Other:
Results: During two days of emergency operations on August 6-7, 2024, 1,524 in-person appointments were converted to video visits. This represented a 100% increase in video visit volume each day. Of the converted appointments, 89.6% were successfully completed, resulting in 1,366 patients who were able to keep their appointments on the same day with the same provider, even during a natural disaster. The estimated financial impact is around $273,200 in direct revenue. Downstream and indirect revenue estimates are likely higher, given that maintaining patient access during the storm enabled future patients to be seen as anticipated.
Conclusions: DTC Telehealth services, especially those supported by a remote TCS team, can be vital element in COOPs as an effective tool to maintain both patient access and business continuity. Telehealth has already demonstrated its capability to improve patient access during pandemics but should continue to be considered as a flexible method for maintaining access during temporary natural disasters and emergency operations. Though virtual urgent care services exist throughout the country and can be leveraged for urgent needs, DTC video visits can enable patients to see their own providers, as scheduled, and for their specific needs, regardless of local disaster impacts.
Community Health Workers Are the Key Agents in Delivering Primary Healthcare Using Telemedicine to Accelerate Universal Health Coverage Using a Hub and Spokes Model in Lusaka, Zambia
1University Teaching Hospital, Adult Infectious Disease Center, Lusaka, Zambia; 2Morehouse School of Medicine, Lusaka, Zambia; and 3Morehouse School of Medicine, National Center for Primary Healthcare, Atlanta, GA
Description: The COVID-19 pandemic created difficulties in providing HIV services, which negatively impacted PLHIV's continuity of care and resulted in a treatment pause with a rise in missed appointments. Community health workers (CHWs) are key players in the implementation of HIV-related programs.
Abstract: Morehouse School of Medicine (MSM) and the Ministry of Health (MOH) are collaborating to implement a telemedicine program in Lusaka, Zambia, using a hub and a spoke model. To minimize disruptions in the care of people living with HIV who are receiving anti-retroviral therapy (ART). Since 2021, the program has successfully scheduled and seen over 7000 appointments for those who have been identified (over 8000). CHWs have led telemedicine activities from telemedicine health education and consent, identifying eligible RoCs, appointment scheduling, and appointment reminders as well as retention of missed appointments for continuity of ART treatment for PLHIV. MSM has provided telemedicine capacity building by providing mentorships to over 150 community health workers in the telemedicine flagship sites and training 18 CHWs from September 2023 to November 2023, which resulted in a reduced missed appointment rate of 5% against the Ministry of Health's recommended 10% target.
Classification of Research: Clinical Outcomes
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: When it comes to telemedicine adoption, best practices demonstrated by CHWs should be applied in similar contexts or programs. CHWs must give top priority to informing and educating patients on the strengths and benefits of telemedicine as they play as they are tools for fostering change in communities for PLHIV to seek health services utilizing the telemedicine platform.
Conclusions: To achieve an HIV sustainability response in Zambia, governments must support and encourage a community-centered approach to HIV telemedicine program implementation.
Digital Allies in Trauma Care: Using Relational Agents to Improve Screening, Brief Intervention, and Referral for Substance Use
Laura M. Acosta, MA,1 Ken J. Ruggiero, PhD,1 Sarah German,1 Ebonie Powell,1 Timothy Bickmore, Ph.D,2 Sara M. Witcraft, PhD1
1Medical University of South Carolina and 2Northeastern University
Description: Relational agents (RAs) offer a scalable solution to meet national mandates for substance use screening, intervention, and referral. In this presentation, we present initial insights from staff and providers in trauma centers about the model's implementation.
Abstract: Annually, approximately 3 million U.S. adults sustain injuries that necessitate inpatient hospitalization, with up to 50% screening positive for alcohol or illicit drugs on admission. Since 2006, the American College of Surgeons (ACS) has mandated the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocols for alcohol use in trauma centers. However, the quality of SBIRT implementation varies widely across centers due to the lack of standardized procedures that result in inconsistent implementation, inequitable access to alcohol/drug screening, and absence of intervention. Cost-effective and technology-driven solutions offer a promising approach to improving compliance with ACS mandates and enhancing patient outcomes. One such solution is using relational agents (RAs) to deliver scalable and effective SBIRT in trauma centers. RAs are interactive virtual characters that use speech, gaze, gestures, and nonverbal cues to engage patients in a face-to-face conversational experience. Considering their ability to conduct assessments with fidelity while building rapport and maintaining patient engagement, RAs have the potential to streamline SBIRT processes, alleviate provider burden, and ensure equitable access to screening and intervention services. This study is to establish proof-of-concept for RA-delivered SBIRT (RA-SBIRT) in a Level I trauma center located in the southeastern United States.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: To assess integration, we will conduct a 45–60-minute focus groups with 8-12 trauma center staff, including nurses, social workers, and trauma center leaders. We will explore the perceived impact of RA-SBIRT on (1) workload impact, (2) implementation barriers, (3) workflow challenges, and (4) integration recommendations. Feedback will provide insights into barriers and facilitators for implementing RA-SBIRT, guiding future adjustments to enhance its implementation in trauma settings. Additionally, quantitative data from 100 patients receiving RA-SBIRT will be compared to a historical sample of provider-led SBIRT cases to assess completion rates for brief interventions and referrals.
Conclusions: By standardizing procedures and minimizing bias, RAs could address health equity concerns associated with substance use interventions. Feedback from trauma center staff will guide refinements, highlighting RAs' adaptability to real-world clinical settings. By providing standardized and efficient SBIRT, RAs may support national mandates while alleviating provider workload.
ETBOND SHERLOCK ROBOTIC SYSTEM FOR TELE SUPERCONSULTATION
Kumar Shah, MD
Endocrine Technology, LLC
Description: The recent advances in “Alternate Complement System” Proteins such as Factor H and Factor D is a subject of over 17800 global publications (1). This provides the secret sauce of “New evidenced based scientific data”. This data is used to provide superconsultancy services in major life threatening diseases.
Abstract: In evidenced based medicine “Recent Advances in Genomics and Fundamentals of Immunology” is a missing component. This has contributed to “99.99% error proned, multibillion dollar drug development system”. This is contributing to wide dissatisfaction in life science stack holders including patients. We focused on this missing component to overcome the drawbacks of evidenced based medicine. We are advancing a drug with industry best human safety record. On May 22, the Senate passed S.204, the 'Trickett Wendler, Frank Mongiello, Jordan McLinn and Matthew Bellina Right to Try Act', and sent it to President Trump who signed it on May 30, 2018, creating a uniform system for terminal patients seeking access to investigational treatments that FDA allows if the drug has “Human Safety Record”. A global implementation of such law will provide a scientific frame work to eliminate error prone drug developments and its adverse effects. A new science will emerge that will provide “Super Consultancy services” through telemedicine platform in disease specific manners globally. This will reduce global health inequality and cost of futuristic drug developments.
Classification of Research:
Classification of Research – Other: 1. Access to care; 2. Cost analysis; 3. Quality improvement; 4.
Artificial intelligence and 5. Information Technology
Method: Data Analysis of 17800 global publications over 20 years and developing drug with human safety that modulate immune pathogenesis of major life threatening diseases
Method- Other:
Results: A global implementation of “Right To Try Law” will provide a scientific frame work to eliminate error prone drug developments and its adverse effects. A new science will emerge that will provide “Super Consultancy services” through telemedicine platform in disease specific manners globally. This will reduce global health inequality and cost of futuristic drug developments.
Conclusions: Artificial intelligence applied to “Self–Non Self” (SNS) modeling to develop “Super Consultancy Services to all life science stack holders. Thus for example in Covid-19 mortality and morbidity could be reduced by over 50% based on Advances in Fundamentals of immunology and its bed side disease applications. 1. https://www.ncbi.nlm.nih.gov/pmc/?term=Factor+H; 2. FDA Right to Try Fact Sheet for Patients 1-10-20 PDF (www.fda.gov)
Evaluating a Menopause-Specific AI Model for Patient Portal Inquiries: Impact on Clinician Workload and Patient Perceptions
Nihar Ganju MD, Heather Hirsch MD, Liz VanSkike
1Heather Hirsch Collaborative
Description: This study assessed the use of an AI model trained in menopause to assist clinicians in responding to patient portal inquiries. While 66% of patients rated the AI responses as accurate, patient opinions on AI in health care were divided. Findings suggest AI can reduce clinician workload but require further refinement.
Abstract: Timely responses to patient portal inquiries are crucial in menopause care but can contribute to clinician burnout. To address this, we implemented an AI model trained on menopause-specific knowledge to assist clinicians in generating responses to non-urgent patient questions, aiming to reduce workload while maintaining response quality. Over a three-month period, an AI agent was used to respond to patient queries, with human triage ensuring high-acuity or urgent cases were directed to clinicians. Patients receiving at least one AI-generated response were surveyed to evaluate accuracy, tone, and their overall perception of AI in health care. Of the surveyed patients, 66% found the AI responses mostly or perfectly accurate, and 87% felt the AI matched the clinician's tone. However, opinions on AI were divided: 33.3% had a positive view, 33.3% were unsure, and 33.3% expressed concern. Additionally, 53% supported continued AI use to enhance clinician accessibility, while 26% felt it was potentially harmful. In conclusion, the AI model showed promise in reducing clinician workload and burnout by providing accurate, timely responses. However, mixed patient perceptions suggest further research is needed to improve AI integration and ensure comfort with its use in menopause care.
Classification of Research: Clinician Experience
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: 66% felt the AI-generated responses were mostly or perfectly correct. 26% felt the responses were somewhat or not correct. 87% reported that the AI responses matched the language tone of their clinician. Opinions on AI use in health care were divided: 33.3% viewed it positively, 33.3% were unsure, and 33.3% expressed concern. 53% supported continued AI use to improve clinician accessibility, 20% were unsure, and 26% felt it was harmful.
Conclusions: The menopause-specific AI model demonstrated potential in reducing clinician workload and addressing burnout by providing accurate and timely responses to patient inquiries. However, the mixed patient perceptions suggest further research is needed to improve AI integration and ensure patient comfort with its use. Future work should focus on long-term impacts on clinician efficiency and patient outcomes.
Evaluation of a Virtual Multidisciplinary Care Delivery Model for Gastrointestinal (GI) Disorders
Sameer K. Berry, MD, MBA,1,2 Jeffrey A. Berinstein, MD, MS,3 Joseph C. Ahn, MD, MS,4 Walter W. Chan, MD, MPH,5 John I. Allen, MD, MBA,3 William D. Chey, MD3
1Oshi Health; 2Division of Gastroenterology and Hepatology, NYU Langone School of Medicine, New York, NY; 3Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI; 4Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; and 5Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Description: This study evaluated the impact of a novel virtual multidisciplinary care delivery model for GI disorders on access to care, patient-reported outcomes, and care quality.
Abstract: Gastrointestinal (GI) disorders are associated with significant distress and expenditure. Multidisciplinary care has demonstrated superior outcomes. However, access is not widely available. This retrospective study was conducted on 8,836 patients receiving telehealth multidisciplinary GI care. Care was delivered by advanced practice providers, dieticians, psychologists, and gastroenterologists. Wait times, symptoms, engagement, patient-reported outcomes, and satisfaction were assessed. The study cohort (N=8,836) was 61% female and 39% male, with a mean age of 42. Disorders of gut-brain interaction, esophageal disease, and inflammatory bowel disease constituted the predominant diagnoses. Mean time to consultation was 5.2 days (SD 4.16) - a significant improvement compared to 26.1 days in traditional care. At baseline, 69% of patients endorsed moderate to severe symptoms, with 72% reporting symptoms ≥3 days per week. Longitudinal analysis of a paired sample cohort revealed a statistically significant reduction in the prevalence of moderate to severe symptoms from 71% at baseline to 7.1% following four encounters. 92% reported symptom control, 94.9% indicated symptomatic improvement, and 98% expressed satisfaction with care. This study demonstrates that virtual multidisciplinary care has widespread reach and significant impact, providing timely access to high-value care for individuals suffering from GI disorders
Classification of Research: Access to Care
Classification of Research – Other:
Method:
Method- Other: Retrospective cohort
Results: See Abstract
Conclusions: See Abstract
Healthcare Challenges vis-a-vis the Virtual Telehealth care for Indian Population
Dr. Bhagwant Singh Ratta,1 Satyamurthy Lakkavalli2,3
1Ruby Hall Clinic, Pune, India; 2Suquino Telehealth India; and 3Planet Aerospace Bangalore, India
Description: This paper explores the challenges and opportunities within virtual telehealth care for the Indian population. It focuses on policy evolution, technology innovations, health care provider training, and patient engagement. The aim is to identify key areas for improvement and propose strategies to create a robust telehealth framework in India.
Abstract: “Ayushman Bharat Digital Mission” (ABDM), the flag ship Health care mission of Government of India, undertook major digitization of country’s health data for better tracking and management of health care delivery during Covid-post Covid era. The shift towards virtual telehealth care in India has revealed significant challenges, including data security, digital literacy, and regulatory frameworks. As the country navigates the complexities of telemedicine, key areas for improvement emerge, such as enhancing data protection measures in compliance with laws like the Digital Personal Data Protection Bill, 2023. This paper emphasizes the importance of advancing technological infrastructure, including AI and machine learning, to optimize patient outcomes and streamline telehealth services. Training health care providers on effective telehealth practices is vital, as is empowering patients through health literacy initiatives. Collaborative efforts involving public-private partnerships and international best practices can help create a more integrated approach to telehealth. Through targeted research and pilot programs, India can develop a sustainable telehealth model that addresses current challenges while ensuring equitable access to health care for all populations. Overall, by focusing on policy, technology, training, and collaboration, the future of telehealth in India can enhance health outcomes and reshape the health care landscape.
Classification of Research:
Classification of Research – Other: Review of Policy and Implementation
Method: Survey/Qualitative
Method- Other: Special Program Implementation
Results: Successful integration of Telemedicine platforms into existing health care systems. Progressive implementation of population registry. Better compliance to Legal aspects and Telemedicine practice guidelines. Adaptation specific technologies for secured health data management and Mobile Apps for health tracking. Usage of unified Telemedicine Platform like “e Sanjeevini” developed by Government Research Lab Centre for Development of Advanced Computing (CDAC) strengthening public private partnership. Example of one such private Startup in collaboration with Tata Industrial enterprise reported 10 million Teleconsultation in two years. Strengthening health care infrastructure with diligent budget allocation. Better efforts for capacity Building, training, and upskilling of health care workers.
Conclusions: In conclusion, addressing the challenges faced by telehealth in India requires a multifaceted approach involving policy evolution, technological innovation, and enhanced training for health care providers. Ayushman Bharat Digital Mission (ABDM) paved way for digitization of health records and revision of population registry. Post Covid Virtual Care accelerated adoption of tele-consultations and enhanced monitoring of chronic conditions. By fostering collaboration and empowering patients, India can establish a sustainable and effective telehealth framework. This will not only improve access to health care with aided telehealth practice but also enhance overall health outcomes for the population. Governance and Management of National Telehealth program in Asia . Published May 2015
Implementation and Impact of a Virtual Urgent Care Follow-up Program for Emergency Department Discharges: A One-Year Review
Grace Lee, BA,1 Brendan Holderread, MD,1 Sarah Pletcher, MD,1 Ngoc-Anh Anh Nguyen, MD,1,2,3
1Center for Innovation, Houston Methodist Hospital, Houston, TX, USA; 2Department of Emergency Medicine, Houston Methodist Hospital, Houston TX, USA; and 3Department of Virtual Urgent Care, Houston Methodist Hospital, Houston TX, USA
Description: Virtual Urgent Care (VUC) is a 24/7/365 telemedicine program providing on-demand remote care. This study examined the utilization and impact of VUC on patients discharged from the emergency department (ED). Demographic variables and clinical outcomes, measured by spontaneous 90-day ED revisit rates, were compared between the VUC and No-VUC groups.
Abstract: The period following an acute care visit (ED or hospital admission) is challenging for patients as they adjust to new medications and coordinate outpatient care. Failure to do so increases their risk of clinical deterioration.1 In July 2023, we identified VUC as a potential solution to bridge care gaps after ED discharge. We implemented an automated text messaging system to contact all discharged ED patients 48 hours post-visit, providing a link to schedule a follow-up VUC appointment with an advanced practice provider. This program was piloted at an urban quaternary hospital ED in Texas and later expanded to three free-standing emergency care centers. Over a year (September 2023–October 2024), 622 patients requested a VUC follow-up, and 216 of them successfully scheduled an appointment. Of these, 64 canceled (No-VUC group), and 152 completed their appointments (VUC group). We compared the baseline demographic and clinical characteristics of the two groups, including age, sex, and Emergency Severity Index assigned during their ED visits. We also evaluated the spontaneous 90-day ED revisit rates for each group, excluding revisits directed by a VUC provider. The program is ongoing, and additional data will be included to enhance statistical power before the conference.
Classification of Research: Quality Improvement
Classification of Research – Other: Clincal Outcomes
Method: Observational
Method- Other:
Results: Both No-VUC and VUC groups were predominantly female (73.44% and 72.37%, respectively) and had mean ages of 53 and 55 years (P=0.598). The median Emergency Severity Index was 3 for both groups. Ninety-five VUC patients received additional care, including new prescriptions (35.79%), ambulatory referrals (20%), and instructions to return to the ED (18.95%). 29.69% of the No-VUC patients had a spontaneous 90-day ED revisit, compared to 15.13% of VUC patients when excluding revisits from VUC referral. The odds of a spontaneous 90-day ED revisit were significantly higher in No-VUC group compared to VUC group (OR: 2.38; 95% CI: 1.18–4.75; P=0.023).
Conclusions: There were no differences in baseline characteristics between No-VUC and VUC groups. No-VUC group had a significantly higher 90-day revisit rate compared to the VUC group. The VUC program demonstrated potential as an effective transition-of-care intervention by reducing post-ED discharge revisits and promoting continued engagement with the health care system. It provided patients the opportunity to address remaining concerns and facilitated referrals to appropriate levels of care. Our findings suggest that automated messaging is a simple and efficient strategy to encourage timely follow-up care with VUC. Further research is needed to assess long-term outcomes and patient satisfaction with the VUC model.
1Van Spall HGC, Rahman T, Mytton O, et al. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017;19(11):1427-1443.
Implementation of AI-powered Virtual Nursing Programs Across Multiple Hospital Settings
Lindsey Kuiper, Greg Hall, Saurabh Chandra
Center for Telehealth, University of Mississippi Medical Center
Description: The U.S. is currently facing a significant nurse staffing crisis, limiting hospital bed availability and service capacity. Our Virtual Nursing program leverages AI and large language models to enhance nurse recruitment, retention, and support bedside staff, addressing the shortage while helping hospitals maintain financial viability and meet community health care needs.
Abstract: Nursing is the nation's largest health care profession. According to the U.S. Bureau of Labor Statistics, the country will need more than 203,000 new registered nurses every year through 2026 to fill the gap in care left by a shrinking workforce. Mississippi hospitals in 2022 were missing a quarter of their total registered nurse staff, 21.4% of their licensed practical nurse staff and 21.3% of their certified nursing assistant staff. The crisis is particularly acute in rural areas, where 38% of hospitals are at risk of closing. We aim to bridge these gaps through the implementation of Virtual Nursing program which will be driven by remote connectivity between bedside nurses and patient rooms, and an AI solution for preventing hospital-acquired injuries. The AI technologies will enhance the virtual nursing program which, taken together, is predicted to dramatically reduce the workload of the bedside nursing team.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Moving Ideas to Implementation
Method- Other:
Results: The Virtual Nursing model is a unique approach to addressing nursing staff shortages that ballooned during the pandemic. An effective Virtual Nursing program would allow an on-site team to spend more time on patient care and less time on administrative tasks. This has the potential to reduce bedside nursing burnout, satisfaction, retention and ability to recruit. Upon implementation of Virtual Nursing at a Mississippi Critical Access Hospital, we will measure and report key performance indicators across several domains: clinical outcomes, operational efficiency, patient safety/quality, patient experience, cost effectiveness, and staff satisfaction.
Conclusions: Overall, the Virtual Nursing program has potential to prevent hospital closures, benefiting the local community in several ways: 1) Patients wouldn’t need to travel for care, leading to better health outcomes; 2) Reduced nursing shortages would expand available services; 3) Keeping hospitals open would stabilize local employment and support businesses dependent on health care facilities, such as pharmacies and labs. Future work will demonstrate the value of the program, address challenges and barriers, and establish best practices for implementation in various hospital settings.
Improved Patient-Provider Interactions in Telehealth Encounters Assisted by an AI-based Scribe
Center for Telehealth, University of Mississippi Medical Center
Description: Strong patient engagement has the potential to transform Telehealth into a vital component of comprehensive, patient-centered care. In this study we have explored the impact of AI scribe on provider reported experience with technology and patient engagement.
Abstract: Several barriers can hinder patient engagement during telehealth visits. One of the key barriers is the absence of a personal connection with the provider that is established over a Telehealth platform as opposed to face-to-face visit. Documentation and other administrative tasks can significantly prevent meaningful patient-provider interactions. Artificial intelligence (AI) scribing is designed to assist clinical providers by transcribing patient interactions, medical histories, and clinical notes. This allows physicians to focus more on patient care rather than administrative tasks potentially leading to more meaningful conversations and improved patient-provider interactions. In this study, an AI-scribing tool was employed to assist with real-time medical documentation during Telehealth visits. The AI-driven platform utilizes advanced speech recognition and natural language processing to transcribe provider-patient interactions during Telehealth visits. A pre-post intervention study was conducted by recruiting and training 19 health care providers across three specialty areas (urgent care, behavioral health, and geriatrics) to utilize the AI-scribing tool. All providers were given a pre-intervention survey before implementation, as well as two post-intervention surveys at 1 month and 3 months. Among the 19 participants, 89.47% (n=17) were female, 84.21% (n=16) were aged between 35 and 54 years old, and 15.79% (n=3) were at least 55 years old.
Classification of Research: Clinician Experience
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: Before using the AI-scribing tool, 21.05% reported burnout from regular scribing, 15.79% were dissatisfied with the time spent, and 21.05% felt they had no control over their workload. Prior to implementation, 52.63% believed the AI tool would improve efficiency, 57.89% were comfortable using it, and 52.63% expected more patient time. After 1 month of use, 50% reported reduced burnout, rising to 61.54% at 3 months. Satisfaction with documentation increased from 66.67% at 1 month to 76.92% at 3 months, and satisfaction with the tool’s quality grew from 66.67% to 84.62%.
Conclusions: Our findings indicate that AI scribes can significantly improve the efficacy of patient-provider interactions by automating documentation tasks, allowing health care professionals to focus more on patient communication and care. Future research will focus on addressing cost-effectiveness of the technology.
iTREAT Mobile Telestroke: Driving Stroke Treatment Forward
Brett Schneider, BA,1 Kathryn Fivelstad, MD,1 Nina Solenski, MD,1 George Lindbeck, MD,1 Christine Buttenshaw, MPH,1 Brian Gunnell, BS
UVA Health
Description: Improving Treatment with Rapid Evaluation of Acute Stroke (iTREAT) places telemedicine equipment in the back of ambulances for the purpose of conducting a telestroke exam during an emergency patient transport. Completing these tasks during transport allows care teams to improve their efficiency once the patient arrives in the Emergency Department.
Abstract: The goals of iTREAT are to validate stroke assessments completed by emergency medical services (EMS) personnel and to improve key efficiency metrics that are tied to patient outcomes. To accomplish these goals, the iTREAT program at UVA Health installs telemedicine equipment in ambulances throughout central Virginia. Upon installing equipment, EMS personnel receive additional training on stroke care and facilitating telemedicine encounters. To illustrate the effectiveness of this program, we examine the case of an adult male in his 40’s with a possible stroke. Upon arrival, the EMS crew quickly assessed the patient, loaded them in their ambulance, and an iTREAT activation was requested with a 45 minute transport duration to the UVA Health comprehensive stroke center. The vascular neurologist at UVA placed a video call to the ambulance, gathered all pertinent history, and examined the patient via the telehealth application. Upon arrival at the Emergency Department, the patient was briefly re-examined and was quickly sent to radiology for stroke imaging. No contraindications to treatment were identified.
Classification of Research: Clinical Effectiveness
Classification of Research – Other:
Method:
Method- Other: Case study
Results: In our case study, the patient received the thrombolytic Tenecteplase within a facility record breaking 14 minutes of arriving at the ED. The patient was admitted, where his symptoms quickly improved. The patient was discharged home the following day with near-complete resolution of their symptoms. By using telehealth technology during transport, the neurologist had more time to gather information, conduct an examination, and make a decision on treatment than they typically would. This greatly improved the speed of treatment while allowing ample time to make decisions in a safe and deliberate manner.
Conclusions: iTREAT is an effective tool in UVA Health’s ongoing efforts to improve stroke patient outcomes and enhance patient safety. Significant improvements in door-to-thrombolytic times can be achieved by using telehealth capabilities to reduce the neurologist-to-patient access time, resulting in improved patient-centered outcomes.
Keeping to a True North on Data When Delivering Acute Speciality Care across 50 States
Vanisa Patel
Access Telecare
Description: A lack of standardization, operational leadership, and accountability led to inaccurate reporting of patient volumes. The concern was the impact to revenue, management systems, and both internal and external customer confidence/satisfaction. This led to a DMAIC framed project focused on ensuring a true north on volumes with a multidisciplinary team.
Abstract: As the need for acute speciality care providers only grows, it has rapidly grown and scaled Access TeleCare rapidly. This meant undergoing mergers and aquisitions that set a foundation necessary to provide services across all 50 states. The side effect of rapid growth included a varied processes, operational leadership, and accountability that led to inaccurate reporting of patient seen. The concern was impact to revenue, management systems, and both internal and external customer confidence/satisfaction. An improvement project kicked off in the fall of 2023 using DMAIC methodolgoy. The aim was to develop metrics, build data visualization, and set up reporting governance structure by Q4 2024, with the goal of improving the percentage (%) of complete encounters by Q1 2025.The project identified the three metrics to be reconciliation of inaccurate billing/coding, preventable voids, and incorrect assigning of no charges to encounters.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: A daily Tableau management tool rooted in metrics was implemented with all specialties to use on a weekly basis for encounter volume reconciliation. Introduction of management reports ”culture of discipline through people, thought & action"
Conclusions: N/A
Motivation for Standardization: Redefining Telehealth Provider Onboarding
Bryna Rickett, Julia Carriker, Sshune Rhodes, Dylan Sutherland, Christine Larson
Medical University of South Carolina
Description: Telehealth services are more in demand, with an increase in Telehealth specific provider onboarding and training. Onboarding elements that impact reimbursement, payments, clinic flow, patient and provider satisfaction need to be addressed with new providers hired to demonstrate success with a Telehealth service and offer optimal care to patients.
Abstract: The development team in a Telehealth department reviewed onboarding elements needed from a regulatory and best practice standpoint and developed a standardized checklist and onboarding plan for providers. The plan included ongoing communication with leadership and the provider on any barriers that might impact provider’s start date and jeopardize patient care. Collaboration with a HR onboarding specialist to better understand the pre-hire elements and processes so that the provider would have the necessary tasks completed prior to coming to Telehealth for onboarding. This team met biweekly to review pre-hire elements such as credentialing, payer packet completion, licensing needs, employee health screening, and contracts as well as timelines for completion and any barriers to onboarding. A soft handoff from HR to the Telehealth team was established. A standardized onboarding to the Telehealth department that covered service develop builds (template builds for EMR documentation, scheduling requests and builds, requesting provider equipment) as well as a mapped-out orientation plan for the provider that was communicated to the provider prior to start date so that ideas can be shared. This included orientation to the Telehealth department, meet and greets with leadership, Telehealth training, compliance training, platform training, and identifying point people for ongoing support.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: Prior to standardized onboarding: 40% of providers onboarded without any outstanding onboarding tasks by the providers’ first scheduled shift. 25% of the providers received compliance and documentation/billing training prior to first shift. 81.6% -average score on compliance audits of documentation and billing (which caused a delay in completion of documentation, billing, and recommended care for the patient). Post standardized onboarding: 100% of providers onboarded without any outstanding onboarding tasks by the providers’ first scheduled shift. 100% of the providers received compliance and documentation/billing training prior to first shift. 97.8%-average score on compliance audits of documentation and billing.
Conclusions: Standardized orientation and clear communication and partnership with HR onboarding specialists have shown positive impacts in both patient care and provider readiness. The model is scalable and allows foundational support for future virtual specialties.
Outpatient On-Site Video Services Diffusion Process
Jennifer Anderson, Rebecca Clig, Janelle Goetzinger
Mayo Clinic (Center for Digital Health)
Description: The Mayo Clinic Center for Digital Health developed a scalable model for implementing outpatient on-site video services, which improve health outcomes, reduce travel burdens, and increase access to care. This virtual option supports patients with limited technology or internet access while enhancing clinician availability and fostering better collaboration among care teams.
Abstract: This case study outlines the processes, structures, and best practices for deploying a scalable on-site video program. Developed by the Mayo Clinic Center for Digital Health, the program serves over 5,000 patients a year at Mayo medical centers in Arizona, Florida, Rochester, as well as a multi-site health system in the Midwest. It details a comprehensive approach to service assessment, including the use of key performance indicators (KPIs) to gather insights and guide the initial adoption phase. The study also explores strategies to bridge the digital divide, ensuring access to care for a diverse patient population. Emphasizing the importance of a collaborative, multidisciplinary team, the case study highlights how integrating stakeholder feedback and engagement across various phases of the implementation fosters continuous quality improvement. Through this approach, the Mayo Clinic Center for Digital Health has been able to enhance patient access, improve outcomes, and optimize the delivery of virtual care services.
Classification of Research: Measurement Frameworks & Tools
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: Results of this approach have provided scalability and have led to over 5,000 patients per year being seen as part of over 240 live services across the Mayo Clinic enterprise.
Conclusions: On-Site Video services were introduced to the outpatient setting at Mayo in 2018. Since its introduction, implementation processes and deployment strategies have continually been refined to ensure scalability and optimize clinical and operational outcomes. Over time, the on-site video program has expanded to include over 240 services, serving over 5,000 patients per year. This telemedicine option has been shown to improve health outcomes and reduce travel burdens for both patients and care teams, making health care more accessible and convenient. Additionally, on-site video has improved multi-disciplinary collaboration, allowing clinicians to work together more effectively and efficiently, ensuring better patient satisfaction.
Patient, Provider Experience and Quality Improvement with a Virtual Hospitalist Admissions Program
Ngoc-Anh Anh Nguyen, MD,1,2 Brendan Holderread, MD,1 Henry Ellison, MD,3 Grace Lee, BS,1 Sarah Pletcher, MD1
1Center for Innovation, Houston Methodist Hospital, Houston, TX, USA; 2Department of Emergency Medicine, Houston Methodist Hospital, Houston TX, USA; and 3Department of Internal Medicine, Houston Methodist Hospital, Houston TX, USA
Description: The study aims to evaluate patient and physician satisfaction with a virtual Telehospitalist care initiative to improve staffing during times of high-volume times of hospital admission. Qualitative and quantitative survey feedback for acceptability and quality improvement (QI) along with admission metrics were collected.
Abstract: A nocturnal Telehospitalist program using audio-video technology with an artificial intelligence (AI) interface was implemented during times of emergency department (ED) volume surges starting October 1, 2024. Metrics for Telehospitalist patients such as time to consultation, time to note completion, time to plan of care, call duration, admission volume, and length of stay will be obtained in aggregate. Patient satisfaction through surveys with six questions using the Likert scale (1= Strongly Disagree, 5= Strongly Agree) and qualitative comments are sent to patients for feedback. Staff satisfaction is being assessed through six questions using similar methodology and different questions. The program is being implemented at an academic medical center and three free-standing emergency departments (FSED). Of note, at FSEDs patients previously would wait to be seen by their hospitalist upon transfer to the academic center, which could take up to several hours. Initial challenges included technology difficulties at the stand-alone locations, difficulty with identification of the ‘cart’ required to use the technology, and patient reports of high-volume in non-private rooms. Our leadership stakeholders have addressed privacy issues and worked with our vendor to address technology difficulties. The program’s implementation is ongoing.
Classification of Research: Patient Experience
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: 15.5% (19/123) of admitted patients completed a survey. Responses to patient surveys have been provided in Table 1. 3/7 (42.9%) of participating physicians have completed the 1-month feedback survey. Preliminary qualitative feedback from three hospitalists in the program has been positive when considering patient care. Preliminary qualitative feedback from ED nursing leadership has been positive with increased access compared to an in-person hospitalist. Note: Table 1 includes the full, actual questions, and patient responses with an average and standard deviation.
Conclusions: After one month, the Telehospitalist health initiative has received preliminary positive feedback from patients, physicians, and nursing leadership. As with all new implementations, rollout challenges occurred and include: technology limitations and privacy concerns from patients. Patient’s satisfaction from survey results is trending positive, which may mean patients are receptive to the telehospitalist. QI metrics such as time to consultation, time to note completion, time to plan of care, call duration, admission volume, and length of stay will be obtained in aggregate at the 3-month mark and presented, if accepted.
Planned Parenthood filling in the gaps in gender-affirming care via telehealth
Nicole Levitz, Heather Bendix
Planned Parenthood Federation of America
Description: Gender-affirming care (GAC) is Planned Parenthood’s fastest growing service and telehealth is proving essential in meeting that need. Looking at virtual care for GAC, we learned the states with the most appointments come from across states of all political leanings.
Abstract: Gender-affirming care (GAC) is Planned Parenthood’s fastest growing service and telehealth is proving essential in meeting that need. A quarter of all Planned Parenthood GAC appointments are now delivered through virtual health centers. Among the services we offer via virtual health center, only birth control and STIs outpace GAC. Birth control is most popular accounting for a third of all virtual health center visits. STIs is the second most popular service and is only ahead of GAC by less than a percent. Exploring the states with the most GAC appointments, population size and the affiliate centering the virtual health center modality drives the most patient volume. The top five states over the last 12 months are Texas, Pennsylvania, Michigan, New York, and Ohio. However looking at the top states for receiving patients from out of state it becomes much more complicated with Washington, DC, DE, NH, KS and RI sitting at the top. We continue to explore patterns to drive actionable insights to bring back to Planned Parenthood affiliates to iterate on telehealth for GAC.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: Gender-affirming care (GAC) is accessible across 23 states via Planned Parenthood’s virtual centers. States across the political spectrum are represented. On average GAC via virtual care was booked for an average 3 days sooner than in-person care. The wide range of states offering virtual care greatly improves accessibility to these services, and virtual care itself improves the speed at which patients get the care they need.
Conclusions: We continue to explore patterns to drive actionable insights to bring back to Planned Parenthood affiliates to iterate on telehealth for gender-affirming care (GAC). Patient needs and the hunger for increased accessibility to these services continues to drive growth in GAC and virtual care provides not only wider accessibility but improved efficiencies.
Scaling Up Providers Privileges by Investing in a Robust and Agile Professional Practice Evaluation (PPE) Process
Vanisa Patel, Maria Zayas
Access Telecare
Description: This project focused on how Access TeleCare’s internal PPE process has improved year over year since 2022, due to a focus on standardization and daily management cross-departmental processes.
Abstract: The PPE program is a regulatory requirement for any care setting with a medical staff delivering care, by accreditation and governmental agencies. Being required at the regulatory level provides the confidence to communities that no matter where a provider practices, their performance is representative of all care delivered. In 2022, Access TeleCare underwent a large growth of providers across numerous specialties, leading to varied and unrealistic PPE expectations from the variety of care settings served. This was only worsened by heavily manual and varied internal processes with consistent delays and gaps in completion. This project used the DMAIC methodology aimed at improving compliance to 100% timely completion annually. From 2022 to 2024, Access TeleCare’s number of providers also increased 22%. Even with this rapid growth, 100% compliance was met by end of December 2023 and is on track to meet compliance even sooner in 2024. This is attributed to optimization of internal software to automate process steps, robust facilitation across departments to hold better accountability, and agility to pivot when measures were not being met.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: From 2022 to 2024, Access TeleCare’s number of providers requiring professional practice evaluations increased 22%. Compliance to completion of PPEs was 100% across all service lines in 2023 by December 31, 2023 and is on track to meet compliance even sooner in 2024. The improved 2024 process required evaluators to share feedback with the providers, compliance to this only reach 12%. It required the intervention of the Quality Department to ensure 100% of providers receive and review their PPE.
Conclusions: This project proved that as the volume of providers and privileges grow, the process to assess their performance must be agile. Using the DMAIC methodology ensured the design and planning is rooted in measures with ability to pivot. Standardization across all specialties with regular communication and report outs have ensured all providers are thoughtfully and equitably evaluated and compliance is met annually. An area of opportunity is having evaluators connect directly with their providers to encourage more real-time dialogue. This discussion and results will be reviewed with clinical leadership to continue improvement efforts in 2025.
Telehealth Mindfulness-Oriented Recovery Enhancement: An Efficacious Intervention for Chronic Pain, Opioid Use, and Opioid Use Disorder
Eric Garland, PhD1
1University of California San Diego
Description: The opioid crisis was driven by physical and emotional pain, yet access to evidence-based treatments for pain and addiction is limited. This research proposal describes outcomes from two randomized controlled trials of Mindfulness-Oriented Recovery Enhancement (MORE) as delivered by telehealth for people with chronic pain and opioid use disorder.
Abstract: The opioid crisis was driven by an epidemic of physical and emotional pain. Unfortunately, few evidence-based therapies simultaneously treat addiction, emotional distress, and chronic pain. Further, a scarcity of trained providers hinders access to evidence-based interventions for this complex comorbidity. To meet this need, Mindfulness-Oriented Recovery Enhancement (MORE) was generated through a decade-long NIH-funded treatment development program. MORE unites mindfulness, cognitive-behavioral therapy, and positive psychology into an intervention that can be delivered by telehealth. Here we present results from two federally-funded randomized controlled trials of MORE for veterans on long-term opioid analgesic therapy for chronic pain (N=230), and for people with OUD and pain in methadone treatment (N=154). In the first trial, MORE was delivered by telehealth and in-person; MORE reduced chronic pain (p=.01) and opioid dosing (p=.029) to a significantly greater extent than supportive therapy, and MORE delivered by telehealth was noninferior to MORE delivered in person. In the second trial, telehealth MORE reduced days of illicit drug use (p<.001) and pain (p<.001) and improved methadone adherence (p=.04) to a significantly greater extent than addictions treatment as usual. Results from these trials demonstrate that delivering MORE via telehealth is a feasible and efficacious approach to addressing the opioid crisis.
Classification of Research: Clinical Effectiveness
Classification of Research – Other:
Method: Randomized Controlled Trial
Method- Other:
Results: In the first randomized clinical trial, MORE was delivered by telehealth and in-person; MORE reduced chronic pain (p=.01), opioid dosing (a 21% decrease, p=.029) and increased indicators of emotional wellbeing (p=.01) to a significantly greater extent than supportive therapy. MORE delivered by telehealth was noninferior to MORE delivered in-person. In the second randomized clinical trial, telehealth MORE reduced days of illicit drug use (p<.001), pain ratings (p<.001), and depression scores (p=.04), and improved methadone adherence (p=.04), to a significantly greater extent than addictions treatment as usual.
Conclusions: Results from these NIH- and DOD-funded randomized clinical trials demonstrate that delivering MORE via telehealth is a feasible and efficacious approach to simultaneously treating addiction, emotional distress, and chronic pain. MORE has applications along the continuum of care from prevention to treatment of addiction, mental health, and also in pain management. As such, MORE should be considered for widespread dissemination as an insurance-reimbursable service via telehealth platforms to address the ongoing opioid crisis.
Telehealth Utilization Patterns among Patients with Multiple Chronic Conditions in Arkansas
Description: Patients with multiple chronic conditions (MCCs) face care coordination challenges and poorer health outcomes. Outpatient telehealth may be an effective way to enhance MCC patient care given the need for multiple visits and specialists. This study seeks to describe telehealth utilization between 2013 and 2023 in Arkansas.
Abstract: We utilized the Arkansas All-Payer Claims Database (APCD) to identify patients diagnosed with high-prevalence MCCs comprising diabetes with comorbid hypertension, hyperlipidemia, or asthma. We then measured telehealth utilization defined as any claim associated with a telehealth modifier code, a place of service code defining the service as occurring in the patient’s home, or remote patient monitoring. Finally, we created payer-specific (e.g., commercial or Medicaid) yearly measures of the number of any telehealth claims among MCC patients divided by the number of MCC patients for that year. Linear regression was used to measure the difference in utilized during the COVID-19 pandemic versus prior to the pandemic.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: Overall, the COVID-19 pandemic era was associated with an increase of telehealth utilization among commercial patients by 1.01 telehealth claims per MCC patient (95% CI: 0.39 to 1.62, p<0.01) from a baseline value of less than 0.01. For Medicaid patients, the increase was 1.94 telehealth claims per MCC patient (95% CI: 1.00 to 2.89, p<0.01) from a baseline value of less than 0.03. These results were driven by increases among patients with diabetes and asthma, whose experienced increases in utilization that are about 50% larger in magnitude than those with diabetes and hyperlipidemia or diabetes and hypertension.
Conclusions: Variations in telehealth uptake among MCC patients suggest heterogeneity in its suitability and necessity. We will later evaluate whether telehealth use is associated with different levels of inpatient and emergency department utilization. We expect the findings to provide clarity on the suitability of telehealth use by MCC disease status.
Telehealth, Gender, and Substance Use Disorder: Exploring Utilization Patterns and Implications for Care
Emily Giangrande
1University of Illinois Chicago
Description: This study analyzes gender differences in telehealth utilization for substance use disorder (using 2022 National Survey on Drug Use and Health data. Findings reveal that women were more likely to use telehealth alone, though both genders showed similar overall utilization patterns. Implications for service provision and collaboration are discussed.
Abstract: Research on gender differences in substance use disorder (SUD) has highlighted distinctive treatment needs, addiction pathways, and barriers to treatment for women and men. Phone and video-delivered (telehealth) SUD services can deliver effective care while overcoming many access barriers, such as lack of transportation or childcare, fear of stigma, and others. However, much is still unknown about how telehealth SUD services are used, whether on their own or in conjunction with other services, and their differential impact by gender. Using survey data from the 2022 National Survey on Drug Use and Health (NSDUH), this analysis explored: 1) Utilization of substance use telehealth services and their association with in-person care, telehealth for mental health, and telehealth for physical health among people with SUD; 2) Differences in utilization between men and women. We used data from the 2022 National Survey on Drug Use and Health (NSDUH). Respondents included in the analyses met criteria for SUD within the past 12 months (N = 10,806). Chi-square analysis and binary logistic regression were applied to examine treatment associations and compare means between groups.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: 5.5% of respondents received telehealth services for treatment of SUD (N = 890). 91.6% of respondents who used telehealth for SUD used it in conjunction with other kinds of care. Men and women did not have significantly different odds of using telehealth SUD services (p = 0.385) or using different numbers of services (women = 4.8, men = 5.5; p = 0.133), but women had significantly higher odds than men of utilizing telehealth SUD services alone, without any other care (aOR = 2.38; p = 0.04). Services with significant associations with telehealth were largely outpatient and community-based.
Conclusions: Utilization of telehealth SUD services was similar to that of in-person care. Although a relatively small number of respondents who received SUD services used telehealth alone, women had higher odds than men of being in this category. Women and men did not significantly differ in their overall use of telehealth SUD services and had minor differences in use of the in-person services they used along with telehealth. Possible implications of the types of services associated with telehealth will be discussed, including the potential for collaboration with peer specialists and primary care providers.
Telemental Health Care Providers’ Comfort with Telemedicine Prescribing: A content analysis of semi-structured interviews
Julia Ivanova, PhD,1 Mollie R. Cummins, PhD, RN, FAAN, FACMI,1,2 Hiral Soni PhD, MS, MBA,1 Triton Ong PhD,1 Brian E. Bunnell, PhD,1,3 Brandon M. Welch, PhD1,4
1Doxy.me Science, Doxy.me Inc., Charleston, SC, USA; 2College of Nursing and Spencer Fox Eccles School of Medicine, Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA; and 3Department of Psychiatry and Behavioral Neurosciences, Mor
Description: We report findings from 2024 interviews with prescribing telemental health care providers regarding their comfort, barriers, and workarounds when prescribing over telemedicine. We found that providers use three main parameters to determine whether they are comfortable prescribing over telemedicine: practicing within their expertise, being compliant, and having needed patient health information.
Abstract: As policymakers gather more information to determine how best to update telemedicine laws and regulations, there is a need to assess providers’ feelings of comfort and safety when prescribing over telemedicine. Between February and April 2024, we conducted 16 semi-structured interviews with prescribing telemental health providers. We developed a content analysis codebook based on the results of a previously completed, cross-sectional survey. We applied the codebook to specific subsections of interview data over three iterations to identify provider perspectives regarding comfort, barriers, and workarounds when prescribing over telemedicine. Participants were mostly male physicians who provided care mostly over telemedicine. We found that participants felt comfortable prescribing over telemedicine when they thought they were compliant with laws and regulations, had access to the necessary patient health information, and practiced within their expertise. Providers reported frustrations related to e-prescription platforms and communications with pharmacies, and many of their workarounds dealt with minimizing the effects of such frustrations and honing their telemedicine workflows. Providers emphasized that patient well-being was the critical driving factor in their decision-making.
Classification of Research: Regulatory & Policy Research
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: Interviewed participants tended to be male (11/16) and psychiatrists (8/16) or physicians (3/16) who mainly provided care over telemedicine (11/16). We identified three principal codes of comfort (n=98 codes), barriers and challenges (n=85 codes), and solutions (n=27 codes). Providers described what made prescribing over telemedicine feel comfortable (n=68 codes) or uncomfortable (n=30). We defined three parameters that providers must practice within to feel comfortable prescribing over telemedicine (i.e., comfort parameters): the limits of their expertise and telemedicine technology, adequate knowledge of the patient and their health information, and laws and regulations.
Conclusions: Providers describe prescribing over telemedicine within the boundaries of their comfort parameters. With the expected evolution of the laws and regulations surrounding prescribing over telemedicine and improvement in access to timely patient health information, these comfort parameters may further change. Providers reported that when they did not feel comfortable prescribing over telemedicine, they would refer patients to other providers or request an in-person visit, if possible. The providers described they act as needed to ensure patient safety and well-being. Policymakers must take into account providers’ experiences to ensure effective, meaningful changes in telemedicine laws and regulations.
Telemental Healthcare for Mississippi Institutions of Higher Learning: Initial Outcomes for the Universities Network of Integrated Telemental Expansion (UNITE) Clinic
Description: The Universities Network of Integrated Telemental Expansion (UNITE) Clinic aims to enhance health equity and support academic success by providing college students with accessible and timely telemental health interventions. This report presents an analysis of the initial outcomes of the UNITE program across Mississippi's eight public Institutions of Higher Learning.
Abstract: UNITE (Universities Network of Integrated Telemental Expansion) is a grant-funded initiative launched in April 2024 by the Department of Psychiatry at UMMC to help address increasing mental health needs of Mississippi college students. UNITE encourages health equity and promotes academic success through timely, accessible mental health care interventions. UNITE was funded in 2023 by congressional-directed legislative spending, in collaboration with SAMSHA and UMMC. This analysis reports UNITE Clinic’s initial program outcomes across Mississippi’s eight public Institutions of Higher Learning (IHL). All program implementation costs were grant funded, and telemental health counseling and medication management services are free for patients. UNITE’s virtual design prioritizes ease of access for patients with mental health challenges, offering next-day appointments. An online registration form connected to a cloud-based EHR, EPIC, helps schedule appointments that last 30-60 minutes. A multidisciplinary team of LPCs, counseling trainees, and psychiatric NPs from UMMC facilitate these encounters. For the purposes of program evaluation, deidentified patient data is collected via EPIC for analysis. Variables of interest span service utilization rates, locations, and patient demographic characteristics, which were used to evaluate program engagement and impact.
Classification of Research: Access to Care
Classification of Research – Other:
Method:
Method- Other: Descriptive Analysis
Results: From April 15, 2024 to October 31, 2024, UNITE Clinic served 89 patients across 389 encounters. 104 sessions (26.74%) were for medication management and 285 sessions (73.26%) were for mental health counseling. Of patients seen through UNITE, 27.76% of patients were male and 72.24% female. 47.04% were African American, 43.19% Caucasian, 5.14% Asian, 4.37% Other, and 0.26% did not specify race. The Index of Medical Underservice (IMU) Score weighted by encounters across college counties is 48.06. Of encounters, 57.84% were from public institutions in rural medically underserved counties and 42.16% were from institutions in non-rural medically underserved counties, as designated by the HRSA.
Conclusions: Findings show how the UNITE Clinic enhances access to mental health services for IHL college students across Mississippi. Notably, there were 15.86% more rural than non-rural telemental health encounters, and 100% of these encounters were from underserved communities. The weighted IMU Score of 48.06 highlights the degree of medical underservice observed in patients across all encounters. Limitations of this study included restricted access to provider recommendations and patient diagnoses when assessing clinical outcomes. Future research should investigate culturally informed, tailored approaches to program implementation, alongside patient capacity limitations for on-campus mental health providers. We have included the following scientific references, which should be placed in the “additional information” category of the ATA “Call for Abstract” submission form.
1. Please note, the following authors are NOT associated with this project: Health Resources and Services Administration. (2023). Medically Underserved Area (MUA) Find. U.S. Department of Health & Human Services. Retrieved November 6, 2024, from https://data.hrsa.gov/tools/shortage-area/mua-find
2. McAfee NW, Schumacher JA, Carpenter RK, Ahmad Z. College student mental health, treatment utilization, and reduced enrollment: Findings across a state university system during the COVID-19 pandemic. Journal of American College Health, 2023;73(2):803-12. https://doi.org/10.1080/07448481.2023.2248495
3. Stoltzfus M, Kaur A, Chawla A, et al. The role of telemedicine in health care: An overview and update. Egypt J Intern Med. 2023; 35(1):49. https://doi.org/10.1186/s43162-023-00234-z
1Center for Telehealth, University of Mississippi Medical Center and 2Department of Neurology
Description: We implemented an inpatient rounding and response model-based TeleNeurology service at a hospital that serves four rural Mississippi counties to provide continuity of care when no in-person neurologist is available. Here we demonstrate a paradigm for providing specialty support to hospitals and patients in regions with limited access to specialists.
Abstract: Limited access to specialty care is a major cause of health care inequity in rural areas, leading to an overburdened primary care workforce resulting in delayed care for patients and worse clinical outcomes. According to the National Rural Health Association, there are 30 specialists per 100,000 people in rural areas, compared to 263 specialists per 100,000 people in urban areas. TeleNeurology is a telehealth service model provided by University of Mississippi Medical Center (UMMC) neurologists to inpatients at South Central Regional Medical Center (SCRMC). SCRMC has an in-person neurologist present for half of each month, while remote neurology rounding supports patient care for the remaining half. The service bridges the gap in neurology expertise by offering daily virtual consultations to hospitalized patients with acute neurological disorders. The program also supports continuity of care, ensuring timely interventions and follow-up for complex cases. Patient demographics, volume, and diagnosis/procedural codes were reviewed over a 12-month period to assess the service that was provided.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Descriptive
Method- Other:
Results: During the study period, TeleNeurology provided 609 virtual consultations for 294 distinct inpatients, with stroke, seizures, and acute encephalopathy as primary reasons for hospitalization. The service operated on average 13.7 days each month. The patient population included a significant representation of rural residents.
Conclusions: Rural hospitals face significant challenges in the recruitment and retention of specialists. Faced with imminent risk of closure of inpatient neurology services, SCRMC turned to UMMC to provide continuity of care to acute neurology inpatients through telehealth. Our study shows that a hybrid in-person/telehealth model can effectively support local inpatient specialty care, ensuring that patients continue to receive high-quality care despite staffing limitations.
Temporal Patterns in Adverse Event Reporting Among GLP-1 Patients on a Telehealth Platform
Description: This study examines patterns of patient and provider interactions with an asynchronous adverse event reporting tool on a telehealth platform offering GLP-1 pharmacotherapy. By analyzing the timing of unprompted patient reports and provider responses, we explore how continuous access to care can support side effect management.
Abstract: Glucagon-like Peptide-1 Receptor Agonists (GLP-1s) are widely recognized for their strong efficacy and favorable safety profile; however, they can cause side effects that can lead some patients to discontinue treatment. Telehealth is an increasingly popular modality for GLP-1 pharmacotherapy for overweight and obesity. Telehealth platforms that enable asynchronous care can allow for 24/7 adverse event reporting as well as rapid provider intervention and counseling, even during off hours. This continuous support can enhance side effect management and improve treatment adherence. The purpose of this study was to assess temporal patterns in patient and provider interactions within an asynchronous adverse event reporting module on a telehealth platform offering GLP-1 pharmacotherapy. On the platform, patients are required to report any adverse events during scheduled asynchronous renewal visits, but can also reach out independently to report adverse events at any time. We focused on these unprompted reports, where patients actively sought guidance. Using a random sample of 10,000 patients who independently submitted 13,391 adverse event reports between January and August of 2024, we analyzed patterns in the timing of patient reporting and provider response using descriptive statistics and chi-square tests comparing demographic differences.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Observational
Method- Other:
Results: Most patient adverse event reports occurred between 8:00am-12:00pm (30.1%, n=4036). Reports outside office hours (5:00pm-8:00am) totaled 43.1%, with 14.9% (n=1994) pre-office hours (12:00am-7:59am) and 28.2% (n=3772) post-office hours (5:00pm-11:59pm). A quarter (24.2%, n=3241) were submitted on weekends. Reporting times did not differ significantly by patient sex or age. Most provider responses (45.8%, n=6127) occurred 7:00am-11:00am, with 23.4% (n=3137) pre-office hours, 5.6% (n=747) post-office hours, and 22.6% (n=3032) on weekends. Median response time was 89 minutes (mean=401.4, SD=894.8).
Conclusions: Results show that when given access to continuous adverse event reporting, patients regularly engage outside of normal office hours. This highlights the demand for accessible, anytime health care during GLP-1 pharmacotherapy. Findings also demonstrate that providers responded promptly when patients report adverse events asynchronously, offering timely guidance on side effects that may improve medication adherence and outcomes. However, the expectation of 24/7 provider availability can present challenges; the implementation of continuous adverse event reporting should balance patient accessibility with provider workload and well-being.
The Cost-Benefit of Telehealth Services to the Wyoming Medicaid Program
Paul E. Johnson, MD
Wyoming Department of Health
Description: One of the reported benefits of telehealth as a modality is potential cost savings. This might be more pronounced in rural and underserved populations like those on the Wyoming Medicaid program. We sought to determine the potential cost savings of telehealth visits to the Wyoming Medicaid program.
Abstract: Purpose: To determine and quantify the cost benefit of telehealth services to the Wyoming Medicaid Program. Methods: An analysis of the financial impact of telehealth utilization to Wyoming Medicaid was performed for the financial year 2022. Costs associated with transportation reimbursement, gasoline and lost wages were calculated. Additionally, the estimated reduction in carbon emissions were calculated. Findings: Telehealth services were of financial benefit to the Wyoming Medicaid program and its recipients, including a reduction in transportation liability costs, lost wages to the recipient or their guardian, and estimated gasoline costs. The total cost benefit is an estimated range of $974,646 - $1,792,654 out of a total claims paid expense of $580.5M in 2022. Additionally, we estimated reduced vehicle carbon emissions associated with telehealth visits of 581,429 kg of carbon dioxide. Conclusions: Telehealth is a cost-effective modality to provide care to the Wyoming Medicaid population. It also reduces the carbon footprint associated with in-person care.
Classification of Research: Cost Analyses
Classification of Research – Other:
Method: Cost Analysis
Method- Other:
Results: Telehealth services were of financial benefit to the Wyoming Medicaid program and its recipients, including a reduction in transportation liability costs, lost wages to the recipient or their guardian, and estimated gasoline costs. The total cost benefit is an estimated range of $974,646 - $1,792,654 out of a total claims paid expense of $580.5M in 2022. Additionally, we estimated reduced vehicle carbon emissions associated with telehealth visits of 581,429 kg of carbon dioxide.
Conclusions: Telehealth is a cost-effective modality to provide care to the Wyoming Medicaid population. It also reduces the carbon footprint associated with in-person care.
The Impact of a Robust Quality Infrastructure to the Joint Commission (TJC) Telehealth Accreditation Readiness
Ashley Hill, Vanisa Patel
Access TeleCare
Description: The new TJC Telehealth (TEL) Accreditation was the catalyst to improvement work to readiness. This was launched in consideration of inadequate cross-departmental collaboration, communication to Quality Department, and buy in to the required level of sophisticated process and documentation evidence needed to meet the more robust standards.
Abstract: In early Fall 2022, the new Quality Dept team assessed issues of ownership and collaboration over various policies/standards under the organization’s TJC accreditation. This status is critical for the company's infrastructure to ensure high quality and patient safety, and an expectation of the care settings our providers serve due to their CMS/TJC requirements. An issue was noted when 44 standards list owner as “Unknown” in TJC Evidence and only 43% of the standards were compliant months before the expected 2023 reaccreditation survey. The internal Quality department had to ultimately manage in preparation for survey. Nearly 80% of standards required Access TeleCare’s Quality Department to be heavily involved in facilitation and ownership to obtain the successful compliance survey in October 2023. The organization has learned from these lessons and is optimizing survey readiness with adoption of the AMP software, a comprehensive training program, and setting a more rigorous structured method of internal accountability to the more robust standards ahead.
Classification of Research: Regulatory & Policy Research
Classification of Research – Other:
Method: Implementation Science
Method- Other:
Results: Ownership to TJC standards compliance was under 20% a year prior to our reaccreditation survey. The internal Quality Department tracked compliance efforts and escalated to the Executive team throughout June, July, and August 2023, which resulted in an increase from 30% to 43% completion. The organization managed to get to the needed 100% compliance to all standards by the time of the survey in October 2023, only once Quality facilitated and closed gaps on the remaining near 60% of standards.
Conclusions: Quality Department’s oversight and facilitation was critical to a successful 2023 survey. The upcoming 2026 survey under the new TEL program will require only more collaboration and accountability. Therefore, the organization has adopted AMP software to optimize the level of coordination and documentation needed. As a work in progress, the goal is that standards are met quicker and accountability can be better enforced to ensure a higher level of participation and readiness in 2025 and beyond.
The Trinity of Correctional Telehealth: Primary, Specialty, and Urgent Care
Ryan R. Lau, MS, R.EEG/EP T, CNIM, CLTM, FASET,1,2 Amanda S. James, MSHI, RN, BSN,1 Sheila Roxanne Riser, PA-C, MPAS1
1Medical University of South Carolina, Charleston, SC and 2Capella University, Minneapolis, MN
Description: South Carolina has a significant incarcerated population who face barriers to accessing timely medical care, particularly for primary, specialty, and urgent needs. Restrictive access factors include geographic limitations, transportation challenges, costs, and limited resources. Telehealth technology offers a way to overcome these obstacles, improving clinical outcomes and reducing costs.
Abstract: The Medical University of South Carolina’s (MUSC) Center for Telehealth partnered with the South Carolina Department of Corrections (SCDC) to expand health care access and reduce expenses for incarcerated individuals at 21 correctional facilities statewide. By May 2024, the “telehealth trinity” of primary, specialty, and urgent care services was fully operational following a phased rollout. Available specialties include, but are not limited to, Cardiology, Dermatology, Endocrinology, Gastroenterology, Podiatry, Psychiatry, Rheumatology, and Surgery.
Classification of Research: Cost Analyses
Classification of Research – Other:
Method: Cost Analysis
Method- Other:
Results: Transporting inmates for urgent or emergent care incurs high costs, averaging $3,980 per transfer, which covers three correctional officers, ambulance services, and an emergency department visit. Even for primary and specialty care, in-person visits cost between $100 and $400, making Telehealth a more cost-effective solution. Between May and October 2024, SCDC saved $912,525 through Telehealth, achieving a 43% reduction in emergency department visits. Implementing a statewide Telehealth system has generated substantial savings for both SCDC and the state of South Carolina, underscoring Telehealth’s critical role in the future of correctional health care.
Conclusions: Implementing a system wide Telehealth solution for SCDC has saved them, and the state of South Carolina thousands of dollars since the onset of this collaborative venture. Telehealth will continue to play a significant role in SCDC’s health care landscape.
The Use of Telerehabilitation to Improve Movement-Related Outcomes and Quality of Life for Individuals with Parkinson Disease
Joshua Johnson, Jason K Longhurst, Michael Geverzman, Corey Jefferson, Susan M Linder, Francois Bethoux, Mary Stilphen
WizeCare Technologies
Description: The purpose of this study was to assess the feasibility of Tele-Rehabilitation for individuals with Parkinson disease (PD_ and explore clinical outcomes compared to in-person care
Abstract: Individuals with PD can improve their overall mobility and participation in daily activities as they engage in frequent exercise. Despite the need for individually tailored exercises, persons with PD often face barriers to accessing physical rehabilitation professionals who can provide them. Telerehabilitation (TR) may facilitate access to necessary and individually tailored rehabilitation for individuals with PD.
Classification of Research: Clinical Effectiveness
Classification of Research – Other:
Method: Randomized Controlled Trial
Method- Other:
Results: Of 389 patients screened, 68 met eligibility criteria, 20 were enrolled. (Clinic +TR, N=6;TR Only, n=6; and UC, n=8). Regardless of group allocation, both patients and therapists generally rated the mode of care as “good” or “very good” across all constructs assessed, including overall satisfaction and safety. The analysis of all groups showed no differences in clinical outcomes at the discharge visit.
Conclusions: High satisfaction among patients and clinicians, regardless of group, combined with no significant between-group differences in clinical outcomes, suggest that TR is feasible for individuals with PD in the early-moderate stages.
Unlocking Insights: The Pros and Cons of AI-Enabled Medical Interpretation
Dipak Patel, CEO
GLOBO Language Solutions
Description: Artificial intelligence is redefining how providers can communicate with limited-English-speaking patients to achieve equitable care. A 2024 research study evaluating AI-powered interpretation tools highlights their potential and limitations to aid health leaders striving to scale linguistic services to America’s increasingly diverse, geographically dispersed limited English proficiency (LEP) patient populations.
Abstract: Communicating effectively across multiple – even hundreds of – languages is more important than ever. Accurate, empathetic, and transparent communication is not just a convenience – it is a national imperative for accessible, equitable high-quality care. Speed to linguistic services, preferably in a patient’s native language, mitigates errors, promotes regulatory compliance, and fosters trust. Over a three-month pilot period in 2024, researchers at GLOBO Language Solutions assessed a spectrum of language and speech technologies, including traditional approaches and generative AI models, including large language models and their multimodal variants. The study aimed to better understand their capabilities and ensure that the AI-enabled interpretation handled provider-patient communication with care and consideration. The novel research was designed to provide health care leaders with key insights into AI interpretation performance covering four key domains: Assessing the process of AI interpretation; evaluating how AI-enabled interpretation is measured; exploring the current state of AI tools; and identifying where AI technologies fall short with interpretation. To adequately evaluate AI interpretation, it must fulfill the significant roles that human medical interpreters provide and meet four measures: Accuracy, realism, latency, and cost. While AI technology can produce an interpretation quickly, researchers identified nuances to consider when evaluating its quality.
Classification of Research: Patient Experience
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: Researchers discovered limitations based on each step of the AI interpretation process. Some language models cannot handle transcribing multiple languages at a time. Some models cannot assess the importance of uncertainty, meaning “out-of-the-box” AI technologies lack a” human” common-sense filter to ask for clarity. Some models translate medical terminology incorrectly. In short, AI models don’t “think” in the same way humans do, and any safety processes and procedures are all learned behavior for them. To effectively integrate AI interpretation, health leaders must ensure AI models are tested and configured to meet interpretation needs at all care interactions.
Conclusions: The performance of AI interpretation tools in care settings varies, especially in high-stakes hospital departments like the ICU or ED. Although AI tools are evolving rapidly, staying current with the latest models and advancements can be challenging without adequate expertise. Providers must configure and fine-tune AI models to ensure high-quality medical interpretations, as no language models are designed to be used as out-of-the-box solutions. Moreover, the health care industry lacks a universally accepted standard for interpreting quality, leaving leaders to determine if AI is on par, better, or worse to human interpretation before transitioning to a fully automated language services solution.
Use of Telehealth for Chronic Disease Management in Rural Florida
Cynthia Williams, PhD, Di Shang, PhD,1 Chris Baynard PhD1 Aishwarya Joshi, MHA1
University of Central Florida
Description: Older adults who have chronic disease and live in rural areas experience inequities in access to quality care. In 2020, the Centers for Medicare & Medicaid Services expanded reimbursement coverage for telehealth. This expansion increased payment parity and removed restrictions; rural areas may have other challenges in using telehealth.
Abstract: Purpose: This study examines the effect of telehealth parity on telehealth utilization among Medicare and Medicaid beneficiaries for chronic disease management in rural Florida during COVID19. Methods: Using a retrospective design, we retrieved visit-level data from a State of Florida Medicaid and Medicare Managed Care Organization of 2019 and 2020, we included 54,927 unique patients across Florida. We aggregated telehealth use at the county level and calculated the percentage of patients who used video telehealth in each county during the study period. We used data from the Digital Divide Index (DDI), Health Professional Shortage Area Designations (HPSA), and Florida Health Outcome Rankings to investigate the intersectionality of rurality, digital divide, health professional shortage, health outcome, and telehealth utilization during the pandemic. T-test and regression analysis were used to examine the study objectives.
Classification of Research: Access to Care
Classification of Research – Other:
Method: Secondary Data Analysis
Method- Other:
Results: Our results suggest that telehealth visits in non-Metro counties was higher than in non-Metro counties before the pandemic (2.84% vs. 0.61%, p-value < 0.001). However, during the pandemic, telehealth usage in non-Metro counties was lower than in Metro counties (35.17% vs. 40.6%, p-value < .001). The digital divide was higher in non-Metro counties (p-value < 0.001) and negatively associated with telehealth usage in 2020 (p-value < .001). The analysis of health outcomes shows that the digital divide and health professional shortage were negatively associated with county health outcome rankings (p-value < 0.001).
Conclusions: Support telehealth parity alone is not sufficient to promote telehealth in rural areas. Improving technology infrastructure and community resources could increase telehealth utilization for vulnerable patients in rural areas. Rural counties presented significantly lower telehealth utilization rates and higher digital divide, despite telehealth parity. The health professional shortage was not significantly associated with telehealth use, however, both health provider shortage and digital divide contributed to overall health of the community.
Utilizing Home-Based Telerehabilitation to Improve Patient Access Following Orthopedic Surgery
Jacob Daniels,1 Ryan McGlawn,1 William Pannell,1 Derrick Burgess,1 Lindsey Kuiper,1 Yunxi Zhang,1 Lincy Lal,2 Ying Zhang,1 Michael Swint,2 Jennifer Reneker,3 Saurabh Chandra,1
1University of Mississippi Medical Center; 2University of Texas Health Science Center; and 3Northeast Ohio Medical University
This project was made possible by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) as part of the National Telehealth Centers of Excellence Award (U66RH31459). The contents are those of the author(s) and do not necessarily represent the official views of nor an endorsement by the HRSA, HHS or the US Government.
Description: Early rehabilitation intervention is critical to optimize patient outcomes following anterior cruciate ligament (ACL) reconstruction. This project aims to assess the feasibility of using a telehealth rehabilitation application to increase patient access to health care prior to and following an ACL reconstruction.
Abstract: Access to health care is a significant issue for many Mississippians living in rural communities. Telehealth is a potential solution to this problem. However, providing telehealth services to rural populations presents many unique challenges. Early access to health care is particularly important for patients undergoing anterior cruciate ligament (ACL) reconstruction. It is imperative these patients regain their range of motion as soon as possible to prevent permanent functional deficits. However, barriers such as transportation, limited access to physical therapists, family support issues, or scheduling conflicts can delay care, leading to poor outcomes. Telehealth rehabilitation applications have shown promising results for their potential to improve patient outcomes when used as an add-on to traditional physical therapy services. This pilot study aims to enroll 20 ACL surgical candidates (ages 13+), located throughout Mississippi. Once identified and enrolled in the study, patients will be provided with a telehealth application to participate in pre-rehabilitation and physical therapy treatment sessions following surgery, until they can access in-person care. This study will assess the feasibility of telehealth for this population and evaluate patient and provider experiences by utilizing post-treatment surveys with open-ended questions and 5-point Likert scale ratings.
Classification of Research:
Classification of Research – Other: Clinician and Patient Experience
Method: Survey/Qualitative
Method- Other:
Results: This research project is moving into the implementation phase and has not begun recruiting at this time. The study is awaiting final IRB approval. Therefore, there are currently no results to report.
Conclusions: This study aims to assess feasibility outcomes related to the patient and provider experience. Variables related to completion rate, compliance with therapy sessions and home program will also be collected. This information will provide key insights into the feasibility of utilizing telerehabilitation to increase patient access following surgery.
Virtual Consenting for Food Security Research Study
Gerard Frunzi
Common Spirit Health
Description: Common Spirit Health Mountain Region applied for USDA funds to support a research project around food security. The project goals and Intended outcomes are listed below. The telehealth aspect is getting IRB permission to consent virtually as many IRB's are hesitant to agree to virtual informed consent.
Abstract: The purpose of this project is to demonstrate and evaluate the impact of a clinical local-produce prioritizing produce prescription nutrition incentive and nutrition education program on the dietary quality and food security of patients who are managing or at risk of developing a chronic disease. This project seeks to improve health outcomes and reduce health care costs, while also supporting local economies as nutritional security is a major determinant of health. Between October 1, 2021 and September 30, 2024, the goals and expected outcomes are as follows. Goals 1-4 will be measured among patients in Pueblo County who are at higher health risk due to presence or risk of chronic disease and participate in either SNAP or a state health insurance program such as Health First Colorado (Colorado's Medicaid program), whereas Goal 5 will be measured among providers. The project has since been extended into 2025.
Classification of Research: Clinical Outcomes
Classification of Research – Other:
Method: Survey/Qualitative
Method- Other:
Results: In study still
Conclusions: Study still continues
Virtual Nursing: A Pilot Program on an Acute Care Inpatient Unit
Description: As the need for new, innovative care models grow, a virtual nursing (VN) program was initiated to better support bedside nurses and improve patient throughput. Virtual nursing care models have been utilized to support inpatient nursing. This project evaluates the impact of VN on nurse satisfaction and discharge times.
Abstract: Purpose: A virtual nursing pilot was designed to support the discharge process on a busy inpatient unit. The pilot aimed to increase efficiency in the discharge process while maintaining patient safety and staff satisfaction. Methods: The 5-month pilot occurred on a 26-bed adult general medicine unit, with VN coverage eight hours per day, Monday through Friday. Each bedside was equipped with a Cisco Room Kit Mini initially deployed for Isolation Communication Management (ISOCOMM) during the COVID-19 Pandemic. These devices connect to a long-standing and existing infrastructure operated by telemedicine. The VN reviewed and reconciled the discharge instructions with the primary medical team, reviewed the discharge paperwork with the patient, ensured that the patient had medication, equipment, and post-discharge instructions, and completed nursing discharge documentation. Total discharge time, total length of stay, principal diagnosis, and demographic information were collected for each patient. These metrics were compared to patients who had been cared for on this unit in the three months prior to the pilot and to patients who were not discharged by a VN (synchronous controls). In addition, a survey was created for nurses to provide feedback regarding their experience with the VN conducting their discharge and the process in general.
Classification of Research: Quality Improvement
Classification of Research – Other:
Method:
Method- Other: Learning Health System Science
Results: Over five months, 117 patients had VN discharges, compared to the 164 patients in the pre-intervention group, and 112 synchronous controls. The mean discharge times, defined as the time the discharge order was placed to the time the patient left the unit, were 2 hours 25 minutes, 2 hours 29 minutes, and 2 hours 30 minutes respectively. Statistical analysis (ANOVA and Kruskal-Wallis tests) found no significant differences either in mean or median times. The median time saved for bedside nurses was 45 minutes per discharge. Ninety-one percent of nurses indicated they thought VN discharge was very helpful.
Conclusions: This pilot showed that a VN program in the acute care inpatient setting is feasible and helpful to bedside nurses. Longer-term patient outcomes, such as readmissions within 90 days, ED visits within 30 days, and adherence to follow-up outpatient appointments are currently being tracked. Our taskforce is currently developing the next phases of the program, which will include the addition of VN services for admission, patient education, and mentoring.
