Vidyo’s versatile telehealth solution is being embraced globally by leading medical establishments (American Well, Massachusetts General Hospital, etc.), and today, Holy Cross Hospital’s innovative Virtual Care Services in Silver Spring, Maryland, is joining the healthcare revolution. Holy Cross is using Vidyo’s technology to connect with patients, caregivers and other providers beyond the limits of the hospital, including extended care facilities, nursing homes, rehabilitation facilities and even the homes of patients and their families.
Dr. Andrew Barbash, Medical Director for Neurosciences and Clinical Director of Virtual Care Services at Holy Cross Hospital, wrote for the Vidyo Blog about the meaning of virtual care and about what it can bring to healthcare:
What is “Virtual Care”, as opposed to “TeleHealth or TeleMedicine”?
- Doctor Andrew Barbash
Healthcare is a “people process” – always has been and will be into the future. While “telemedicine” is an important component of virtual care, it is merely a subset of a more global process. Virtual Care is more generic and implies that anyone should be able to receive the right level of prevention, pro-active care, diagnosis, decision-support, treatment and monitoring/follow up at the right time and place, from the best source of expertise, regardless of geography, personal demographic or economic status. In order to achieve this we need to advance the “workflow process” of how PEOPLE support other PEOPLE along this path. The technologies are enablers, not the main drivers of success…the key is that all of this can now begin to take place “virtually” because the “tele” technologies have evolved to far greater levels of simplicity and affordability.
The essence of virtual care is that, by bringing the communications process into a ubiquitous, globally informed and highly affordable state (the clear trend that will never reverse)—people are empowered to connect with the right “other” people in order to make better decisions and manage their personal time resources far more effectively – all the while obtaining “better” and more effective care, independently from the traditional geographic or organizational silos. If people are educated as to HOW to achieve this, all of the tools, technologies, services and methods exist to bring this about.
Example: Engaging patients and family caregivers in shared decision-making in real time
A family had seen a specialist for a second opinion and wanted to review the findings with an endocrinologist who had known them for several years .The family was given a CD with some of the images and test results and had it in their hands, at home, 3 hours away. A time was arranged by email to have the latter physician connect with them by video chat, have them put the CD in their computer and display what was on their screen, so that all could discuss the likely findings in real time and avoid a long trip just for a follow up discussion. The family was happy to pay for the experience directly, but the process was so efficient for the physician, taking 15 minutes, that it was considered easier than trying to explain it all by phone or reviewing things by mail at some other time!.
Virtual care involves leveraging the entire continuous stream of advances in personalized communications while respecting the necessary boundaries that people require in order to function effectively. It will involve the evolution of new models of collaboration and incentives to do so, well out of the bounds of the traditional model of healthcare delivery and financial remuneration for activity….probably more on an “availability model” than on a “specific service widget” one.
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Example: Crossing the chasms of care
A hospital based physician is covering for the group of doctors who routine manage all the inpatients and are responsible for fielding phone calls about patients who had recently been transferred to other facilities. At 9PM a phone call arrives from a skilled nursing rehab center about a patient discharged from the hospital earlier that morning in stable condition. The patient is having more trouble with some motor changes in the right arm, not specifically reported on admission or noted in the discharge documents received by fax. The nurse is not known to the doctor, the doctor is not familiar with that patient, and the physician is home, potentially with language obstacles between providers and/or staff. The physician is able to “ping” a mobile device on wheels or any mobile computer within that facility near the nursing station, and request to have a quick video conversation with both the staff nurse and the patient or family attendant. Added history is obtained, an observation that the arm is really aching more than before, but not truly weaker, some local therapy recommendations made and a planned follow up visit the following morning by the staff attending physician is arranged. A night time urgent transfer via 911 or ambulance was avoided
If it has made sense traditionally to have people come to “medical homes for primary care” and “multispecialty clinics” for integrated care, then it is perfectly reasonable to expect that advances in telecommunications should bring all of that expertise, when needed, right to where the patient, the family caregiver are at any time. It becomes a partnership model of virtual collaboration in whatever level of instantaneity is appropriate to the task and eliminates the traditional obstacles to effective decision making that were based on physical access limitations.
Example: Real time collaboration of specialists with the medical home:
A busy primary care physician in a community health clinic for the under-insured has a patient with an interesting skin lesion or an unusual shaking of an arm that was noticed a few days ago. From any computer, phone, tablet or device within reach she “looks for and finds” a specialist who is accessible according to their “online personal availability” who arranges to “click back and drop in for a quick video consult” within the next 15-30 minutes. A brief interaction takes place in which the specialist gets a bit more history, takes a look at the skin lesion or tremor, and provides some advice to the primary care physician or mid-level provider on interim management, with a plan to do a quick virtual follow up when the patient returns to the clinic next week. Nobody had to be inconvenienced–the patient, the family, the primary caregiver, the office staff, the remote specialist or his/her office staff, etc. Everyone’s level of confidence was higher than if done any other way, and better care in the short term resulted.
Virtual Care means better care and better care means collaboration and shared decision-making that is not at all defined by physical boundaries or the constraints of clinic/hospital or other environments. It is not a virtual substitute for being physically present. It is about having knowledge and expert human support being far more present than ever before. Virtual care is the next phase in our evolution to far better and more effective care for anyone, any time, any place.”
Learn more about how Holy Cross selected Vidyo in the full press release.
- Full Vidyo Press Release: “Vidyo’s Telemedicine Platform Delivers Unmatched Video Conferencing and Collaboration between Hospitals, Extended Care Facilities, Patients and Families”
- Doctor Barbash’s Blog: the NowDox Virtual Care Blog
- Our blog post: “American Well Chooses Vidyo’s Platform to Power its Online Care Services”
- Our blog post: “Massachusetts General Hospital Chooses Vidyo’s Technology for Telestroke Program”