University of Missouri Health Care in Columbia, Missouri, has been performing telehealth visits for decades, but the COVID-19 pandemic forced the Cerner ITWorks℠ client to rapidly expand its virtual services.
MU Health Care providers previously conducted about three to five scheduled telehealth visits a day leveraging the Amwell telehealth platform. After implementing free screening for COVID-19 calls, the daily average of telehealth visits jumped to 940, causing the organization to increase its Amwell usage and begin using the Zoom telehealth solution to meet the demand.
“There were several days when we were doing over 100 COVID-19 video visit screenings with patients throughout Missouri,” said MU Health Care’s Telehealth Manager Carey Ruekberg, who works closely on telehealth initiatives with the Tiger Institute1, a unique private/public partnership between the organization and Cerner. Ruekberg said the screenings keep “people away from our clinics” and help limit potential exposure.
While MU Health Care uses more than one telehealth platform, it had an existing relationship with Amwell, and the health system decided to use Amwell to provide an on-demand screening service for the community to access. In the first month, providers conducted close to 2,200 on-demand telehealth visits.2 MU Health Care emergency medicine providers take most of those incoming requests for video visits and provide them for free.
“Virtual care can sometimes be expensive,” Ruekberg said. “MU Health Care felt it was our responsibility to help community members either self-identify or get confirmed through testing if they thought they may have COVID-19.”
As of late April, MU Health Care had tested more than 5,020 people on-site, with 114 patients testing positive.
MU Health Care’s future goal is for staff in skilled nursing facilities to use Amwell to screen elderly patients for possible COVID-19. Emergency personnel would administer tests at the nursing home, rather than making the patient visit a drive-thru testing site.
While its supply chain is currently stable, MU Health Care initiated conservation efforts with personal protective equipment (PPE) by limiting elective procedures and being more thoughtful in its usage.
“We equipped the emergency department (ED) and some inpatient units with iPads,’” Ruekberg said. “To conserve PPE, we communicate through the iPad when it's not necessary to walk into the patient’s room and wear a gown.”
‘Patients are loving the way we can provide this care’
By using technology to reach patients at home, MU Health Care has extended its community outreach in unprecedented ways—a new approach, which may have a lasting impact on health care in the region.
“Some of our clinical leaders said, ‘It's hard to put the genie back in once you open the bottle,’” Ruekberg said. “Patients are loving the way we can provide this care. This pandemic forced us to go beyond what we were doing in a traditional brick-and-mortar setting and think about how we could creatively reduce costs.”
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1 MU Health Care and Cerner formed the Tiger Institute for Health Innovation in 2009 to connect health care providers with each other and with patients to improve the quality, cost and access to care for all Missourians.
2 March 13 – April 13, 2020