Case for support virtual care

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CASE FOR SUPPORT VIRTUAL CARE CENTER

MISSION’S VIRTUAL CARE CENTER VISION

Mission Health is creating a transformative patient care vision that combines its remarkable compassion with new, advanced technologies to augment and enhance the delivery of coordinated and integrated care for the people of western North Carolina (“WNC”). Our region’s mountainous terrain, challenging demographics (older, poorer, sicker and less likely to be insured) and rural physician shortages create a “perfect storm” that isolates many families and communities from easy access to effective health care. Not surprisingly, individuals in western North Carolina often face challenges in living a healthy life, including: • • •

Difficulty accessing care providers due to the rugged terrain, distance from healthcare facilities, and a provider shortage; Low health literacy scores and a lack of access to the education required to promote understanding of disease prevention amanagement; and Difficulty accessing resources that support wellness and the prevention of disease such as healthy foods and exercise facilities.

Mission has a unique vision for a network of Virtual Care Centers that can help hospitals and health systems utilize the current supply of physicians more efficiently, connect specialists to rural physicians and hospitals and generally improve patient access to care. Mission Health seeks to improve the health of the people of western North Carolina by providing world-class healthcare close to home utilizing virtual care offerings. In 2010, Mission Health established the Center for Advanced Virtual Care as an innovative solution to the challenge of providing timely and convenient access to health care for the rural communities of western North Carolina. It’s now time to build upon that commitment and reach the full potential for this critically needed service in our community.

Our vision is to offer comprehensive virtual care services to transform the care delivery process: more accessible, lower cost access to care in order to prevent disease and better manage chronic conditions. These services will support the goals of: 1.

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Prevent disease and educate our community; Managing chronic diseases prevalent in WNC population; Establishing the home as an expanded site of care; Improving access to primary and specialty providers across western North Carolina; Driving healthcare value improvement through consumer connectivity; and Sharing lessons learned for the benefit of care improvements across the nation.

Investments in these state-of-the-art technologies will ensure that WNC residents have access to health care services when and where they need them by bridging the distance in time and travel with Virtual Care Centers. In addition, Mission’s partnership with specialized and highly trained clinicians will ensure coordination of important clinical programs throughout WNC.

NEED FOR VIRTUAL CARE CENTERS

A focused expansion of the Virtual Care Centers program will address numerous health disparities and barriers to care in the region by providing patients direct access to high quality specialty care in a timely, cost-effective manner within their own community. The need for expanded virtual care services in the region includes: •

Lack of health care providers. The proposed project will directly address the lack of available health care providers in the region by making specialized providers at one location available to patients at multiple locations in the region through virtual care technology.

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Economic barriers. Care will be less costly as the result of the proposed project – patients will not have to take extra time off work or travel to the hub site for medical care. In addition, early intervention frequently leads to savings from improved outcomes such as reduced avoidable admissions/office visits, ED visits, and readmissions. Simply put, each patient will receive a higher quality of care at a lower cost, and with less life disruption. Today patients and their families often drive great distances to receive care, costing them both time and money. Worse yet, many of those patients forego preventative or preemptive care due to the costs and eventually require higher cost services that could have been avoided. Reducing the amount of time required to be seen provides direct cost savings to patients and more rapid access to clinicians improves outcomes and reduces avoidable services and admissions. Consumers are more accountable for the cost of their own care than ever before. Virtual care offers a wide variety of wearable technologies, remote home monitoring, smart phones applications and attachments, home computers and other consumer health care devices will create a new platform upon which we can connect with patients at critical junctures in their health to improve the experience and decrease overall health spending.

NEED FOR VIRTUAL CARE CENTERS CONT.

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Chronic disease prevalence in western North Carolina is higher than state and national averages for many conditions such as diabetes, hypertension, hypercholesterolemia, asthma, chronic obstructive pulmonary disease, kidney disease and other similar conditions. These patients, especially those with multiple chronic diseases, consume significant resources. Virtual Care Centers and the care model we wrap around those centers will transform the way we manage this patient population – improving the experience of care, improving outcomes and reducing the cost of care.

VIRTUAL CARE CENTER MODELS

Mission will use Virtual Care Centers to better manage relationships across the continuum of care by providing the following services:

eVISITS: PROVIDER-TO-PROVIDER CONSULTATIONS

This virtual care service will serve as the foundation of the hospital-to-hospital and primary care physician (PCP)-to-specialist relationships. eVisit technology will enable real-time specialty provider collaboration, data sharing and pooled resources across the entire enterprise. While Mission already makes programs like teleStroke available, more specialties will be enabled by this technology to connect with regional hospitals and PCPs seeking specialty consultations not available locally so that they can get immediate and timely support for their patient’s ongoing health needs.

PROVIDING ON DEMAND ACCESS TO THE PATIENT

By utilizing technology to enhance care management capabilities and expand the portfolio of consumer- based health technologies supported by an online portal that is customizable to the patient’s needs. The patient will be able to access approved educational content, join support groups made up of similar patients, insert and track healthy living metrics and use tools such as online appointment scheduling. The transparency provided by this service will be key to matching the consumerism need.

VIRTUAL CARE CENTER MODELS CONT.

REMOTE MONITORING

Allows health care delivery to move from a model of Intermittent episodic care to one of continuous observation. This technology enables and empowers patients with chronic disease or after an acute illness or surgery to monitor their clinical status and progress.

It can provide similar access for families and other care givers Remote Patient Monitoring enables the care team to have “real-time” visibility into a patient’s condition/ progress.This technology adds comfort and security to patients and families that their loved ones are being closely monitored by medical professionals.

When a patient’s condition changes, the system will alert a care manager who then coordinates with the PCP or specialist so that a timely intervention occurs.

FINANCIAL PROJECTIONS Capital Expenses necessary to implement the stated goals include: •

Centralized Scheduling Mechanism for Virtual Visits - $1,000,000 - Mission Health’s Information Technology department will build a centralized scheduling mechanism for virtual visits, with a ballpark estimate cost of $1M to build, implement and train users.

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Patient Technology Endpoints for virtual visits - $1,410,000 •

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47 possible endpoint locations @ $30,000 per location

Provider Technology Endpoints for Virtual Visits - $189,000 •

63 possible endpoint locations @ $3,000 per location

Multi-Channel technology platform (that includes voice,video,text,chat,email) that engages the patient outside of the health system by providing on demand access to educational content, data gamification, support services and online scheduling. - $2,500,000 •

• Remote Monitoring Interface – $3,000,000 - The Remote Monitoring will be done by leveraging a multi-channel technology platform to establish the home as a site of care, monitoring their patient’s symptoms so that an intervention can occur in a timely fashion.This interface will also house the data for research purposes. Remote Monitoring Kits: $560,000 - $840,000 •

Cost per Kit – Estimated $280. Kit includes a scale, blood pressure device, oxygen saturation device, blood glucose monitor, peak flow device, thermometer, ECG heart rhythm device.

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Would need between 2,000-3,000 kits