When Owings Mills resident Wayne Webb responded to a follow-up call from a staff member at Northwest Hospital asking him to open his front door, he was shocked to see paramedics waiting for him. Although he was not feeling well after a visit to the hospital's Emergency Department a few days prior, he had no idea why the paramedics were at his home.
The paramedics explained they were called to check on his medical status and if emergency care was needed. They then entered his home, set up a computer screen and emergency medicine physician, Jonathan Thierman, M.D., appeared and inquired about his symptoms.
"I didn't know there was an issue, just that I wasn't feeling well," said Webb. "[The doctor] was telling me what he thought was going on because of the way I was sitting. He was more concerned about me than going on to the next patient," he added.
A short time later, Dr. Thierman determined Webb needed emergency care and he was taken to the hospital where he was immediately admitted and remained for four days.
Webb is one of many patients who are experiencing the benefits of LifeBridge Health's virtual hospital, a new model of care that is enhancing care coordination, efficiency and improving patient satisfaction throughout the system.
Located at Sinai Hospital of Baltimore, the virtual hospital is led by Dr. Thierman, who also serves as chief medical information officer and medical director of LifeBridge Health's Virtual Hospital. It combines the use of a clinical command center, telemedicine services (which includes tele-triaging and tele-hospitalists) and international clinical call centers to provide patients with coordinated care in a timely manner. Each component ensures patients are efficiently monitored, swiftly evaluated and receive effective treatment or are placed in the most appropriate level of care.
By using all these components we can coordinate visits remotely to patients in their homes, transport them to the hospital, if necessary, and find the right location in the hospital where they need care. We can also conduct virtual visits to patients in our affiliated facilities and coordinate the movements of those patients to different levels of care."
Dr. JonathanThierman, chief medical information officer and medical director, LifeBridge Health's Virtual Hospital
The virtual hospital's clinical command center is staffed with a multi-disciplinary team who monitor the efficient flow of patients into and out of the hospital. By watching digital screens with real-time data, staff can track the number of incoming patients, patient discharges and bed availability. A representative from Pulse Medical Transportation is also on hand to coordinate the transfer of patients by ambulance to and between LifeBridge Health facilities.
As a way to increase patients' access to care, the virtual hospital's telemedicine service allows providers to communicate remotely with patients through a video conferencing monitor that Pulse staff can bring to patients when they respond to a call for medical assistance or if the hospital sends the ambulance to a patient.
"With telemedicine our providers are set up in a designated room, have a video session up on one screen, a patient's EMR (electronic medical record) up on another, and can talk directly to the patient on screen to assess their condition," said Dr. Thierman. "The providers are quite active. Currently we are seeing over 1,000 cases in per month."
Telemedicine also has been quite successful in reducing wait times and increasing the swiftness of care for patients in Sinai and Northwest hospital's emergency departments (ED). While nurses triage patients, virtual hospital providers can see and interact with patients at the same time through the telemonitoring video screen. Providers then can immediately request and review tests and lab work, see notes made by the nurse, make a diagnosis and create a treatment plan.
Additionally, the virtual hospital ensures patients receive the support they need through the international Clinical Operations Call Centers. The centers, located in Jerusalem, Israel and Manilla, Philippines, are staffed with nurses and advanced practice providers who are licensed in Maryland. The center in Jerusalem provides telephone support to patients who have questions, follow-up calls to recently discharged patients and manages prescriptions refill requests. LifeLink, the Philippines-based center, helps to schedule follow-up appointments and transportation for patients.
The virtual hospital is a prime example of LifeBridge Health's innovation in enhancing patient care and the patient experience. The system's use of digital health is transforming the way patients receive and connect to their care resulting in expanding access to health care, reducing wait times, and increasing efficiency. This is all being accomplished while reducing hospital expenses.
Since January, more than 4,000 patients have used LifeBridge Health's telemedicine service via tele-triage visits to connect with a provider in the emergency department (ED). This increase followed a successful piloting of the service in Northwest Hospital's ED last year in which the overall door-to-provider time dramatically decreased from an average of one hour and 26 minutes to less than 26 minutes (a decrease of 69%) during the pilot from July to September. In another case, the average time for a hospitalist to admit patients from the ED to a unit decreased by more than 90 minutes in November 2018 with the use of telemedicine.
"We are doing something very unique at LifeBridge Health by combining the telemedicine and the clinical care alongside all the operations in one center in this virtual hospital. We've had a lot of success so far on this journey and are piloting more projects in the future," said Dr. Thierman.
Of his experience, Webb said he was in awe as he watched the virtual hospital's telemedicine service in practice at his home. The entire experience was "outstanding" and one for which he is grateful.
"If it wasn't for him [Dr. Thierman] I would have stayed at home and never would have gone back to the hospital. It was probably the best thing that happened."