It's been a couple of years since the United States Department of Agriculture (USDA) announced five Distance Learning and Telemedicine (DLT) grant awards to help provide treatment for the growing opioid epidemic in rural central Appalachia. The DLT award includes nearly $1.4 million for five projects in Kentucky, Tennessee and Virginia to help these areas address the epidemic. Baptist Health decided to take on the epidemic wiht the help of telemedicne solutions from Polycom.

We had a chance to speak with Chris Holcomb, Executive Director of Behavioral Health at Baptist Health and Anthony Powers, Vice President of Patient Care at the organization to talk about the grants process and what they plan on doing with this highly sought after award. Here’s what they had to say:

Polycom: Can you talk a little bit about the challenges you were facing that drove you to apply for the USDA grant and develop your program?

CH: One of the biggest barriers for individuals residing in a rural area is the distance to see a specialist.  Economic hardships for families should not prevent them from receiving quality care.  Our commitment is to improve the lives of individuals in our communities so we decided that creating various telemedicine access points would help to reduce that problem.  Another challenge has been the sustained recruitment of medical providers in our rural area.  By offering telemedicine as a component of our treatment model, we can cast a larger net to recruit providers without having them commute to our hub location.  

Polycom: How did you get started with the grants process? And what was your experience with the Polycom Grant Assistance Team?

CH: From a quality and care transitions standpoint, we realized a gap in our medical-based services and felt that telemedicine could help fill that void.  I reached out to various professionals nationwide and learned of the potential grant opportunities.  We formed a great relationship with the Polycom Grant Assistance Team and they have been absolutely amazing.  They are a dedicated group with amazing subject matter experts.  They helped us to navigate through the grant process while coordinating every meeting.  They are truly remarkable and I can’t emphasize that enough.

Polycom: Can you tell us at a high level what your plans are for your telemedicine/treatment program at Baptist Health? 

CH: The ultimate goal is to give our customers another option in their medical care instead of the traditional face-to-face appointment.  Our hope is to start with a telemedicine program within the behavioral health specialty and expand services to other professional disciplines.  Some of our goals include: reducing wait times for appointments, decreasing consumer costs via travel, and developing a statewide system of providers to meet the needs of our customers.

Polycom: How do you see your telemedicine program helping address the opioid crisis in Kentucky and Tennessee?

CH: The opioid epidemic has been widespread in central Appalachia for roughly two decades and overdose deaths continue to steadily rise.  Our goal is to provide more access points for care and consultation.  Individuals battling substance use disorders typically don’t understand where or how to seek treatment.  We plan to utilize telemedicine to help patients determine the appropriate level of care so they can begin their journey to recovery.

PSV: Are there any tips or advice you could give others interested in pursuing a grant for collaboration technology?

CH: The Polycom Grant Assistance Team is very knowledgeable and I would recommend them for anyone considering a technology grant.  Be sure to involve as many community stakeholders as you can, even outside your agency, because collaborative relationships can help secure the resources needed for the greater goal of improving community health.

Are you part of an organization looking to implement telemedicine but need help with funding? The Polycom Grants Assistance Team is here to help! Click here to find out more.

I recently sat down with Veronica Southern, Clinical Lead on the Teleswallowing project for  Blackpool Teaching Hospitals NHS Foundation Trust. Coincidentally, she had attended the NHS England Chief Allied Health Professions Officers Conference 2015 in London a few days before we met.  It was interesting to hear Veronica’s feedback on the conference so I decided to share our collective thoughts via this blog.

Doing more with less: Multiply the usage instead of investment

Veronica: As a firm believer of video, my recommendation to all professionals is to use collaboration technology. Not only use it, but exploit it for day-to-day jobs. Video enables staff to connect and collaborate - not just externally with patients for providing remote consultations - but also internally to defy the barriers of distance.

Polycom:  We have heart-warming success stories about the many ways collaboration improves the delivery of many different types of healthcare services such as in paediatric neurology, dysphagia, dialysis, heart problems to name a few. Each case presents a unique way in which video collaboration is being used. So there is no upper limit to the number of ways a therapist, a doctor, a patient, a surgeon, a hospital or staff can use video collaboration. Be creative and the sky’s the limit.

Fewer people doing more work is not resourceful or sustainable

Veronica: The economy is tough and it is affecting professionals and therapists who are struggling to keep their heads above water. Sustaining services in tough economic time does not and should not mean staff cuts. The demand for healthcare services is at record-high levels and will continue to grow [The Kings Fund: Spending on health and social care over the next 50 years]. It means that you need to think outside of the box and that the traditional approach might need a rethink to design more advanced and sustainable ways of doing the same job. Video collaboration is one innovation that can help us achieve the results we want.  

Polycom: In business, the strength of your process optimisation programmes can define and shape the workplace of the future. For healthcare, the focus for optimisation should be spread across the organisation rather than being placed on patient-to-specialist touch point only. A lot of work is also completed behind the scenes placing peer-to-peer collaboration of the staff at par. Elleuno in Italy understood this challenge, overhauled the system and are now reaping the benefits of workplace collaboration.

Ageing population means ageing staff too!

Veronica: We are yet to come face-to-face with one of the biggest challenges that the healthcare industry would ever

face – the population where a majority are elderly. About two thirds of NHS clients are aged 65 and over, and yet they only receive two fifths of total expenditure [Age UK: Later Life in the United Kingdom - July, 2015]. Healthcare specialists possess the knowledge that in many cases can be used to deliver expertise remotely and can save lives. As they themselves age, many such specialists will face age-related physical challenges but that does not mean that their clinical brains can’t still be put to good use by delivering their expertise via video rather than by home visits. We need to act now and think about the ways technology can help us meet the demands that the future will impose.

Polycom: The first 150-year old baby is already born and the new retirement age will be much higher than 65 years according to CNN. It is impossible to predict what will happen, yet we are all speculating on the future we are heading towards. As the expectancy of the average human life increases, the pressure of being able to provide healthcare services to many more people increases. And this will keep increasing as we become more advanced in medical sciences.

As one of the leading hospitals for children's heart surgery in the United Kingdom, Evelina London children's hospital is a centre of excellence for paediatric cardiology amongst other services, and around 300 sick children pass through the doors every day. If you don't know where Evelina is, then it might surprise you to learn it is based inside the grounds of St. Thomas' hospital site, directly opposite the Houses of Parliament, London.

I had the pleasure of meeting the lead paediatric cardiologist Mr. John Simpson, Clinical Nurse Specialist Audit & Data Manager Thomas Witter and the Trust's telemedicine expert Frank Baldesare in early January, 2013.  At the time, the team were facing a particular challenge - if a procedure was underway in an operating theatre and an unexpected complication arose, it could take almost ninety minutes for the cardiologist to get scrubbed and gowned in order to enter the theatre.  Often, the cardiologist would only need a few short minutes to look at the echo; an ultrasound image produced by a Philips device, in order to recommend a course of action for the surgeon, but may compete with other clinical commitments on the ward or intensive care unit.

The team were convinced there was a way to overcome the lengthy time delay by using technology to enable a cardiologist to view the intraoperative images and communicate with the team in theatre. After a design session and a series of tests that spanned about eight months and involved the hospital's own Medical Physics department, IT, and the ultrasound manufacturer Philips, the decision was taken to put the telemedicine solution into use inside the operating theatre.

Take a look at the customer story and supporting video and you will learn how video collaboration enabled the team to save about 1,300 hours of consultants’ and surgeons’ time each year through the project.

And so, on 16th September 2013 (which just happened to be my birthday) the system was deployed.  Within hours, it was used for the first time during a procedure and the first successful case was recorded.

The solution shortens the time to review scans from 90 minutes to five minutes and enables quicker operations with less time under anaesthetic for patients. There is a profound improvement in the recovery time of a child by a reduction in anaesthetic, leading to a shorter stay in hospital and many other benefits.

The project has seen many successes within  the hospital, and has also been awarded the Collaborative Communications Product of the Year at the AV Awards 2014 by AV Magazine and the 2014 UK IT Industry Award - IT Project Demonstrating most effective use of Collaborative Technology by the prestigious British Computer Society and Computing Magazine.

         Chris Boba of Polycom picks up AV Award, while I picked up BCS Computing Award with Frank from Guy's & St. Thomas'

I'm very proud the project has been recognized and I was honoured to be at the UK IT Award ceremony with Frank to pick up the Collaborative Technology award.  As we left the stage, we had lots of comments on how wonderful it was to see Evelina win, and that many of the well-wishers children had been treated at the hospital.

I thank the judges of both AV Magazine and the British Computer Society for recognising the fantastic work of the whole team.  This has been one of those projects when everyone had a clear vision of what was required, how to achieve it, and wanted to work together to put it all in place.

With budgets being squeezed across the board, the healthcare sector is constantly searching for innovations to improve the delivery and efficiency of its services.  Technology is able to provide any number of solutions to help relieve the many pressures on the health system, and as current technologies evolve it really can help distribute the highest quality care to every single person in the country.  Video collaboration technology is having a big impact in providing more effective ways for patients needing daily treatment or medication monitoring, where a nurse or doctor is required to be present at certain times.

So how is Video-as-a-Service (VaaS) helping the healthcare sector? VaaS is a centrally managed hosted video conferencing solution that can be delivered on demand to provide the highest quality experience, without the need to invest in your own infrastructure equipment. Our innovative, simple to use, secure and reliable VaaS uses Polycom’s high quality video and audio conferencing technology, through a flexible, hosted solution that allows clinicians to remotely assess and make an informed decision on treatment for patients.  It provides them with the same equal quality of service as if they were face to face with the patient.

The great thing about this solution is that it can be applied to many different scenarios that facilitate the provision of care and has improved patient experiences within a numerous healthcare organisations.  The technology is the same in every implementation, but the applications are almost endless, and we have already deployed the VaaS solution across multiple departments in different hospital sites with great success.

• Alder Hey Hospital pediatric neurology department have benefited hugely by removing the need for travel, allowing patients to access niche specialist care regardless of their – or the clinicians’ – geographical location. 

• Patients of Lancashire Teaching Hospital’s renal department were given more independence, enabling them to perform dialysis at home in a comfortable and familiar environment while being safe in the knowledge that expert help was at hand should they require it. 

• The VaaS solution is also able to provide a rapid response service and has already saved numerous lives or dramatically improved the quality of patients lives post-stroke, as part of the Lancashire and Cumbria Telestroke Network, which ensures that people in the region have 24/7 access to the experts which can deliver thrombolysis treatment following a stroke. 

• Blackpool Victoria Hospital’s Speech and Language Therapy department clinicians and therapists are now able to respond quickly should any elderly nursing home residents, some of whom may have previously suffered a stroke, get into difficulty when eating or drinking.

A patient at home receives advice while dialysising

Thus far we’ve received extremely positive feedback, highlighting the significant changes the VaaS has made to patients’ lives. Video-as-a-Service has no doubt helped to improve the patient experiences and outcomes and has also helped these hospitals realise significant cost savings.  Secondary benefits of the solution include:

• Enabling medical specialists around the country to collaborate remotely, heightening the quality of their communication and dissemination of best practice. 

• Freeing up hospital beds, which are always in high demand, providing a 100% utilization rate of across each hospital. 

• Prevents clinics from being overcrowded and allows the space to be used more effectively. 

• On the patient’s side, those living in the most remote locations can speak with a specialist at the other end of the country if need be. Saving them and their support network money, time and the stress of travelling.

Imerja is proud to have designed and implemented such an innovative solution which benefits both patients and the healthcare system as a whole. Like many other telehealth solutions available today, the VaaS service has serious potential to revolutionise the provision of care in the UK and beyond. So, whether it‘s deployed to support telehealth, telemedicine, teleconsultation or teletherapy applications – or simply to provide a more accessible platform for teaching or facilitating multi-disciplinary team meetings – VaaS has the potential to transform the way we choose to deliver and receive healthcare, and realize better experiences and outcomes for all parties.

We’ve plenty of evidence to support the importance of video within the healthcare industry, both in clinical and administrative
environments, but what about practical advice? A telemedicine deployment needs careful planning and consideration if you are going to derive productivity gains and cost savings, and most importantly; improve patient outcomes. Derived from my experience, here are the top five considerations:

1. Establish a workgroup or steering committee of individuals from your organisation who will contribute to the selection of a solution.  These should include someone from IT/networks, a clinician or medical person who will actually use the solution, a finance person who will be involved in justifying the cost and producing the business plan or approving the purchase, and – most importantly – a trusted partner from industry, such as a consultant, subject matter expert or supplier who has experience in this area. (I can help you with this one if you need help finding a trusted partner – feel free to get in touch with me.)
2. Clearly define the objective for implementing a solution based on technology.  If you want a method of providing emergency medical second opinion during out of hours, put the reason in a concise statement, leaving out the technology aspect and concentrating on the application
3. Get everyone to meet and produce an Output Based Specification (OBS) of what you want the solution to do.  Again, leaving out the technology, the OBS document should have input from each of the steering committee.  IT will want to ensure the solution doesn’t eat up all their network bandwidth and is secure enough to discuss patient confidential information.  The clinician will want to ensure the solution offers clear, uninterrupted conversation and is simple to use, yet consistently reliable.  Gather each of these requirements and list them in sections in your OBS.  (I have a template for an OBS if you need one – get in touch.)
4. Invite your suppliers to demonstrate and present their solution to you.  Ask them where else their solution is in use.  Seeking user references is by far the best method of peer recommendation you can get.  You can learn from their experiences, both good and bad
5. Perhaps most important is to check their solutions are interoperable.  Do they work with the majority of other manufacturer’s technology?  You are going to trust your investment and the way you deliver your future service to your patients with these people

Let me know if you need more information as to how to find a trusted partner or how to complete and Output Based Specification (OBS).