Richard Zane has one word for the University of Colorado Hospital’s investment in telemedicine: prescient. Before the COVID-19 pandemic, UCHealth doctors conducted 20 virtual patient visits per day. As coronavirus spread, that number quickly ballooned to 260, with patient interest and legal mandates causing the hospital’s use of Colorado telehealth companies to grow 1,200 percent day over day.
“Everything that we’ve built from a virtual health perspective is hardwired into the platform so that when you scale it was really already available across the entire system,” said Zane, chief information officer at UCHealth and executive director of the hospital's emergency services division. “It was able to be scaled robustly, almost immediately.”
The non-profit hospital network has long operated as a beacon for virtual healthcare — last year, UCHealth was named the top “most wired” hospital in the state by the College of Healthcare Information Management Executives. But the coronavirus presents a challenge not quite like any it’s faced before.
Still, the hospital’s technical chops allowed it to scale to virtual patient needs “without really having to add anything other than a few more monitors and chairs,” Zane said. As the state and country relax social distancing mandates, telehealth that helps doctors diagnose and monitor patient conditions will become more critical than ever, Zane said.
“It’s almost a death knell if a tech company believes they’ve identified a problem and builds a solution without engaging healthcare,” Zane said. “It’s usually the first sign that that’s a tech company that will never survive. So understanding the problem, engaging providers and patients, and co-developing is really the answer.”
Growth in Telehealth
Zane attributed UCHealth’s swift embrace of telehealth in responding to the pandemic to relaxed laws around the practice.
Prior to COVID-19, Medicare patients were not eligible for virtual care unless they lived in rural areas, leaving most covered under the federal health insurance program for those 65 and older ineligible to visit their doctor virtually. In early March, Congress allowed for all Medicare patients to now use telehealth.
Lawmakers also lifted restrictions on virtual physicians’ practice. Before the coronavirus, doctors could only conduct virtual visits with patients who resided in the state where they were licensed, Zane said. Now doctors can hold digital visits with anyone across the United States. Legislators changed payment terms too, so that physicians who conduct appointments over video calls are paid the same as those who see patients in-person, Zane said.
“Regulations caught up very quickly to the ability to perform and deliver virtual health from a payment perspective and a law perspective,” Zane said. “I’m hoping that things don’t change.”
From Stay-at-Home to Safer-at-Home
Last month, Colorado Governor Jared Polis issued a “safer at home” mandate, allowing local counties to decide on a case-by-case basis which businesses can open under what conditions. In Denver, only essential businesses are open, for example, while all companies in northern Weld County have reopened under a “safer at work” order.
During a pandemic, Zane said that different parts of the state relaxing social distancing restrictions at different times makes reasonable sense. He said the only thing doctors know for sure is that social distancing slows the virus’ spread.
“What we need is moderation,” Zane said. “We need the ability to pivot, which means if we make a decision to do something like open something and we see that cases are going up, that we have the ability to reverse course.”
Partnership With Startups
Two Denver area companies are helping UCHealth diagnose and monitor coronavirus patients.
Before the coronavirus spread, UCHealth already used BioIntelliSense to monitor patients remotely. But after the pandemic hit, the hospital’s use of the product skyrocketed, Zane said. BioIntelliSense manufactures a wearable device that reports patient temperature, respiratory rate, heart rate and more.
“The adoption of BioIntelliSense went up very significantly because it accelerated our virtual health utilization and remote patient monitoring,” Zane said. “For patients who are being discharged who have COVID, they can get precipitously ill and this allows us to monitor them.”
UCHealth doctors have also relied on the RxRevu platform to ensure they are prescribing the right mix of medicines to cover coronavirus patients, Zane said. RxRevu links a patient’s digital medical records to their payer information, allowing doctors to know if a drug is covered under their insurance plan and available at local pharmacies.
RxRevu is embedded into UCHealth’s electronic medical record provider. Zane credited integrations like these with allowing UCHealth to easily scale its virtual doctors offices across its entire, multistate operation.
Most hospitals offer a patchwork of electronic medical record providers, Zane said, which can make integrating the systems — and accessing information about a patient’s medical history and previous office visits — difficult. UCHealth relies on just the Epic Systems platform across its more than 15 locations.
The biggest challenge to scaling its tech systems involved a behavior change, Zane said: convincing doctors and patients that virtual visits were the way to go.
“What everybody learned very quickly was that you could do far more in virtual care than people anticipated,” Zane said. “Hopefully it’s one of those changes that never goes back post-pandemic.”
How Can Tech Support Healthcare Providers?
If the pandemic has highlighted anything, it’s that user experience is key for healthtech firms, Zane said.
“We want every patient and every provider to interact with digital health and virtual health as easily as downloading an app on their phone,” he said.
Zane said tech companies should work to understand how AI can be integrated into doctors’ workflow. He thinks bringing patient health and claims data together into a single system will help physicians make better decisions. The big problem, however, is how healthcare providers can view patients’ medical history from one electronic medical record platform to another, Zane said. He said tech companies should focus on building systems that allow for easy integration and transfer of this data.
“[Interoperability] is not something we’ve struggled with because of COVID,” Zane said. “It’s something that the United States has struggled with since the advent of electronic medical records.”
