Telehealth Network Grant Program
The Georgia Health Policy Center recently spoke to Susan Barry, vice president of virtual care operations, about how TNGP grants have facilitated the growth of virtual services across the 1.5 million patients and 250,000 square miles served by Sanford Health.
To date, what has been the biggest accomplishment or win in your telehealth program?
People living in rural America face unique challenges and access to care is one of the most significant determinants of health. The vast majority of the counties that Sanford Health serves across the upper Midwest are federally designated provider shortage areas. Sanford Health has provided more than 650,000 virtual consults with patients over the last decade and has saved roughly 25 million miles of travel for patients while still receiving high-quality care. We have also been able to partner with 35 Critical Access Hospitals to build programs and virtually assist services with emergency-trained physicians and nurses, neurologists for acute stroke, and burn surgeons.
What is a tip or early learning that you would share with an organization launching a similar telehealth program?
We are continuing to learn on this journey but there are a few lessons that stand out for us. First, find and harness your early adopters — both providers who deliver the care and patients that receive the care. They can be effective advocates and validators. Second, change management is huge —bring in those clinical and operational stakeholders in the early stages of planning and implementation. We want to make sure that our virtual care solutions mirror their existing workflows or make them better or easier. We all know communication is the key to gaining buy-in. So, communicate, communicate, communicate and know how to articulate the why. What problem are we solving? A lot of it comes down to building trust. Virtual care programs can create challenges or mistrust just because clinicians are used to doing things a certain way. Our virtual care strategies and tools that we use have to evolve as health care evolves. It is not one and done. The challenges that we faced during the pandemic and the workforce challenges we are experiencing are not going away. We need to invest in new care delivery models to be sustainable and serve our communities for the future.
How do you see participation in the Office for the Advancement of Telehealth’s Telehealth Network Grant Program (TNGP) impacting your broader telehealth or health improvement efforts?
The funding that we received from the TNGP has been mission critical for us. We wouldn’t be able to serve our patients virtually across our footprint without it. We received several grants from TNGP that have not only laid the foundation for our virtual care programs, but also served as a catalyst to continue to expand access to high-quality, convenient care for the rural communities that we serve.
Specifically, it enabled us to create our infrastructure to launch several programs, tele-emergency, telestroke, tele-burn, virtual behavioral health, virtual infusions, and specialty consults. With our tele-emergency service, one of the goals was to avoid unnecessary transfers and we have seen a 46% avoided transfer rate, which allows patients to stay in their local communities to receive care and keep those dollars in the local community. The average time for a rural provider to get access to our telestroke service is five minutes or less. This program gives providers in the community confidence when evaluating patients for acute stroke. The protocols that we have in place allow neurologists at a distance to review labs and CT scans in a matter of minutes to determine if a patient needs an intervention and collaborating with the providers and staff at the bedside on a treatment plan. We know this program has saved lives.
What will your organization be doing more of or differently to emerge stronger from the pandemic?
We did try several things that we did not think we would during the pandemic, like all health care organizations probably did. Some things worked better than others. But as we look to the future, we are really focused on providing the right care at the right time in the right place. We know that 60% of health outcomes are determined by a person’s ZIP code, not their genetic code, which makes our virtual care strategy an imperative. In the fall of 2021, we announced a landmark virtual care initiative to transform health care for rural underserved communities across the upper Midwest.
With this initiative, we’ll focus on some key pillars, including innovation, access to care and care delivery, education and community learning, and building our virtual care team. Last year in August, we broke ground on a virtual care center, which will house dedicated clinician workspaces, equipped with the latest technology to offer on-demand urgent care, behavioral health care and primary care. We have originating sites across our footprint, but we are also looking at the concept of a satellite clinic and looking at ways to ensure our patients have access to care and services close to home. We are still working through these plans, but the concept would be looking at communities that have no health care and a community that has health care, but maybe only a couple of days a week. The thought is having that staffed by a nurse with a direct connection to clinicians. Patients could present to this clinic for virtual services. There may be lab imaging and pharmacy. It may be an existing building or a very small footprint with 1,500 square feet with one exam room.
We are committed to ensuring patients benefit from world-class care no matter where they live or the health challenges they face. The pandemic served as a catalyst for us to fundamentally change the way care is delivered for future generations.