This document summarizes three illustrations of telehealth innovations during the COVID-19 pandemic. Bridgeport Hospital Yale New Haven Health provides continuing medical education credits for physicians for a telehealth activity. Esperanza Health Centers in Illinois transitioned 74% of patient encounters to telehealth within 3 weeks and conducted interviews to develop sustainable telehealth systems. Presbyterian Medical Services in New Mexico deployed telehealth devices to expand access for patients in rural and frontier areas across their 60 facilities spanning 900 miles. Community Health Center Inc. implemented a tele-MAT hybrid visit model combining in-person and virtual care to continue providing medication-assisted treatment services during the pandemic.

1. Illustrations of
Telehealth Innovations
September 16, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.

3. Illustrations of Telehealth Innovations
https://intouchhealth.com/

4. COVID-19 in the United States
6,604,355 cases on 9/16/20 up 6,326,791 cases on 9/8/20 195,765 deaths
https://coronavirus.jhu.edu/map.html

7. COVID-19 News Updates
• WHO -highest single-day record in global
infections on 9/13 with 307,930 new cases
• India leads ~100,000 cases a day
– Argentina, Indonesia increasing
• United Nations -up to 265 million people could
face starvation by the end of the year (April
2020)

8. COVID-19 News Updates
• AstraZeneca resumes vaccine trial
• Pfizer CEO – data expected end of October
– Possible vaccine distribution before end of 2020
– Expanding to more vulnerable populations

9. Speak softly to reduce viral spread
• A 6-decibel reduction in average vocalization
intensity –lowers transmission risk
– equal to doubling the ventilation rate in a room
• A loudness increase of about 35 decibels, the
difference between whispering and shouting,
boosts particle emission rate by 50 times
• “Quiet zones” -high-risk indoor environments
– Clinic waiting rooms, dining facilities
https://bit.ly/3hiXws2

10. Resources
• Nuvance health 1150+ articles reviewed:
https://spark.adobe.com/page/usNN4WCpWhNOy/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

11. Illustrations of Telehealth Innovations:
Esperanza Health Centers
Jeffrey McInnes
Director of Billing and Patient Access
Esperanza Health Centers

12. Esperanza Health Centers
Building Sustainability
• Within 3 weeks of Illinois stay-at-home order, telehealth
use grew from 0% to 74% of patient encounters
• Initial implementation was led by two directors, allowing
for rapid rollout and scale, but additional bandwidth was
required to transition from disruption to long-term strategy
• Conducted agency-wide interviews across care teams to:
– Learn what was and wasn’t working
– Leverage the talent of the care teams in developing sustainable
systems
• Developed task force to address common challenges
– At-home BP Monitors
– Patient connectivity issues solvable through local resources
– Resolve scheduling, administrative challenges

13. Illustrations of Telehealth Innovations:
Presbyterian Medical Services
Doug Smith
Executive Vice President,
Presbyterian Medical Services

14. Presbyterian Medical Services
Telehealth Access in Rural New Mexico
• Operates 60 facilities Statewide
– 900 miles furthest distance between locations
– Rural and Frontier status – smaller footprints
• Geography and infrastructure challenges
• Addressing access
– Hotspots / mobile devices
– Deploying phone and video devices to patients
– Working with the Navajo Nation on internet access
• Initial Outcomes
• Long-term Implications and Next Steps

15. Telehealth Rapid Response
0
5000
10000
15000
20000
25000
30000
35000
40000
February March April May June
Presbyterian Medical Services
Face to Face Telehealth

16. Illustrations of Telehealth Innovations:
Community Health Center Inc.
Kate Gager
Patient Experience Supervisor,
Community Health Center, Inc.
Sydney Kennedy
Assistant Director of Telehealth Administration,
Community Health Center, Inc.

17. Visit Types

18. Tele-MAT Hybrid Visit
Nurse Visit
•Standard in-
person nurse visit
timeframe
•Vital testing
•Overview
•UDS screening
•Same billing
Nurse bring in
kiosk
•Mobile-kiosk
•Laptop with
modified
software &
hardware to only
launch Zoom
Provider Visit
• Provider
located
offsite
• Billing similar
with added
telehealth
modifier
Room cleaning protocol – wipes for kiosk, standard cleaning protocols
Patient In-Person

20. 20 * This initiative is supported by

21. Thank You!
https://www.weitzmanlearning.org/the-path-forward/