Texas Health Resources has created internal committees to serve a checks-and-balances function regarding technological improvements, he says.
Presbyterian Healthcare Services, based in Albuquerque, NM, is using a two-way video chat program to divert nonemergent patients from the ED and to help them find a primary care physician, schedule appointments, and educate them. The program operates out of the 453-licensed-bed Presbyterian Hospital in Albuquerque.
Patient navigators there operate the video chat program for patients at two of the eight-hospital system's smaller facilities, the 198-licensed-bed Kaseman Hospital in Albuquerque and the 68-licensed-bed Rust Medical Center in Rio Rancho, NM.
Through the video chat, patient navigators help direct nonemergent cases to an appointment or follow-up care with a primary care physician, if a medical screening in the ED shows they do not need immediate care, says John D. Johnson, enterprise director of the customer service center for Presbyterian Healthcare Services.
Patient navigators meet face-to-face with patients at Presbyterian and counsel patients at Kaseman and Rust Medical Center via the video chat program when they are not handling cases in person.
Since 2010, there have been more than 8,000 patients seen by patient navigators. At least 76% of patients who went to the ED were referred to primary care physicians with "minimal complaints," Johnson says. "Our goal is to educate patients and get them established with a primary care physician, thus improving continuity of care."
As a result, the health system is predicting a savings of as much as $15 million for the three hospitals during a five-year period, according to Johnson.
The hospital system employs 10 patient navigators stationed at Presbyterian Hospital.
"We're doing the right thing for the individuals and community," he says. "Patient navigation is about connecting patients with the right provider and the right venue at the right cost."
Success key No. 1: Telehealth
Telehealth is one of the most popular technological innovations for health systems because of its capability of having a broad reach for patients, especially those who live in rural areas and at great distances from hospitals. Health systems that have been successful in developing telehealth systems are now focusing on using programs for specific service lines, such as the intensive care unit.
When the Sutter Health system launched its telehealth eICU patient safety system in the San Francisco area several years ago, it was one of the first health networks to bring online two ICU centers for constant monitoring of critically ill patients.
The eICU system has enabled Sutter to detect sepsis through a standard set of screening and treatment processes throughout its 26 hospitals, and it monitors as many as 30,000 patients from its ICU hubs in Sacramento and San Francisco, says Teresa Rincon, RN, BSN, CCRN-E, the eICU nurse director at Sutter Health.
The process also has had a carry-over effect: Sepsis-related deaths in the hospital system have decreased 29% since 2008, with more than 1,300 lives saved between 2007 and 2010. The hospital has estimated that it has saved $21 million in costs because of reduced time patients spent hospitalized during that period, according to Rincon. Length of stay has been cut at least 17%, she adds.