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Moving towards Transformational TeleHealth at Intermountain Healthcare

June 1, 2013
by Mark Hagland
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Wesley Valdes, D.O., telehealth services director at Intermountain Healthcare, sees the future of telehealth

One of the speakers at the 2013 American TeleHealth Association Conference, held in Austin, Texas, May 5-7, was Wesley Valdes, D.O., who is telehealth services medical director at the Salt Lake City-based Intermountain Healthcare. While at the American TeleHealth Association Conference, Dr. Valdes and his colleagues at Intermountain staffed a booth that featured advanced telehealth solutions developed at Intermountain, including a virtual NICU (neonatal intensive care unit) that allows parents 24-7 visual access to their babies, as well as the capability for eVisits with their babies’ care providers.

Intermountain Healthcare’s leaders have committed significant support to establish telehealth technology across the system’s 22 hospitals and 185 clinics. The organization’s telehealth solutions, along with an open source community, are expected to support the organization’s strategy to transform healthcare by delivery high-quality care at sustainable costs, to a widely dispersed population.

Shortly after that presentation, Dr. Valdes spoke with HCI Editor-in-Chief Mark Hagland regarding his and his colleagues’ efforts at Intermountain Healthcare. Below are excerpts from that interview.

When you presented in a session at the American TeleHealth Association Conference, you partnered with another telehealth director, correct?

Yes, I was on a panel with Andrew Watson, M.D., director of telehealth at UPMC [the University of Pittsburgh Medical Center health system].

Wesley Valdes, D.O.

What are you doing with telehealth at Intermountain these days?

Intermountain Healthcare, as an organization, has responded to the new healthcare rules and regulations that the government has passed, in its own unique way. You’ve familiar with ACOs [accountable care organizations]; Intermountain would consider itself as already having been, in effect, an ACO, for years. If you look at the actual ACO model, it’s quite noticeable that it leaves out a key player in the healthcare process, as far as we’re concerned—the patient. The accountable care model doesn’t really encompass the patient, so we’ve developed our own concept, called shared accountability. The concept has two main phases. During 2013-2014, the focus is on intra-case cost reduction, which is a fancy way of talking about the admission-to-discharge timeframe when someone is an inpatient. It’s looking at making hospital stays more effective, efficient, and cost-effective. Then during 2015-2016, we’ll be focused on population health management.

And in putting this strategy in place, we decided that telehealth and mobile health would need to be a key part of all this. Intermountain had looked at telehealth earlier than that, but it really fit into this strategy well. At the time, I was a subject matter expert on telehealth from Microsoft, while an employee of the University of Illinois, and Microsoft and Intermountain had conversations, because Microsoft wanted to see how their technologies could provide telehealth solutions. So long short, in November 2011, I came out from the University of Illinois to Intermountain to help out with this. And in looking at the shared accountability strategy, we came to the conclusion that telehealth could help with both phases. The majority of Intermountain’s 23 hospitals are actually small, 10-25-bed rural hospitals; then they have seven mid-range hospitals, the 100-200-bed hospitals, and then four large hospitals.

So in talking about intra-case cost reduction and efficiency, we started a conversation about the element of redefining the concept of waste. And so what we were able to present to the organization is that, by taking the telehealth concept, which is usually cameras pointed outside your walls, if you turn those cameras to inside your walls, you create an infrastructure for greater efficiency. So we decided to put telehealth equipment into every single one of our patient rooms. We’ve been rolling that out, and are rolling it out over the next 12-15 months. That’s where the concept of the interactive patient room came in. And by doing that, we were able to look at several other projects, including patient education, patient entertainment, and patient stimulation, and merge all those projects into one. So while the interactive patient room will have a telemedicine/telehealth capability, it will also incorporate patient education and entertainment as well. So we were demo-ing that concept at both the HIMSS Conference and the telehealth association conference as well.

How will the interactive patient room be set up at Intermountain?

There will be a camera in the ceiling, something patients usually don’t see in their rooms. And the pillow speaker will be more of a touch-screen device. We haven’t yet decided what the form factor will be—it might look like an iPhone or iPad, but it will be some kind of touch-screen-driven device that the patient holds and that can access different features and functions—everything from turning the lights on and off to watching movies; but we also realized there are all sorts of other things we could enable it with. For example, if we’re not using the camera to do a remote consult at the moment, we realized we could also use the room to enable the patient to, say, do a Skype call with their grandchildren.