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Michigan Cancer ConsortiumVirtual Care Offerings for OncologyHenry Ford Health SystemNovember 7, 2018These slides are the property of the presenters. Do not duplicate without permission.
Henry Ford Health SystemCore Services: Outpatient Dialysis Five acute med/surg and Two behavioral health hospitals Home Health Care Henry Ford Medical Group Health Alliance Plan (HAP) –– 27 Medical CentersInsurance Provider– 1200 physicians & scientistsThese slides are the property of the presenters. Do not duplicate without permission.
Henry Ford Cancer InstituteThe Henry Ford Cancer Institute is creating more hope forpatients around the world. With one unified team of cancerspecialists and innovations ranging from precision medicineto MRI‐guided radiation therapy, we deliver one‐of‐a‐kindcancer treatments.Our 900 highly skilled doctors, researchers, nursenavigators and other healthcare specialists provide worldclass cancer care to thousands of patients each year. Withfive hospital locations, six additional outpatient cancercenters and dozens of aligned doctor’s offices, theCommission on Cancer designates us as an integratednetwork and recipient of the 2016 OutstandingAchievement Award.These slides are the property of the presenters. Do not duplicate without permission.
Brigitte Harris Cancer Pavilion New 6‐story, 187,000‐square foot Detroit cancerfacility Destination for comprehensive cancer care: ambulatory cancer treatmentprecision medicineclinical trialsenhanced support services for cancer patients andcaregiversThese slides are the property of the presenters. Do not duplicate without permission.
"If you ask the customerhe would have asked for a faster horse" Henry Ford“Whether you think you can, or think you can’t, you’re right.” Henry FordThese slides are the property of the presenters. Do not duplicate without permission.
Virtual Care MissionTo improve the value of healthcare by leveragingvirtual care to impact the customer experience,access, cost reduction, efficiency, and clinicalquality.Technology Doctor Virtual CareExperience * (Technology Operations Build Engagement) Virtual CareThese slides are the property of the presenters. Do not duplicate without permission.
SynchronousVirtual Care CapabilitiesAsynchronousMyChartVideo Visit*MyChartMessagingClinic to tual PostOp Visit*Some insurance payers will reimburse for these servicesThese slides are the property of the presenters. Do not duplicate without permission.
MyChart Video VisitsVideo Call: Real‐time Audio and Video Scheduled appointment, patient can “see” theirprovider without going to the clinic. Video call using patient personal device MyChart mobile app from their smartphone or tablet MyChart website from laptop or desktop computer(with a web camera) Insurance Coverage – Some payers cover Not covered by Medicaid or non‐ACO Medicare A&BThese slides are the property of the presenters. Do not duplicate without permission.
MyChart Video Visit Programs Survivorship 2 providers servicing 3 clinic locations Available to any patient completing treatment OncoStat 10 providers servicing 5 clinic locations APPs available to patients during course of treatment Radiation Oncology 2 providers servicing 2 clinic locations Available for consults and post‐procedure visitsThese slides are the property of the presenters. Do not duplicate without permission.
Clinic to Clinic Telemedicine VisitVideo Call: Real‐time Audio and Video Similar to a regularly scheduled appointment,but patient will go to one clinic and beconnected to a doctor at another distant clinic. Patient will check in and be shown to an examroom, and a Henry Ford team member willconnect patient to the doctor in real time. Insurance Coverage – Most payers coverThese slides are the property of the presenters. Do not duplicate without permission.
Telemedicine Program Urology surgical consults referred from clinicsoutside tri‐county area Surgeon providing robotic kidney surgeries forpatients diagnosed with kidney cancer Considerations ConnectivityTechnology/EquipmentSpace/Support Staff (tele‐presenter) at patient locationMedical Licensure & Credentialing of HFHS providerRadiology Images & Medical RecordsBilling/ClaimsThese slides are the property of the presenters. Do not duplicate without permission.
Telemedicine Program Urology surgical consults – testimonial:“This has to be one of the most fruitful andfunctional telemedicine arrangements. Thanksfor your participation. Our staff and patientsare very appreciative.”These slides are the property of the presenters. Do not duplicate without permission.
Telemedicine Program Consults performed 2017 9 2018 (through August) 10 Miles saved 2017 3,897 2018 (through August) 4,330 Minutes of travel saved 2017 3,618 2018 (through August) 4,020These slides are the property of the presenters. Do not duplicate without permission.
HFHS Virtual Care Specialties Allergy MVVBehavioral Health Services (Adult and Geriatric) C2C Cardiology eC Center for Autism and Developmental Disabilities MVV Dermatology C2C/MVV/eV/eC Dialysis MVV Endocrinology MVV ENT (Ear, Nose & Throat) C2C/MVV/VPO Functional Medicine MVV C2CGastroenterology (IBD) Infectious Disease MVV International Travel Medicine C2C Nephrology C2C Neurology MVV/eC Neurosurgery VPO Oncology C2C/MVV C2C/VPOOrthopedicsPharmacy (Medication Therapy Mgmt) MVVPreventive Cardiology (Cardiac Rehab) MVVPrimary Care MVV/eVRadiation Oncology MVVReproductive Medicine (IVF) C2CRheumatology C2C/MVVSleep C2CSpeech Therapy MVVSports Medicine C2CStructural Heart Disease C2CThoracic Surgery C2C/MVVTobacco Treatment MVVTransplant (Liver & Kidney) C2CUrology C2C/MVVVascular Surgery C2C/MVVWomen’s Health/OB MVVeV eVisiteC eConsultMVV MyChart Video VisitsC2C Clinic to Clinic TelemedicineVPO Virtual Post OpThese slides are the property of the presenters. Do not duplicate without permission.
Virtual Care Enables Us To: Increase/improve access and reachOffer alternate access to healthcareTrack with patient experience and expectationsReduce costs (time, travel, convenience, etc.)Increase clinician productivity/efficiencyConnecting with customers where, when, andhow they want to be reached All For You!These slides are the property of the presenters. Do not duplicate without permission.
Contact InformationMarie LeeProgram Coordinator, Virtual yford.com/services/virtual‐careThese slides are the property of the presenters. Do not duplicate without permission.
Advanced Technology in Caringfor Cancer Patients RemotelyGeralyn Roobol, LMSW, RN, CMACDirector Cancer Services, Spectrum Health Cancer CenterMichigan Cancer Consortium Annual MeetingNovember 7, 201811These slides are the property of the presenters. Do not duplicate without permission.
Objectives Spectrum Health MedNow Overview Spectrum Health TeleOncology2These slides are the property of the presenters. Do not duplicate without permission.
Overview of Spectrum Health Spectrum Health is a not-for-profit health system, based inWest Michigan and West Michigan's largest employer withover 29,000 employees3These slides are the property of the presenters. Do not duplicate without permission.
Overview of Spectrum Health Health Plan: Priority HealthSpectrum Health Medical Group:Spectrum Health Hospitals 790,000 members 1500 physicians & APPS12 hospitals 3400 physicians & APPsInpatient and outpatient rehabilitationHospiceHome Care (VNA, medical home)Ambulatory Services, Surgery Centers and Urgent Care 200 sites4These slides are the property of the presenters. Do not duplicate without permission.
The Spectrum Health Cancer Center Provides comprehensive services and a robust clinicalresearch program; only BMT program in West Michigan Affiliated with MSU School of Medicine and Van AndelResearch Institute Leading edge programs & technology 4000 analytic cases 30% of patients on trials 15 sites of service Leader in Tele Oncology5These slides are the property of the presenters. Do not duplicate without permission.
Telehealth comes in many forms Two-way video Email Smart phones Wireless tools6These slides are the property of the presenters. Do not duplicate without permission.
7These slides are the property of the presenters. Do not duplicate without permission.
What is MedNow ?SM Telehealth program at Spectrum Health that is a fast,convenient and affordable way for patients to receive careusing technology to bridge the distance between patientand providers. Three areas of focus Direct to Consumer (Direct to Patient) Specialty Care Remote Patient Monitoring Two core tools Video visits E visits8These slides are the property of the presenters. Do not duplicate without permission.
Why?Why?ConsumerDemandValue BasedCareTechnologicalAdvancements& CompetitionCost SavingsThese slides are the property of the presenters. Do not duplicate without permission.
Consumer Demand - What Matters Most?ConvenienceOn DemandAccessLow CostLocalHighQualityThese slides are the property of the presenters. Do not duplicate without permission.
Remove Geographical Barriers to CareThese slides are the property of the presenters. Do not duplicate without permission.
Requires a New Care ModelTraditionalAccessPointsLow AcuityHigh AcuityPrimaryCare OfficeEmergencyDepartmentConsumerOriented AccessPoints Source: Mehrota A et al, "Visits To Retail Clinics Grew Fourfold From 2007 To 2009,Although Their Share Of Overall Outpatient Visits Remains Low," Health Affairs, August2012; Health Care Advisory Board interviews and analysis.These slides are the property of the presenters. Do not duplicate without permission.
What is MedNow ?SMDirect to Consumer MedNowCare is available for low acuity primary care conditions using videovisits or eVisits. The patient and clinician are in different physicallocationsSpecialty MedNowAllows patients with more serious conditions to have aconsultation with a Grand Rapids-based Spectrum Healthspecialist via a secure video connection from remote clinics andhospitals.Remote Patient MonitoringRemote monitoring of chronic conditions by way of technology13These slides are the property of the presenters. Do not duplicate without permission.
Spectrum HealthMedNowSMDirect to ConsumerMedNowSMMedNow at HomeSpecialty MedNowSMBehavioral HealthRemote PatientMonitoringCongestive HeartFailureCardiologyMedNow at WorkInfectious diseaseMedNow in RetailMedNow at SchoolOncologyDiabetesCOPDPediatricsWoundMedNow inCommunityVascularThese slides are the property of the presenters. Do not duplicate without permission.
Remote Patient Monitoring CHF COPD Diabetes Goals: Reduce hospitalreadmissions Improve QOLThese slides are the property of the presenters. Do not duplicate without permission.
Specialty MedNowSMAllows patients with more seriousconditions to have a consultation with aSpectrum Health specialist via a securevideo connection from remote SpectrumHealth clinics and hospitals.These slides are the property of the presenters. Do not duplicate without permission.
Specialty MedNowSMCare Settings Oncology Bariatrics Behavioral Health Cardiology Diabetes Infectious Disease Ob/Gyn/NICU Orthopedics Pediatrics/PICU Pulmonary/Sleep Vascular Wound CareOver 24 specialties and 90 Use CasesEDInpatientOutpatientHomeThese slides are the property of the presenters. Do not duplicate without permission.
Let’s Talk Tele Oncology – Why Open up Access Physician Satisfaction Patient Satisfaction Decrease the Overall Cost of Care18These slides are the property of the presenters. Do not duplicate without permission.
Access ASCO published its report The State of Cancer Care inAmerica: 2016, which detailed a potential workforce shortage ofoncologists over the next decade just as the demand foroncology services will be surging. Telemedicine or tele-oncology will definitely help mitigate theproblem of a physician workforce shortage. In addition, the technology allows other populations ofphysicians, such as retired, disabled, or stay-at-home momsand dads, to continue to use their medical expertise bypracticing medicine as virtual consultants as long as theymaintain their board certification and keep current through CMEcourses19These slides are the property of the presenters. Do not duplicate without permission.
Increase Rural Access2012 report by the Institute of Medicine for the NationalAcademies, entitled The Role of Telehealth in an EvolvingHealth Care Environment (DOI: 10.17226/13466), found thattelehealth drives volume, increases quality of care, andreduces costs by reducing readmissions and unnecessaryemergency department visits for rural communities. Throughtelemedicine, rural hospitals can serve rural patients at bettercosts and help cut down on the time it takes rural patients toreceive care, particularly specialty care.20These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology – Current Outcomes 35, 81 and now 176 YTD Slow but now steady growth Patient satisfaction – top box currently 91% Provider satisfaction – top box currently 91% No difference for either group by age or indicationIn Oncology, physicians are now actively searching foropportunities After exposure to the technology, believe in the potential Physical exam remains a barrier despite available tools21These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology at Spectrum Health Areas of focus determined by: Alignment with strategic plan and areas of growth Potential market Community need Financial feasibility Physician interest/ readiness22These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology - Model Specialty based pre visit reviews are performed by theprogram coordinator Eligibility for the program Results of imaging Originating site is the regional cancer center Schedule patient for a tele oncology visit at bothoriginating and central locations Patient registered and roomed at originating site Originating site bills the technical (facility) fee23These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology - Model Visit begun by physician after thepatient is in the room Visit performed Follow up appointments are madebased on physician recommendations Physician bills the professionalcomponent24These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology – Areas of Focus Psych Oncology Consult to onco-psychiatrist triggered when distress 7-10 Tele oncology used for non suicidal high distress regionalpatients Lung Program Lung Nodule follow up appointments Lung Cancer Screening counseling and follow up New patient evaluation for lung nodules Routine follow up from the Lung Cancer multispecialty clinic25These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology – Areas of Focus Heme/ BMT Routine follow up with normal testing Low risk BMT patients at this point Benign Heme General Cancer Center Initiatives Medical Genetics consultations - Two studies in 2014 reported in Journal ofClinical Oncology indicate that telephone-based education or counseling initiatives can besuccessful in educating individuals at familial or genetic risk of cancer and in inducing these atrisk individuals to undergo recommended screening (J Clin Oncol 2014; DOI:10.1200/JCO.2013.51.6765, J Clin Oncol 2014; DOI:10.1200/JCO.2013.51.3226). Survivorship Cancer Smoking Cessation counseling and follow up26These slides are the property of the presenters. Do not duplicate without permission.
Innovation - Knock Out CancerPartnering with our community resources to provide cancer prevention and education to ourunderserved areas .The main topics discussed included: Exercise/Physical activity Diet/Nutrition Family cancer history Smoking cessation Cancer screening recommendations based on age and gender Guests knowing what is normal for their bodies and the need to report changesThe nurse at Mel Trotter follows up with guests after each visit to ensure they have a planto follow through on recommendations or to help make appointments as needed.27These slides are the property of the presenters. Do not duplicate without permission.
Tele Oncology – Opportunities Melanoma Skin Lesion screening: Dermatology is not yet a believer inthe technology, despite the high resolution tools, and areworried about risk Melanoma multispecialty team: Dermatologist participationin MST conference from their office28These slides are the property of the presenters. Do not duplicate without permission.
Patient ImpactBMTTotal Time:14.5 Hours6HHours & 34Minutes-PatientTravels toLudington (iftraffic,construction, orweather allow))10 MinutesPatient LeavesOffice andReturns toVehicle15 MinutesPatient Meetswith Specialist15 MinutesPatient Waits inExam RoomPatient Lives inMarquette, MIPatient'sHouseholdIncome is 37,355Traditional ModelPatient CostsFood Expense: 16.00Total Gas Expense: 434.16Wages Lost: 161.64Total Patient CostsExcluding Any MedicalExpenses: 611.8020 MinutesPatient Waits inWaiting Room10 MinutesPatient Walksto Specialist'sOffice10 MinutesPatient Parksand LocatesBuildingElevatorPatient'sAppointment iswith Specialistin GrandRapids, MIPatient MustTake Time Offof Work toAttendAppointment6 Hours & 34Minutes-Patienttravels to GrandRapids (if traffic,construction, orweather allow)Patient LocatesCorrect ParkingRamp ofSpecialist'sFacilityThese slides are the property of the presenters. Do not duplicate without permission.
Patient ImpactBMTTotalTime: 0.7Hours5 MinutesPatientTravels Home5 MinutesPatientLeaves Officeand Returnsto Vehicle15 MinutesSpecialistMeets withPatient viaTelehealthPatient Livesin Marquette,MIPatient'sHouseholdIncome is 37,355Tele OncologyPatient CostsFood Expense: N/ATotal Gas Expense: 1.43Wages Lost: 12.57Total Patient CostsExcluding Any MedicalExpenses: 14.002 MinutesPatient Waitsin ExamRoom5 MinutesPatient Waitsin WaitingRoom5 MinutesPatient Parksand LocatesSpecialist'sOfficeIRS MileageRate of .54 aMilePatient'sAppointmentin MarquettePatient MustTake Time OffWork toAttendAppointment5 MinutesPatientTravels toMarquetteLocationThese slides are the property of the presenters. Do not duplicate without permission.
Patient ImpactLungTotal Time:2.97 Hours49 Minutes –Patient Travelsto Hastings (iftraffic,construction, orweather allow))10 Minutes –PatientLeaves Officeand Returns toVehicle15 Minute –Patient Meetswith Specialist15 Minutes –Patient Waitsin Exam RoomPatient Livesin Lakeview,MITraditional ModelPatient CostsFood Expense: 9.00Total Auto Expense: 53.76Wages Lost: 36.51Total Patient CostsExcluding Any MedicalExpenses: 99.2720 Minutes –Patient Waitsin WaitingRoom31Patient'sHouseholdIncome is 25,52910 Minutes –Patient Walksto Specialist'sOffice10 Minutes –Patient Parksand LocatesBuildingElevatorIRS MileageRate of .56 amileP ti t'Patient'sAppointmentis withSpecialist inGrand Rapids,MIPatient MustTake Time Offof Work toAttendAppointment49 Minutes –PatientP ti tTravels toGrand Rapids(if traffic,construction,or weatherallow)P ti tPatientLocatesCorrectParking Rampof Specialist'sFacilityyThese slides are the property of the presenters. Do not duplicate without permission.
Patient ImpactLungTotalTime: 0.7Hours5 Minutes –Patient TravelsHomePatient Livesin Lakeview,MIPatient'sHouseholdIncome is 25,529Tele OncologyIRS mileagerate of .56 amilePatient Costs5 Minute –Patient LeavesOffice andReturns toVehicle15 Minutes –SpecialistMeets withPatient viaTelehealthFood Expense: N/ATotal Auto Expense: 3.35Wages Lost: 8.59Total Patient Cos
Henry Ford Health System November 7, 2018 . access, cost reduction, efficiency, and clinical . Remote monitoring of chronic conditions by way of technology Direct to Consumer MedNow Care is available for low acuity primary care conditions using video visits or eVi
