Value (Business Strategy and Financial Management)
EP-155 - The Business Case for Telemedicine Emergency Services: Workforce, Clinical, and Financial Success
Tuesday, May 1
9:55 AM - 10:10 AM
Location: Education Zone, Booth 2416, Screen 5
In 2009, The Leona M. and Harry B. Helmsley Charitable Trust awarded two multi-million dollar grants to Avera Health, a health system located in Sioux Falls, South Dakota. Avera had created a telemedicine program (Avera eCare) to provide support to the rural hospitals and providers within their system, and Helmsley asked them to build their infrastructure to serve the seven-state service area of the Helmlsey Rural Healthcare Program. One of the primary reasons Avera created their eCare services was to help with recruiting and retention of rural providers. One of the primary reasons The Helmsley Trust chose the seven upper Midwest states of IA, ND, NE, MN, MT, SD, and WY to focus their Rural Healthcare Program was the healthcare workforce shortages in those states. A partnership continues, and together Helmsley and Avera have outfitted over 146 hospitals with eEmergency services. Beyond the support of Helmsley, eCare has expanded to other states and services. The business model that enables small, rural Critical Access Hospitals to sustain the program beyond the life of the Helmsley grants includes several facets that apply to all hospitals, in addition some hospitals are able to change their staffing and call-model for their emergency departments. Once CMS provided clarification on EMTALA regulations that was hampering hospitals from utilizing a physician via telemedicine (live, two-way video) to supervise non-physician providers in the emergency department, hospitals began changing their emergency room staffing models. This has allowed hospitals to staff their ED with advanced practice providers with supervision via a Board certified emergency physician, rather than staffing the ED with locum tenens and/or paying local physicians or locum physicians to be on-call for oversight of non-physician providers covering the emergency room. This allows hospitals to save hundreds of thousands of dollars (Actual case studies will be shared in the presentation), which is more than adequate to subsidize the service fees and connectivity fees of the eEmergency services. Recently the State of Iowa revised a law and rules that will allow Iowa hospitals to follow the federal regulations which will allow supervision of advanced practice providers via telemedicine. Twenty Iowa hospitals that utilize eEmergency services will now have the opportunity to review their ED staffing model and make changes as they choose (Case studies for potential savings will be shared in presentation). In addition to saving the patient and family money as well as saving expenses to other payers, this presentation will present the business case for a rural hospital to utilize telemedicine for emergency services. This presentation will look at the multiple business models: 1.) From the funder's perspective: how can the project become sustainable; 2.) From the service provider's perspective: how can it sustain and grow, pricing and scaling; 3.) from the hospital's perspective: how can the hospital afford this new, additional service and sustain it after the grant, and 4.) savings to patients and payers.
- describe an effective business model for teleEmergency services in small, rural hospitals.
- demonstrate awareness of physician and advanced practice provider recruitment and retaining improvement and improved job satisfaction.
- compare financial and staffing models for rural hospitals before and after implementation of teleEmergency services.