Latest / Becker’s Healthcare Podcast / Scaling Specialty Care Through Telemedicine to Strengthen Rural Hospitals

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Scaling Specialty Care Through Telemedicine to Strengthen Rural Hospitals · Becker’s Healthcare Podcast

• 0:00
  Hello, everyone, and welcome to the Becker's Healthcare
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  podcast. My name is Chanel Banger. And today,
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  I'm excited to welcome doctor Chris Gallagher. He's
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  the founder and chief strategy officer for Access
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  Telecare.
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  And as a bit of background, he began
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  his career as a cardiologist in rural Texas
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  hospitals,
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  where he saw firsthand how delays in care
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  could impact patient outcomes. When he couldn't find
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  a virtual solution that ensured timely, high quality
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  care across hospitals, he decided to build one
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  himself. Access Telecare is now the nation's largest
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  high acuity telemedicine provider that today supports virtual
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  care programs across all 50 states reaching more
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  than two sixteen million Americans.
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  Doctor. Gallagher,
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  welcome to the podcast. Hi, Chanel.
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  And to get us started out, the shortage
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  of specialty physicians in rural communities is well
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  documented. But what does it actually look like
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  on the ground? And how does the lack
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  of access ripple through a rural hospital and
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  the patients it serves?
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  Well, when hospitals and communities don't have the
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  physicians they need or they don't have the
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  the specialists they need, oftentimes, that that means
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  one of two things. Either either patients go
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  without
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  or in the case of the care settings
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  where we most often operate, which is inside
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  of hospitals, patients have to be transferred. When
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  you have those gaps, when you lack those
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  specialists,
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  those patients, they will go somewhere else, and
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  so the community loses those patients.
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  When the community loses those patients,
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  the hospital loses revenue.
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  We know when patients transfer and and they
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  leave the community, oftentimes their outcomes are worse
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  than if they could have received care locally.
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  So,
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  there's also downstream impacts to the hospital's,
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  ancillary services themselves, you know, services that aren't
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  utilized. So if you're not using your MRI
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  machine,
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  if you're not using your speech therapist, if
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  you're
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  not using your NICU, these are services begin
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  to close or begin to shutter. And so
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  sometimes you can see a a downward spiral
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  spiral or a negative spiral
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  in the services that are that are offered,
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  not only at the hospital, but in the
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  overall impact.
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  So it really sets up a a feedback
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  loop, and that feedback loop if you invest
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  in a community, if you add services as
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  positive, but that the opposite is true.
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  It can be a negative feedback loop as
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  you begin to lose specialty, you develop gaps
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  in care,
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  you have less services.
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  And, ultimately, that can lead to to hospital
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  closure, which is which is a a big
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  negative for for communities.
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  Absolutely. And a lot of rural hospitals have
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  dabbled in telemedicine,
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  but sustainability
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  is a different challenge entirely.
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  In light of the rural health transformation program
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  providing funds for the next five years, establishing
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  programs that can be sustained financially beyond the
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  funding window is critically important. How does Access
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  Telecare help rural hospitals build programs that will
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  last?
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  Well, I think it starts first with with
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  quality and assuring there's there's good solid clinical
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  reasons to to build a program that will
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  impact patients
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  that are served the hospital and and the
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  staff at the hospital as well as the
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  overall community.
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  And and once you, you know, assure yourself
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  that you can there's a clinical need that
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  you can deliver with a high level of
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  quality and, you know, a true commitment to
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  excellence,
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  then it's it's making sure that it is
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  sustainable. And so understanding if we if we
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  put this into place, what are those costs
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  gonna be to to start up a program,
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  and then what does this look like over
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  two, three, five years in the future?
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  And,
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  in our case, what we look at, you
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  know, working inside the the four walls of
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  the hospital
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  is, is making sure we're keeping care local.
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  We're making sure patients don't have to transfer
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  from,
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  from their home communities.
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  That means relying less on,
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  ambulances, relying less on helicopters, and and really
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  admitting those patients to the hospital. And so
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  as a result, that means that,
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  a hospital will be paying for a service
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  to be available.
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  But by paying for that service, they're able
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  to drive admissions, retain those patients in the
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  community,
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  and that that really is what what makes
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  it sustainable is, is using the kind of
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  existing health care infrastructure and reimbursement models,
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  to to power that innovation.
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  Got it. Got it. And unnecessary transfers are
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  costly for hospitals and disruptive for patients. What
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  kind of impact are you seeing when rural
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  hospitals get better access to specialty care, and
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  how does that change the dynamic for both
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  the clinical team and the community?
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  Well, out of the gate, what we see
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  and, you know, we've
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  launched 2,600
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  programs in the last decade,
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  is 40 to 60% of hospitals where we
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  launch programs that did not have a service
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  are able to retain patients. So forty forty
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  to sixty percent of the patients they would
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  have transferred are retained, I think, is maybe
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  a better way of saying it. And, and
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  that's that's really, I think, the the primary
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  outcome that we like to follow
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  is is assuring that if we are building
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  a program to tackle unnecessary transfers,
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  what does the data look like once we
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  go live? How are we retaining those patients?
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  And when you keep those patients, there's there's
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  downstream impacts, and I'll use neurology as a
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  as a great example.
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  When you're retaining neurology patients,
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  now,
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  you have the work to feed the speech
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  therapy
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  department. You have the the work to make
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  sure that you're you're feeding into the radiology
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  programs that you build. Now that you have
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  these complex neurologic patients,
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  the services around epilepsy or EEGs make sense
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  to provide. And then there's downstream impacts to
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  once they, you know, get better, they're discharged
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  from the hospital.
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  Now you have the patients to feed into
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  the outpatient clinic. Right? And that's how you
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  build a thriving, healthy
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  care model at the local ecosystem level.
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  For sure. And in your role as chief
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  strategy officer, you're now looking at the bigger
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  picture around partnerships and growth. How has that
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  shift changed the way that you think about
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  where acute specialty telemedicine can have the greatest
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  impact, and what opportunities are you most focused
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  on? Well, it's been a big shift for
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  me. I've spent fifteen years as the CEO
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  of the company, and
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  I stepped down about a year ago.
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  And, we're an organization of, 1,400 people. And
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  so go from that to now chief strategy
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  officer of department of one, I like to
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  say. It but what it has given me
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  is a lot of time to to really
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  reflect on what we do, the relationships we've
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  built, and the impacts that we could make.
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  And and what really has come out of
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  that has been diving really deep with our
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  system level partners
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  and thinking about
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  how virtual care and telemedicine can impact their
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  patients and their hospitals
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  at a more global level. And and what
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  I mean by that is thinking about not
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  just at a hospital level or a local
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  community level, but a region,
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  or an entire system. We could think about
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  program design around a specialty. So think about
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  neurology care across your entire system. You know,
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  how do we
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  partner to build an approach that assures that
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  every hospital has what they need, and and
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  how do we deploy that in a unique
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  and innovative way. So that, for me, has
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  been probably the most exciting part,
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  where I really have the time and space
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  to to to dive deep, spend a lot
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  of a lot of back and forth, a
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  lot of research with with our system partners,
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  and develop these, regional or sys system level,
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  approaches towards program design.
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  Thank you. That's very helpful context. And now
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  can you share a couple initiatives that you
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  believe will define the next chapter of this
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  work? And what has you most energized about
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  where this space is heading? Yeah. Absolutely. So
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  I I think kind of piggybacking on on
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  the comments I said about the the system
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  level, what's come out of that is this
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  concept when you're thinking about an entire geography,
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  you're thinking about covering six to eight states.
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  You know, you may be covering 30 hospitals.
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  It is standing back, and and I think
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  you can reimagine how would we deliver this
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  specialty across this geography and these these various
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  hospitals.
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  We're beginning to have conversations around a virtual
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  first approach,
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  which is let's reconstruct and think about what's
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  everything we need to do for this service
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  line, what can be done virtually, and then
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  how do we layer in the in person
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  component. So that has been I think being
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  in the space for fifteen plus years, that's
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  been a really exciting development to see that
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  that is resonating and that virtual care is
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  part of the strategy,
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  of all the hospitals we work with. And
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  and so that's been super exciting. And I
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  think that the next thing is,
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  a really important initiative
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  is the concept around that we we just
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  have to change the models of care that
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  we have in place. You know, we when
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  you look at the care, especially of the
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  hospitalized patient,
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  you can look at pictures from the early
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  nineteen hundreds and look at pictures that were
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  taken last week,
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  and it looks exactly the same except the
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  clothes we're wearing. And it's a doctor at
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  the bedside with a patient and a nurse.
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  And,
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  if we think that we're going to be
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  truly innovative without changing how we deliver care
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  and how the models of care are rolled
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  out,
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  I don't I don't think we're gonna be
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  scratching the surface, and we won't be transformational.
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  So that's what's got me really excited as
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  I think we're laying the groundwork
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  to really impact models of care change, which
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  I think will will have transformational impacts to
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  to health care.
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  That's amazing to hear. Well, doctor Gallagher, I
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  wanna thank you for your time today. But
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  before I let you go, is there anything
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  else that listeners should know? I I think
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  the role of of digital health
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  continues to evolve. And I think, with the
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  advent of AI and the role it's being
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  to play is that we need to have
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  an open mindset and an optimistic mindset to
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  to implementing
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  new technologies
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  in AI and and the work that we
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  do. And so we as as health care
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  providers and as health care professionals oftentimes are
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  incredibly resistant to change.
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  And I think this is something that we
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  we absolutely need to embrace wholeheartedly, doing it
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  in a safe way and a, I think,
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  a controlled way. But but, absolutely, I think
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  it's a a needed change. Absolutely. Well, that's
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  a great note to end on. Doctor Gallagher,
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  I wanna thank you once again for your
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  time and insights.
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  We also wanna thank our podcast sponsor, Access
• 9:35
  Telecare. You can tune in to more podcasts
• 9:37
  from Becker's Healthcare by visiting our podcast page
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  at beggershospitalreview.com.