Senior living providers face myriad problems and challenges, particularly in light of the Covid-19 pandemic. But these problems are not insurmountable, and companies across the industry are devising creative solutions.
In this series, we’re surveying industry leaders to highlight these actionable solutions. For this edition, we asked leaders with Belmont Village, Maplewood Senior Living and Trilogy Health Services:
How are you elevating telehealth in your communities?
Patricia Will, CEO, Belmont Village
Houston-based Belmont Village operates a portfolio of about 30 senior living communities.
This is actually a space that’s interested us for quite a while, but we could never find the right platform. And then when COVID-19 happened, and we realized that we were not going to be able to triage [certain] emergencies at the ER … we actually had the experience of having people that had to go to the ER, get sent back. This was very early on. We said, we’d have to get this capability on the inside.
We have an advantage in that we have real nurses in our buildings all the time … We found a platform with board certified emergency physicians with a specialty in geriatrics. And I decided to do a pilot with them, determined that it was incredibly effective, and we have since rolled it out in about half of our communities. We intend to expand to the whole company.
I was a user myself. It’s between Christmas and New Year’s, my dad falls. We don’t know what’s the matter with him. He obviously doesn’t want to go to the hospital, we didn’t want him to go to the hospital. And even without the sophisticated technology that we have today, because we didn’t have one in the community where he lives yet, these marvelous carts with really high-res [technology], but they can also do EKGs and all manner of stuff. But we used telehealth with laptop technology, and they were able to order mobile tests for him almost instantaneously, they immediately followed through with his real physicians, they already had his medical history that we had, because he had signed up for this. And he never went to the hospital … So again, I saw the power of this. The other thing is that my sister, who wasn’t even there, we could video her in, and so we have the whole family there.
And then, we have had this experience with other residents, when they had they had to go to the ER for real, you had these board certified emergency positions calling over there to say, okay, you’re about to get Mr. Smith. We’ve done all this [evaluation], here’s the results of it. Now, go do a CAT scan. Rather than having him sit there, waiting patiently to get his temperature taken. So, I’m real excited about that, because now we’re harnessing the power of that for a lot more than emergencies. For neuro-psych visits, for wound care, for just a lot of things that seniors have to go out for that they don’t really have to go out. And I think that makes for a lot better situation for the seniors themselves, and a lot better situation for their families.
Brian Geyser, Chief Clinical Officer, Inspīr; Vice President of Clinical Innovation and Population Health, Maplewood Senior Living
Westport, Connecticut-based Maplewood Senior Living operates a portfolio of 16 senior living communities, including the newly opened Inspīr highrise in Manhattan.
While we adopted a telehealth program early on, the pandemic forced us to quickly ramp up our offerings and make them more sophisticated to not only keep up with the new demand for telehealth services but to also prepare our communities for a more digital world long-term. We’ve made a significant investment in our telehealth over the past year and continue to improve upon our offerings as it’s proven to be an efficient and effective way of delivering quality care and something we don’t foresee going away anytime soon.
Throughout the pandemic, Maplewood has been using tablets and Temi robots to facilitate virtual visits with a variety of provider types. In most cases, our nurses coordinate these appointments and are present for them to ensure a smooth experience for both the resident and provider. The nurses also communicate information to the provider during the visit as well as provide follow-up care management that may be needed afterward. Family members can also join the virtual visits, which can help the provider gather additional valuable information and reduces the number of calls the provider or our nurses have to make before and after the visit.
At Inspīr, we’re taking telehealth a step further. Through our relationship with Mount Sinai Geriatrics, our nurses can deploy paramedics to the building for certain urgent medical situations that don’t necessarily require an emergency department visit. Once with the resident, the paramedics virtually connect with a board-certified emergency department physician and a medical assessment is conducted. With the paramedics on scene and the physician patched in via video conference, they can perform advanced diagnostics and treatments such as vitals, ECG, pulse oximetry, blood glucose levels, IV fluids, IV Lasix, steroids and pain management. The goal is to treat the resident in place and avoid an unnecessary ED visit or hospitalization. In this case, facilitated telehealth, coupled with community paramedicine, can provide highly coordinated, resident-centered urgent care.
At our newest community, Maplewood at Princeton, we’re partnering with PennMedicine Princeton Health to develop a telehealth/virtual visit platform, which will include peripherals that our nurses will use during facilitated virtual visits to send vitals and other medical data to the provider on the other end of the screen.
Being open to adopting new tools and embracing innovation through technology at an organizational level have been catalysts for our improved telehealth offerings. Our commitment to providing the highest-quality care experience for each of our residents and their individualized needs is what pushes us to continue enhancing our telehealth capabilities, no matter how current they may be.
Barbara Revelette, Chief Nursing Officer, Trilogy Health Services
Louisville, Kentucky-based Trilogy operates a portfolio of 120 communities spanning the continuum of senior housing and care.
Before the pandemic, telehealth was rarely used outside of rural areas. However, during the last week of March 2020, telehealth visits increased by 154% compared with the same period in 2019. At Trilogy, we experienced this increase firsthand, and we welcomed it. Telehealth has been a vital component of our response to COVID-19, and has remained an often-utilized tool in our clinical arsenal. To date, we have conducted over 16,000 telehealth visits.
As every provider knows, when a resident begins to display symptoms of COVID-19, time is of the essence. Telehealth allowed us to assess residents with these symptoms, and provide rapid treatment when needed. Telehealth also allows us to connect residents with a team of geriatric
physicians 24/7 – this team empowers our staff to try interventions when there is a change in condition, and to treat in place, as necessary.
One of our primary goals as a company is to continue to reduce our recidivism rates. Telehealth allows our residents to remain in their homes, which can improve their health outcomes, avoid unnecessary transfers, and reduce the likelihood of readmission to the hospital. Virtual access to practitioners allows us to coordinate resident care, adjust medications as needed, and examine a resident when a change in condition occurs through remote video monitoring.
Our success in utilizing telehealth is due in large part to our ability to provide exceptional care right in our residents’ homes. We have heavily invested in technologies such as wound cameras and point of care blood and urine testing. These tools provide immediate results for diagnostic
testing, which in turn enables our team to make rapid decisions, streamline our workflow, and improve our quality of care. Each of our 120 communities also has a minimum of one National Wound Care Certified Nurse, as well as support team members who are WCC certified.
The cost for each digital wound camera is approximately $500, and they are operated by our National Wound Care Certified Nurses. We only utilize our wound cameras in our skilled nursing areas of our campus. Of course, the photos we take with our wound cameras do not substitute wound measurements or our wound management system inside our EHR, MatrixCare.
Our wound cameras allow us to have a documented visual to accompany the wound assessment. This allows our interdisciplinary team to monitor wound progress over time. Since we implemented wound cameras in 2019, statistics surrounding acquired and worsened wounds have improved quarter over quarter.
We have found that clinical excellence can only be achieved when you combine the best tools in the business with the best people in the business. This is why 73% of our campuses have 4 and 5 Star ratings from CMS, and 94% of our campuses are 3 Star or above.
Companies featured in this article:
Belmont Village, Maplewood Senior Living, Trilogy Health Services
