Author: Jerika Lam
Background The healthcare landscape in the United States has evolved to improve existing health practices, provide new service models and expand patients’ access to care. The 2010 passage of the Affordable Care Act (ACA) impacted everyone from third party payers, providers, patients, and technology. Over the past 15 years, telehealth or virtual care delivery has gradually received increased attention as it helps to improve access to care for patients. Telehealth services span across multiple disciplines of primary and specialty care, such as teledermatology. It includes modalities of synchronous and asynchronous visits, and remote patient monitoring. Telehealth technology has also improved at a rapid pace where accessibility, acquisition, and maintenance costs are lowered and the quality improved, internet speeds increased, and high definition resolution for image transmission and video connections are more affordable. Furthermore, telehealth technologies are becoming integrated into the provider workflow process. As part of the ACA health reform, telehealth can serve as a model that improves the health of patients via a patient-centered approach, enhances the patient care experience through ease of access, reliability and quality, and reduces the cost of care. By establishing a telehealth program at the Hoag Health Center in Newport Beach, California, to deliver direct healthcare to its patients and residents of Orange County, it will offer many benefits including increased access to care, treating patients in their local communities, the potential to expand specialty services, and savings in time and travel-related costs. As part of its emphasis on patient-centered care delivery, a pilot project will be implemented as part of Hoag’s high quality clinical services. The TeleRx pilot will focus on providing interactive, audiovisual medication therapy management (MTM) by a pharmacist faculty-in-residence (from Chapman University School of Pharmacy). The project will provide a number of benefits to Hoag and its patients including, and not limited to: education about medications, assurance of medication adherence, reduction in polypharmacy and medication errors, and screening for drug-drug interactions. The pharmacist faculty-in-residence will offer MTM services via real-time face-to-face communication with the patient through audio and video computer links. Through the web-based e-health service and technology she can provide direct patient care, education and outreach over the internet. Objectives 1. To evaluate the impact of TeleRx on improving the outcomes of patients referred to the pilot. 2. To compare patient perceptions of the technology as a platform for MTM service versus in-person consultations. Methods The TeleRx pilot will be integrated into the Hoag primary care system. Cisco JABBER software will be used for the pilot. The 2 pilot sites will include Hoag Irvine and Huntington Beach clinics. Patients referred to the pilot will be those identified as part of the Hoag Primary Care Initiatives. Significance Findings from the Hoag TeleRx pilot will be applied to expand other clinical services such as chronic disease management, psychiatry and transitions of care. More importantly, the TeleRx pilot will serve as a significant strategy to achieve the ACA’s Triple Aim of improving health, reducing costs, and enhancing positive patient outcomes.
Co Author/Co-Investigator Names/Professional Title: Laura Salazar, MD, AAHIVS
Funding Acknowledgement (If Applicable): Hoag Foundation Primary Care Initiatives Grant