As Dr. Suresh Nellore, an infectious disease specialist, looked at the skilled nursing facility (SNF) landscape in this new age of COVID-19, he saw a pair of old problems with new, deeper challenges: rehospitalization risk and timeliness of reimbursements.
Specifically, Nellore saw a large, unmet need at SNFs and in long-term care facilities, where acuity level of patients was rising and physicians were struggling to keep up with care. The challenges were twofold.
First, if physicians have too many patients, the physical challenge of making the rounds and keeping up with patients is too great. Second, as that physical interaction declines and the number of SNF patients increases, the ability to know patients on a personal level declines as well.
“A lot of times, physicians may not remember all of these patients, and in order for you to make a clinical judgement, you have to know the patient well,” says Nellore, founder and CEO of telemedicine company iDocsWeb. “And if you don’t know the patient well, your first assessment is to send them to the emergency room.”
As a result, hospital readmission rates rise and reimbursements drop. In March, with COVID-19 quickly becoming the main focus everywhere in health care, Centers for Medicare and Medicaid Services (CMS) issued new guidance around telehealth reimbursement in skilled nursing, allowing Medicare to pay for virtual consultations provided through telehealth platforms nationwide, including those conducted in a patient’s residence, including SNFs.
This makes a service such as iDocsWeb invaluable. Nellore’s work has brought him insight into the three biggest advantages that telehealth has for SNFs — advantages iDocsWeb has spent two years delivering.
Significant cost savings
Certainly the top advantage of telehealth for SNFs is cost savings. SNFs using the iDocsWeb platform have been able to keep patients in their facilities rather than transferring them to the emergency room and incurring government penalties.
As a result of their platform and methodology, iDocsWeb over the past two years has driven an average savings of $45,000 per quarter per facility.
“That comes to about $190,000 in savings per facility,” Nellore says. “(These facilities) were beyond thrilled. We have data for two years now. Anyone who wants to see the data, they are able to see it.”
What they will see, Nellore says, is what he sees: improvements to quality of care and, as a result, improved patient outcomes.
Making the rounds — electronically
The challenge of making the rounds to see all of these patients is not merely daunting — it is physically impossible. The iDocsWeb platform facilitates that e-rounding via phone, tablet or computer. Nurses will call the doctors through the platform for a video conference, letting the doctor see the patient and assess vitals.
“They can make a complete assessment and then make a judgment on whether the patient needs to be sent to the ER or kept in place and treated,” Nellore says.
The platform also creates after-hours options, ensuring that patients are receiving the care they need overnight.
“We also gave them an option to do after-hours coverage,” he says. “We will take the phone calls on behalf of the physicians, and physicians are happy to offload this work for us.”
A comprehensive platform
None of these benefits would be possible with the comprehensive platform that iDocsWeb has produced. Doctors need to be able to have all of the same capabilities via telehealth as they would have in person.
“Our platform is the reason they are able to take care of the patients,” Nellore says. “We built a robust platform where they are able to see the patient, they can listen to them, they can look at the vitals, they can look at the lab. They can even include the family member in the discussion, or talk to a consultant.”
In short, it is a comprehensive platform that facilitates clinical judgments, Nellore says, rather than forcing physicians to “fly blindly.”
“We have thought about every single need, and we address that,” he says. “No other telemedicine company comes even close to what we do.”
iDocsWeb is now offering SNFs one free month of use of its telehealth platform. To find out how to take advantage of the offer, visit idocsweb.com.