Before joining TeleSpecialists, I was the Neuroscience Service Line Director for HCA Portsmouth Regional Hospital. Managing the hospital stroke program and the provision of inpatient neurology services, I utilized an employed neurology group on-site with three providers to meet the demands of the hospital during emergency times. Our goal was to become a Comprehensive Stroke Center, but it quickly became clear that we had to look for a more robust neurology service provider to help improve the quality of our stroke program to achieve this certification. It was during this time I initiated a partnership with TeleSpecialists for our neurological services.
Anyone who has partnered with TeleSpecialists is aware of the TeleSpecialists Advantage. This advantage has long been associated with their industry-leading Stroke Alert response times, the quality-focused service, and patient-centric care provided by an elite team of neurologists, second to none. What is not often discussed are the operational and financial advantages in partnering with TeleSpecialists for emergent neurology and general neurology services.
First, let us look at the hyper-acute care of a Stroke Alert. Accreditation standards are aligned with the timely care of patients and the milestones that must be met throughout the continuum of the Stroke Alert process. Many state-level accreditation standards have recognized the need for neurology involvement during this critical time and require bedside presence of a neurologist as a standard. In traditional specialty care service arrangements, the hospital will employ or contract the services of a neurology group to provide the necessary coverage. This requires the neurology group to staff for coverage 24/7/365 to respond to the hospital’s routine and emergent needs, often needing to drop everything to respond to a Stroke Alert patient. One could imagine how disruptive this may be for a neurology practice with patients waiting in the waiting room while their appointment is significantly delayed, or worse, canceled as their neurologist responds to the hospital for a Stroke Alert.
It was this very scenario that motivated me to find a better solution for the care of our emergent neurology patients. The constant interruptions created a highly inefficient workflow for the providers and resulted in declining patient visits and ultimately declining RVUs for the providers. By taking the burden of Stroke Alerts off the neurology group, it allowed them to focus on the outpatient clinic without interruption and run an efficient practice with a consistent provider presence, resulting in improved patient satisfaction.
The second operational motivator was the quality of the inpatient consults. As hospital services grow and a stroke program evolves towards comprehensive stroke level of care, there is a parallel need for outpatient services in the community for follow-up and continuing care. This poses a challenge to hospitals when their inpatient volume is not consistent enough to warrant a full-time neurohospitalist, so they look to the physician neurology group to cover the often-variable inpatient consult volume, emergent neurology coverage, as well as their normal outpatient practice. This often translates into extended hours at the hospital or erratic scheduling. Not only is this disruptive to the patients, but also poses a trickle-down effect in the hospital when it comes to bed management and patient discharge disposition, which can lead to increased emergency bed holds, delayed admissions and discharges, and declining patient satisfaction scores. Efficiency is key, and having consistent coverage for inpatient consults versus costly and inefficient provider contracts contributes greatly to the operational efficiency of your programs. Plus – when you are trying to recruit physicians, how successful are you going to be bringing new providers into an outpatient practice with a workload like this? I wasn’t, either!
By utilizing TeleSpecialists as the primary providers of all neurology services on the hospital side for both Emergent Neurology, Stroke and Inpatient Neurology consults, as well as interpretation of EEGs, patients saw the right physician at the right time. When we shifted the burden of Stroke Alerts to TeleSpecialists and utilized their TeleNeurohospitalist rounding services, it also allowed for consistent outpatient clinic coverage and eventual growth of the outpatient practice. This growth led to the recruitment of additional providers and expansion of the practice to a satellite office in a neighboring community. While there was initial apprehension on the part of the neurology practice in the loss of inpatient RVUs, the practice quickly realized the value of the growth potential for their outpatient services and the strong collaboration they could build in the continuum of care for patients when they left the hospitals.
For the hospital, the financial advantages are realized in many areas. There are significant advantages to having dedicated coverage for inpatient neurology. Without them, your hospital can see issues with patient retention, loss of diagnostic services, bed management issues, and timely disposition of patients associated with gaps in neurology coverage. But for many facilities, a full-time in-person neurohospitalist is not financially feasible.
TeleSpecialists offers a high quality, collaborative, and cost-effective solution to ensure the continuum of care and collaboration with existing providers and deliver a seamless transition to the outpatient clinic. Plus, no time or money is used recruiting neurologists or locum coverage; TeleSpecialists is accessible 24/7/365.
Growth of services is a necessary, but often difficult part, of a hospital’s strategic plan. As CMS continues to recognize the value of telemedicine and the role it plays caring for patients in the hospital, reimbursement for services continues to improve and in turn, reduce the operational costs associated with these services. TeleSpecialists’ pricing is a per-consult pricing model, with no minimums, but can easily be scaled as your hospital’s neurology program grows. The structure of TeleSpecialists’ TeleNeurology services gives organizations a scalable model for growth, versus significant upfront investment with a prolonged ROI.
For me, the addition of TeleSpecialists to my hospital was an easy and phenomenal choice. The integration of their services accomplished all our goals. We were able to improve our metrics, increase our volumes, be more financially efficient, and become a Comprehensive Stroke Center.
For more information on TeleSpecialists’ comprehensive TeleNeurology coverage, or for your complimentary financial assessment for neurology services, please contact us here.