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The TeleSpecialists Advantage

By: | Tags: | October 8th, 2020


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.

Nattasha Acevedo, MD

Dr. Acevedo received her medical degree from the Ponce School of Medicine in Puerto Rico and did her neurology residency at Montefiore Medical Center in New York. She went on to do a clinical neurophysiology fellowship at Emory School of Medicine in Atla nta, Georgia and then joined private practice in Fort Myers, Florida. She currently resides in San Juan, Puerto Rico. She likes running, paddle boarding and spending time with family.

Bernadette Borte, MD

Dr. Borte received her medical degree from St. Matthew’s University School of Medicine in Grand Cayman. She completed her neurology residency at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Her areas of interest include inpatient neurology and acute stroke. When not working, she enjoys spending time outdoors with her family. Dr. Borte joined the TeleSpecialist family in March of 2019.

Mazen Almidani, MD

Dr. Almidani is board certified in pediatrics by the American Board of Pediatrics and board certified in epilepsy, as well as neurology with special  qualification in child neurology by the American Board of Psychiatry and Neurology.  Dr. Almidani is happily married with 4 children. His oldest son has autism and his daughter has complicated seizures; both were a drive for him to become a neurologist. Dr. Almidani enjoys soccer, running and spending time with his family. He is very involved with his sons’ therapy and helping with daily challenges. He is double board certified in Pediatric and Adult Neurology and Epilepsy. He sees children and adults. He also participates in charities for children in Syria who may be underprivileged and/or affected by the war. Dr. Almidani joined TeleSpecialists in August 2020.

Amanda Cheshire, MD

Dr. Cheshire received her medical degree from the University of Louisville School of Medicine in Louisville, Kentucky. She completed her neurology residency at the University of Cincinnati Medical Center in Cincinnati, Ohio. She did a fellowship in neurophysiology at the University of Michigan Medical School in Ann Arbor, Michigan. Dr. Cheshire is double board certified in neurology and clinical neurophysiology. She enjoys traveling, reading and music. She currently resides in Viera, Florida.  Dr. Cheshire joined TeleSpecialists in June 2019.

Jessica Floyd, MD

Dr. Floyd completed her neurology residency at Mayo Clinic in Jacksonville, Florida followed by fellowship training in clinical neurophysiology with focus in EEG and epilepsy at the Medical University of South Carolina in Charleston, South Carolina. She has particular interest in hospital neurology and patient education as well as the blossoming specialty of lifestyle medicine. She strives to take advantage of every encounter with patients and medical staff to empower them to do their own research into how daily thoughts, choices, and habits can add up to create greater and longer-lasting brain and neurologic health for ourselves and our loved ones. She lives in Florence, South Carolina with her awesome husband of 13 plus years and three beautiful children. She is an avid yogi, astrologer, and lover of food and all things neurology! Dr. Floyd joined the TeleSpecialist family in July 2017.

Nancy Futrell, MD

Dr. Futrell received her medical degree from the University of Utah in Salt Lake City, Utah. She also did her neurology residency at the University of Utah as well as a research fellowship in cerebral vascular disease at Jackson Memorial Hospital in Miami, Florida. She currently resides in Salt Lake City, Utah. She has authored 2 books and 50 peer reviewed papers. 

Rebecca Jimenez-Sanders, MD

Dr. Jimenez Sanders received her undergraduate degree from Emory University, and her medical degree from the San Juan Bautista School of Medicine in Puerto Rico. She completed her neurology residency at the University of South Florida in Tampa, Florida, where she also did a specialized headache medicine and facial pain fellowship. She currently resides in Tampa, Florida with her husband and her two daughters. She is also fluent in Spanish and Italian languages, and enjoys photography, baking, boating, and biking.

Cory Lamar, MD

Dr. Lamar received his medical degree from Meharry Medical College in Nashville, Tennessee. He completed his internship and residency at Wake Forest Baptist Health in Winston Salem, North Carolina. Following residency, he completed a clinical fellowship in neurophysiology, with a concentration in epilepsy. He currently resides in Florida and enjoys outdoor activities.

Clifford Meyers, MD

Dr. Meyers received his medical degree from Brown University in Providence, Rhode Island and his MBA from the Simon School of Business at the University of Rochester in Rochester, New York. He completed his neurology residency at the University of Rochester, where he also did a neurophysiology fellowship. Dr. Meyers resides in Webster, New York with his wife and daughter. When not doing teleneurology, he enjoys playing sports with his wife and daughter.

Tao Tong, MD

Dr. Tong received her medical degree from the University of Miami School of Medicine in Miami, Florida. She completed her neurology residency at Jackson Memorial Hospital in Miami, Florida, where she also did a neuromuscular/EMG fellowship.  She currently resides in College Station, Texas. Dr. Tong is married with two boys. She enjoys spending time with her family, traveling and reading.

Shubhangi Chumble, MD

Dr. Chumble attended BJ Medical School. She is a board certified neurologist with a subspeciality interest in sleep medicine. Dr. Chumble did her residency at Howard University in Washington DC and has practiced neurology since 2001 in private and corporate settings. She lives in Melbourne, Florida and loves the sunshine state. Her hobbies include yoga, meditation, cooking , traveling and meeting new people. She also loves to do stained glass, pottery and painting. She joined TeleSpecialists in June 2019.