Over the past year, the Academy of Medicine of Cleveland & Northern Ohio (AMCNO) collaborated with the Physicians Foundation (PF) and the American Medical Association (AMA), to support physicians interested in establishing or sustaining telehealth services and measuring the impact in their practices. The AMCNO worked with seven practice sites to develop case studies to share best practices. A summary of that work is below.
| Cleveland Clinic Neonatal Intensive Care Unit, Dr. Ani Das |
| Cleveland Clinic Children’s Hospital has also been using virtual visits for infants discharged from the NICU. They found highest utilization of virtual visits came from parents of infants with more complex health needs and those who lived further from the hospital. Overall reported patient satisfaction with the visits was high as well, and this has led to their expansion of telehealth care to include prenatal consults for mothers with pregnancy complications and follow up lactation programs for breastfeeding mothers. |
| Cleveland Clinic Respiratory Institute, Dr. Elliot Dasenbrook and Mike Hoffman |
| Remote monitoring at the Cleveland Clinic Lung Transplant Program has led to better clinical outcomes for lung transplant patients by enabling them to take home spirometer measurements. These values then transmit directly to their electronic health record, and it alerts their provider if these values are outside of the expected range. Without this remote data collection, spirometry would be performed much less frequently only at in-person visits while home spirometry allows for much quicker detection of possible infection or rejection and, thus, faster intervention. |
| Cleveland Clinic Center for Pain Recovery, Dr. Sara Davin |
| The AMCNO helped the Cleveland Clinic Center for Pain Recovery continue their telehealth visits for patients with chronic pain through two projects. First was a single session behavioral pain management class delivered by a live therapist for patients with chronic pain and patients preparing for spinal surgery. They found a significant improvement in the pain interference scores of patients who participated. The next project was a virtual intensive outpatient program (IOP) for the most complex and refractory chronic pain patients. This program was shown to be effective and have a significant impact in lowering the participants’ pain scores at their follow-up visit compared to those who did not participate in the IPO. |
| MetroHealth Department of Emergency Medicine, Drs. Thomas Collins and Craig Bates |
| MetroHealth Emergency Medicine worked on evaluating their virtual pre-hospital and EMS program model which gives EMS providers greater flexibility to address the emergency health care needs of patients following a 911 call. They found video conferencing as a safe and effective way for emergency department physicians to triage patients, especially when the individual is refusing EMS transport. In spearheading these virtual emergency medicine programs, Metro Health EM has also built meaningful relationships between EMS providers and ED physicians who are both critical pieces of emergency medical care. |
| MetroHealth Departments of Obstetrics & Gynecology and Maternal & Fetal Medicine, Drs. Kelly Gibson and Barb Rhoads |
| MetroHealth OB-GYN & Maternal Fetal Medicine Departments implemented a virtual maternity care program which providers digital patient education and remote patient monitoring (RPM) for pregnant patients and their babies. They use a mobile app called Babyscripts that provides patients with daily education, health reminders, and checklists along with optional remote blood pressure (BP) monitoring with a Bluetooth-enabled BP cuff. The app immediately sends an alert following an out-of-range BP reading to their prenatal care medical staff. Survey and anecdotal evidence suggest a positive patient response to this program and stronger relationships between patients and clinical staff. |
| OhioHealth Division of Vascular Neurology, Dr. Nikita Dedhia |
| OhioHealth Vascular Neurology Provider Group’s use of telehealth allowed their stroke team to diagnose patients at the community hospital and treat them immediately without requiring transfer to another facility, which was especially critical during the peak of the COVID-19 pandemic when these hospitals were at maximum capacity. Patients had positive outcomes with improvements in the Stroke Scale during their follow-ups. |
| Cleveland Clinic Glickman Urological and Kidney Institute, Dr. Georges Haber |
| The first case study focused on virtual visits for men’s urological care from Cleveland Clinic Glickman Urological and Kidney Institute. From their survey of 1,000 American males aged 18 years and older, they found telehealth visits to be particularly beneficial from an equity standpoint with a high percentage of Hispanic men reporting that they feel more comfortable discussing sexual health issues online instead of in person. This study also led the Institute to more and better diagnoses in reproductive health and erectile dysfunction as well as increased cancer screenings. |
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