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      Rapid Systemwide Implementation of Outpatient Telehealth in Response to the COVID-19 Pandemic

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          The COVID-19 pandemic, with its resultant social distancing, has disrupted the delivery of healthcare for both patients and providers. Fortunately, changes to legislation and regulation in response to the pandemic allowed Emory Healthcare to rapidly implement telehealth care. Beginning in early March 2020 and continuing through the initial 2-month implementation period (when data collection stopped), clinicians received telehealth training and certification. Standard workflows created by means of a hub-and-spoke operational model enabled rapid sharing and deployment of best practices throughout the system’s physician group practice. Lean process huddles facilitated successful implementation. In total, 2,374 healthcare professionals, including 986 attending physicians, 416 residents and fellows, and 555 advanced practice providers, were trained and certified for telehealth; 53,751 new- and established-patient audio–video telehealth visits and 10,539 established-patient telephone visits were performed in 8 weeks for a total of 64,290 virtual visits. This initiative included a new COVID-19 virtual patient clinic that saw 705 patients in a 6-week period. A total of $14,662,967 was charged during this time; collection rates were similar to in-person visits. Initial patient satisfaction scores were equivalent to in-person visits. We conclude that rapid deployment of virtual visits can be accomplished through a structured, organized approach including training, certification, and Lean principles. A hub-and-spoke model enables bidirectional feedback and timely improvements, thus facilitating swifter implementation and a quick rise in patient volume. Financial sustainability is achievable, but to sustain that, telehealth requires the support of continued deregulation by legislative and regulatory bodies.

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          Most cited references 11

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          Virtually Perfect? Telemedicine for Covid-19

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            Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak

            Public health measures were decisive in controlling the SARS epidemic in 2003. Isolation is the separation of ill persons from non-infected persons. Quarantine is movement restriction, often with fever surveillance, of contacts when it is not evident whether they have been infected but are not yet symptomatic or have not been infected. Community containment includes measures that range from increasing social distancing to community-wide quarantine. Whether these measures will be sufficient to control 2019-nCoV depends on addressing some unanswered questions.
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              Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic


                Author and article information

                J Healthc Manag
                J Healthc Manag
                Journal of Healthcare Management
                Lippincott Williams & Wilkins (Hagerstown, MD )
                Nov-Dec 2020
                12 November 2020
                : 65
                : 6
                : 443-452
                Emory Healthcare (EHC) Office of Quality and Risk, EHC Telehealth Team, and Emory University School of Medicine Department of Neurology, Atlanta, Georgia
                EHC Telehealth Team
                EHC Telehealth Team
                EHC Telehealth Team
                EHC Telehealth Team and Physician Group Practice, Atlanta, Georgia
                EHC Physician Group Practice
                EHC Telehealth Team and Emory University School of Medicine Department of Radiology and Imaging Sciences
                Author notes
                For more information regarding the concepts in this article, contact Dr. Esper at gesper@ 123456emory.edu .
                © 2020 Foundation of the American College of Healthcare Executives

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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