With FCC Funding, ChristianaCare Pushes Telehealth, RPM to Patient Homes

A Delaware health system is using federal funding to expand telehealth and remote patient monitoring programs during the Coronavirus pandemic.

ChristianaCare was one of the first healthcare providers to receive money from the Federal Communications Commission’s COVID-19 Telehealth Program. The two-hospital health system is using the $714,322 grant to purchase mHealth devices and data plans, expand telehealth services in underserved parts of the state and ensure the broadband infrastructure for a home-based connected health program.

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“Before COVID-19, ChristianaCare was charting a course to transform care based on the vision that all care that can be done in the home, in the community or on a smartphone will be done in the home, in the community or on a smartphone,” ChristianaCare President and CEO Janice E. Nevin, MD, MPH, said in a press release. “This transformation has accelerated exponentially during the pandemic, because at this time, the safest place for our patients is in their home. The technology supported by this grant will ensure that patients receive the right care, at the right time and in the right place, dramatically lowering the risk of spreading COVID-19.”

Sharon Anderson, RN, BSN, MS, FACHE, the health system’s chief virtual health officer, says roughly one-fifth of the state’s 973,000 residents lack reliable internet access - and that number jumps up to 50 percent in the rural southwestern part of the state.

“Given the disproportionate number of potentially positive high-risk community members who reside in communities with poor broadband access, improving our ability to provide virtual care to all ambulatory COVID-19 cases is of critical importance,” she says.

With the FCC money, the health system is planning to expand its CareVio RPM program, which has been used to provide home-based care management for patients with chronic conditions. Officials want to use that platform to provide care for not only COVID-19 patients, but others with health concerns who can’t safely visit a hospital or clinic.

Through the program, qualified patients stay in touch through a messaging platform with a registered nurse, who can check in with them several times a day. If the patient’s condition worsens, the care plan is scaled up.

Since the onset of the pandemic, officials have used the platform to follow up with more than 4,400 people tested for the virus, answering questions and ensuring that they have a primary care provider. The platform currently monitors some 1,500 people, two-thirds of which have had telehealth visits.

Anderson says the health system has a detailed plan in place to measure the effectiveness of the RPM platform during the pandemic – an important strategy as providers and telehealth advocates look to maintain momentum once the emergency is over and emergency rules regarding telehealth coverage are rolled back. Among the benchmarks being measured:

For COVID-19 confirmed or suspected patients:

• Number of patients who completed a provider telehealth visit;
• Number of patients monitored by CareVio;
• Number of patients by severity of illness at the triage level;
• Number of patients with exacerbation of symptoms requiring an additional provider telehealth visit;
• Number of patients who have participated in a Community-Based COVID-19 Assessment Site;
• Number of devices deployed; 
• Number of in-home virtual visits; and
• Number of “failed” audio-video visits – technical or user perspective.

Patient and provider experience:

• Number of providers satisfied with the telemedicine experience; and
• Number of patients satisfied with the telemedicine visit experience and CareVio monitoring.

Program effectiveness:

• Number of patients who complied with CareVio monitoring program;
• Number of patients who were lost for follow-up;
• Number of ED visits for patients in the telehealth program; and
• Number of inpatient hospitalizations for patients in the telehealth program.

Anderson says the health system’s goal is to continue scaling up the platform after the pandemic to reach more populations, including those living with congestive heart failure, chronic obstructive pulmonary disease, renal disease and diabetes. The program might also incorporate mHealth wearables at some point.

“Healthcare will be changed forever,” she says. “It is very exciting to see how much providers who have just become facile in doing telemedicine visits find the experience very rewarding. Patients have been very pleased as well with the increased access to their provider and the ease of use of the technology.”

“Now that the patient population is connected, the sky is the limit in what we can do in expanding home biometric devices, remote monitoring, synchronous and asynchronous communications.”

The COVID-19 Telehealth Fund was created out of the CARES Act, passed by Congress and signed into law at the end of March. As of April 28, $9.5 million has been awarded from the $200 million fund to help 17 providers in 10 states.