On Thursday, April 23rd, C. William Hanson, MD, Chief Medical Information Officer and Mary Elizabeth Deleener, MBA, BSN, RN, Director of Network Telemedicine at Penn Medicine presented Best Practices for Telemedicine: The Provider and Patient Experience, second in Penn Medicine's COVID-19 Webinar Series.
Defining Telemedicine
Telemedicine has existed, in one form or another, in the United States since the late 1940s. Among the first references to telemedicine in medical literature is a transmission record of radiological images from Chester County Hospital to an office in Philadelphia in 1948.
After years of development at Penn Medicine, telemedicine services had begun to reach the tipping point as a viable alternative to in-person physician visits. With the arrival of the COVID-19 pandemic in the U.S. earlier this year, telehealth systems have been suddenly catapulted into the national spotlight.
What's the Difference Between Telehealth and Telemedicine?
Though often interchanged, the terms 'telehealth' and 'telemedicine' are not synonymous.
HealthIT.gov outlines telehealth as 'the broad scope of remote healthcare services'. Telehealth encompasses telemedicine services, and can also refer to other remote services for providers, such as training and administrative meetings, online tools, and continuing medical education (CME) courses. Telemedicine is a subset of telehealth. This term refers solely to the use of telecommunications technology and information technology to provide remote clinical care.
Best Practices for Telemedicine
The "Best Practices for Telemedicine: The Provider and Patient Experience" webinar was live-streamed on Thursday, April 23, and hosted by C. William Hanson, MD, Chief Medical Information Officer at Penn Medicine, and Mary Elizabeth Deleener, MBA, BSN, RN. Together in their presentations, they offered guidance, practical counsel, and reviewed the current application of telemedicine in the novel coronavirus outbreak.
An intensivist, Dr. Hanson reflected on the history of telemedicine at Penn Medicine, beginning with the health system's Tele-ICU service — Penn E-lert® eICU — for which he was the original medical director. In the following years, telemedicine expanded to include Telestroke and other services, including Telegnetics.
"This is something that most hospitals can't support," he explained. "Penn's genetic counselors work with oncologists and and other physicians to advise on the implications of genetic issues." Dr. Hanson also noted other telemedicine services, including the international teledermatology and Nighthawk teleradiology units.
"There's been a slow evolution of these programs, and in the latter four to five years, with the arrival of Liz Deleener and with the evolution of the Penn Center for Connected Care, we've begun to think about how to introduce telemedicine into our more general practices," Dr. Hanson continued. The Penn Center for Connected Care is the present home of the Penn E-lert® eICU program and Penn Medicine on Demand.
"And then suddenly in mid-March," he continued, "We had a crisis with the COVID pandemic."
Telemedicine in the COVID-19 Outbreak
Director of Network Telemedicine at Penn, Deleener has overseen the response to the novel coronavirus outbreak at Penn Medicine, and reported that the crisis brought telemedicine from an average 20-50 visits per day to more than 6,000 daily.
As of April 22, Penn Medicine had offered telemedicine training to more than 10,000 health care providers across its locations in Pennsylvania and New Jersey.
The success of Penn Medicine's telemedicine programs — there are nearly 3 dozen in place — in reaching these levels was achieved by a rapid response to the outbreak circumstances as they evolved, Deleener added. Expanding on this point, she and Dr. Hanson reviewed the existing guidelines for proactive patient preparation and guidance, provider documentation and billing, and fielded questions from online viewers.
The Q&A portion of the presentation included discussions on the return to new patient visits, audiovisual paradigms, workflow, patient satisfaction and security, intra-provider reimbursement, language interpreter availability, video parameters, operational workflow, and managing the acute crisis patient, among other areas.
Other Ways Penn Medicine is Using Technology During the COVID-19 Outbreak
Telemedicine at Penn Medicine
Penn Medicine specialists are available to see new patients and are accepting referrals. If patients do not require an in-person visit, we will schedule a virtual visit. Upon scheduling, patients will be informed how to submit imaging and medical records to the clinical team.
Penn Medicine specialists are also available for virtual peer-to-peer consultations. Call our 24/7 provider-only line at 877-937-PENN (7366) to be connected with the appropriate provider.
Additional Telemedicine Resources from Penn Medicine