Local nursing home launches innovative telemedicine program

This article was published in the Erwin Record.

The Center on Aging and Health is bringing cutting-edge telemedicine technology to its rural Unicoi County facility to give residents and patients there bedside access to primary and specialty care services that until now were mostly available in urban aand larger metropolitan areas.

Telemedicine isn’t new, but the model the Center on Aging and Health is using is.

Most telemedicine programs offer only silos of care --- for wound care or psychiatry, for example. Or, they offer only “urgent care” or after-hours coverage models, focusing on one-off encounters rather than a continuous true primary care relationship. The Center’s program assigns a dedicated practitioner to the facility where clinicians are available on weekdays and on demand to work virtually with on-site nursing teams as part of regular and scheduled rounds.

“Telemedicine enables our patients and residents to receive care right where they live --- and right from the bedside. This service simplifies the delivery of health care while also helping us to improve health outcomes,” Administrator Alex Gaddy, LNHA, said. “This really is the next best thing to an old-fashioned ‘house call.’”

The Center’s program, TapestryCare™ by Tapestry Telehealth, provides a dedicated nurse practitioner supported by a full-scope multi-specialty medical and behavioral health group. Having a dedicated practitioner is important because it means he or she gets to know the residents and patients as much as the staff, and that knowledge and consistency of care help to improve medical outcomes.

Having daily virtual access to an on-site medical team in rural nursing homes also helps to avoid unnecessary hospitalizations when medical conditions change, and it reduces the need for long, costly and uncomfortable trips outside the facilities for basic evaluations or specialty consults and eliminates delays in waiting for an open appointment.

Specialties include wound care, cardiology, dermatology, endocrinology, gastroenterology, infectious disease, neurology, pain control, palliative care, pulmonology, renal-nephrology and physiatry. Patients have access to daily behavioral services, including both scheduled and 24/7 emergency mental health care and family communication and support.

TapestryCare™ also is shown to help facilities improve and maintain Centers for Medicare and Medicaid Services (CMS) quality and rating measures, especially as regulations governing long-term care change. The Center on Aging and Health already has a four-star CMS rating, the second-highest available.

“Everyone deserves access to quality health care, no matter where they live,” Tapestry’s Chief Medical Officer Dr. David Chess said. “But making sure medical care is available on site every day in rural nursing homes is a challenge. Programs like this close the gap to improve lives and enhance care. Telemedicine services also reduce costs on our health-care system by helping to prevent avoidable and unnecessary hospitalizations.”

How Rural Telemedicine Works

The Center’s facility will have easy-to-use, portable telemedicine carts that put medical professionals at the bedside as part of daily rounds or in moments when conditions change or concerns emerge. The stations are designed for quick visits and simple setup to save nurses time and make seeing patients easy.

A large monitor allows residents and medical professionals to see and speak directly with each other in real time. Working closely with facility nursing staff, clinicians examine patients using a digitally enhanced stethoscope to listen to the heart, lungs and chest; an otoscope to examine the throat and ears; and a high-definition camera to examine even the smallest wound or skin irritation.

The facility nurse and telehealth clinician also work cooperatively to conduct thorough abdominal, musculoskeletal and neurological examinations. The telehealth clinicians can order tests, start treatments and monitor conditions. And because they are dedicated to the facilities, they stay involved every step of the way to ensure patients get healthy and families stay informed.