KU Medical Center helps expand use of telehealth during pandemic and beyond
Technology has served as crucial weapon in the global fight against the coronavirus. It's helped bring people together in a time when it's safer to remain apart. More specifically, telehealth has emerged as a digital bridge, allowing enterprises such as education, research and patient care to advance, even under the paralyzing grip of COVID-19.
While some institutions and organizations are just now fully embracing telehealth, the University of Kansas Medical Center is nearly 30 years into the journey, and the institution is helping its partner, The University of Kansas Health System, and others across Kansas, harness the innovation's power and possibilities.
Prepared to respond
For years, the university has been the sole operator of telehealth programming on campus, including all clinical, research and educational efforts. All that experience perfectly positioned the institution to provide its assistance in early April when the COVID-19 health crisis exploded.
"We've tried to serve other healthcare organizations, nursing homes and schools in many other places," said Ryan Spaulding, Ph.D., vice chancellor for community engagement, who oversees the University of Kansas Center for Telemedicine and Telehealth and the university's telehealth outreach and programming. "We have a broader focus and reach just because we've been doing it for so long, so we were able to assist with implementation, technology and policy issues."
In response to the pandemic, The University of Kansas Health System launched a secure, HIPAA-compliant telehealth platform for more than 1,500 health care providers and 250-plus schedulers across all 20 clinical departments.
What was initially a planned two-year, multi-phase rollout was executed in two to three weeks. Before the coronavirus outbreak, The University of Kansas Health System maintained only a limited telehealth presence. By comparison as of late April, providers had completed more than 25,000 telehealth visits in a five-week period.
Partnering with the university helped The University of Kansas Health System speed up and smooth out the herculean transition to virtual health care.
"Because telehealth was already well understood by many of our providers who work for both the university and health system, we were able to use their knowledge to help us more quickly move from offering in-person to virtual health care," said Keith Sale, M.D., physician vice president of ambulatory services for The University of Kansas Health System and an associate professor in the department of otolaryngology-head and neck surgery at KU Medical Center.
Also, in response to the pandemic, the university, through its University of Kansas Center for Telemedicine and Telehealth (KUCTT), hosted two webinars that drew more than 400 Kansas providers interested in how to develop and launch a telehealth plan in the wake of the crisis.
In addition, the KUCTT offered a Project ECHO series, Implementing Telehealth, aimed at helping organizations quickly create and deploy telehealth programs and services during the pandemic or other large-scale crises. The series, which ran through April, was open to all health care organizations and providers throughout the region. Continuing medical education and continuing nursing education credits were made available to eligible participants.
Finally, the university created a set of short videos called Telehealth Bytes to support the implementation and use of telehealth. The topics were based on frequently asked questions about telehealth, including some relevant to COVID-19.
A history of exploring and educating
With a history that stretches back to 1991, KU Medical Center operates one of the earliest telemedicine programs in the nation.
The university established the first telehealth connection in the state. It relied on off-the-shelf televisions, cumbersome video equipment and large, expensive telephone lines to link pediatric cardiologists at KU to their counterparts at Hays Medical Center who were caring for babies with heart conditions.
Since then, the technology has drastically evolved, bringing high quality internet access, sharp video images and tight cybersecurity. Meanwhile, the university, through KUCTT, has continued to expand its technical knowledge and capabilities as well as extend its services to other locations such as hospitals, clinics, mental health facilities and even schools. In fact, KU Medical Center rolled out the nation's first school-based telemedicine program, Telekidcare, in 1997. Still in operation, particularly in school-based clinics in rural Kansas, but also at a few sites in Kansas City, Kansas, the program complements services provided by school nurses.
KU Medical Center was honored by the American Telemedicine Association for its early leadership in telehealth. Committed to remaining forward thinking and fearless in exploring the innovation's boundaries, over the years, the university has seen just about every specialty, along with other areas such as dietetics and physical therapy, test the technology's waters at one time or another. Some, like psychology and psychiatry, fully embraced it even before the pandemic.
On the educational front, the university was the first in the state to partner with the ECHO Institute in New Mexico. Through KUMC Project ECHO, the institution currently offers four ongoing series, including Telehealth ECHO, which is open to all health care organizations and providers.
Beyond programming, the university has worked closely with the state's Medicaid office to develop telehealth policies that became active in 2004. KU Medical Center also has been a strong advocate for increasing private insurance coverage for telehealth services. For example, the institution threw strong support behind a Kansas law to help ensure many services reimbursed for in-person visits are required to be reimbursed when performed via telehealth. After more than 10 years of work with private insurers and the Kansas Insurance Commissioner, that law went into effect in 2018.
"It's not just us doing for us, but us trying to do for the whole state," Spaulding said.
Here to stay?
Even as the pandemic response downshifts from acute to chronic, it's unlikely telehealth fades into the background. Relaxed restrictions around Medicare, Medicaid and commercial insurance coverage and reimbursement related to the technology have opened the door to providers like The University of Kansas Health System, which can now offer a wide range of services to new and established patients.
"I am hopeful that this technology is now here to stay and will continue to be supported by Medicare and Medicaid as well as commercial payers," Sale said. "As a tech tool kit, telehealth has the potential to close care gaps, improve population health, and reduce ER visits and hospitalizations when used efficiently and combination with in-person visits."
As use of telehealth continues to evolve, one thing is certain. Moving forward, the KU Medical Center will concentrate on academic uses and research of telehealth, while The University of Kansas Health System will handle the clinical aspects of the technology.
"In this very short term, we'll try to help out when we can, but we are not starting any new clinical services," Spaulding said. "However, we are still going to write grants, try new technologies and initiatives with telehealth that haven't been done before, and, of course, be a resource and provide as much education as we can."