It’s been almost two years since one of the nation’s largest Catholic non-profit healthcare systems launched a $54 million experiment to prove that digital healthcare built on an enterprise scale can change how the medical profession does business and delivers clinical care.
And so far, a digital-only hospital launched by Mercy in St. Louis in December 2015 is on track to build a national telehealth platform that can reduce healthcare costs and use telehealth to deliver clinical care far beyond the four walls of a traditional bricks-and-mortar hospital, says Mercy Virtual president Dr. Randall Moore. “What we are doing at Mercy Virtual is meant to be a game changer,” Moore says. “We are building a new model of care.”
Mercy is an established healthcare system with roots dating to 1871 and the Sisters of Mercy religious order. Today, Mercy encompasses 44 acute care and specialty hospitals and a network of more than 700 physicians serving patients in Arkansas, Kansas, Missouri, Oklahoma and a few other states.
But Mercy always had a different way of thinking when it came to administering medical care, Moore says. That’s why in late 2015 Mercy invested $54 million to launch Mercy Virtual as a “digital” hospital that specializes in delivering telehealth services on a national basis, primarily in rural areas where physicians can be scarce and many residents struggle to access healthcare.
Mercy Virtual was launched as a new way of using the web and telehealth to deliver healthcare at a time when there is a national shortage of about 125,000 physicians and with only 10% of doctors practicing in rural areas, Moore says. At the heart of Mercy Virtual’s four-story, 125,000-square foot-facility in Chesterfield, Mo., is a staff of 600 doctors and related clinicians and that use telehealth, electronic medical records and data analytics to diagnose patients and deliver care, Moore says.
“It’s like a hospital without beds,” Moore says. “We have the medical team here, but with technology like highly sensitive cameras and real-time vital signs, our providers can ‘see’ patients where they are.” Mercy’s Virtual Care Center is designed to be a workspace for new ways to deliver patient care, not unlike a new product testing facility, he says. With meeting spaces that include multiple floor-to-ceiling whiteboards on tracks and giant computer monitors, Mercy Virtual was built for collaboration and developing new ideas for getting care to patients when and where they need it, with less expense, Moore says.
For example in one recently launched pilot program, an internal medicine doctor checks in daily with a small set of high-risk patients. “We’re testing the concept that a virtual visit every day in the homes of patients will keep them healthier and out of the hospital,” Moore says. “Rather than having a lot of different doctors for each of those patients’ conditions, they have one doctor who’s monitoring everything.”
In 10 years of operation Mercy has expanded the money dedicated to telehealth to grow Mercy Virtual and telehealth to more than $300 million. Mercy Health won’t release some details such as its annual operating budget or the number of patients the telehealth facility treats annually. But Mercy does measure its progress, including by how many intensive care patients it treated successfully via continual telehealth monitoring who otherwise may have died. “The best part of Mercy Virtual are the 1,300 patients we’ve treated that might have died.” Moore says.
Mercy began laying the foundation for Mercy Virtual with the launch in 2006 of Mercy SafeWatch, a telehealth and remote patient monitoring system that today monitors 2,431 patient beds, including 458 beds for critically ill patients. Today doctors and nurses monitor 30 intensive care units at Mercy facilities in Arkansas, Kansas, Missouri and Oklahoma.
Among other specialties, Mercy provides home monitoring, a telehealth program for emergency rooms treating stroke victims without a traditional neurologist on call, and a nurse-on-call department that via phone, e-mail and text answers more than 285,000 patient questions annually. While currently focused on a regional healthcare market, the system is building and expanding Mercy to be a national program for digital healthcare—and a model for using the web and information technology to change the way healthcare is delivered and paid for.
Mercy is developing a coalition of other healthcare organizations and technology companies to build its national base, Moore says. For example, Mercy Virtual is working with Penn State Health and University of North Carolina Health Care, initially to provide intensive care monitoring services. The ultimate goal of partnering with other healthcare systems is to create a healthcare consortium in which Penn State Health and University of North Carolina Health Care, which is currently merging with Carolinas HealthCare System, can provide virtual care services to other hospitals in the central Pennsylvania region and North Carolina.
“Virtual care will be critical to the future of healthcare,” Moore says. “Healthcare providers must provide better quality and higher value to more people and by forming interdependent partnerships without walls, we will evolve healthcare to a new place that will bring better care to patients everywhere.”
Through 160 work stations Mercy refers to as “virtual care pods,” Mercy Virtual clinicians support and monitor care for over 10,000 patients daily. One clinician keeps a watch on six monitor screens at the same time and checks in with patients at home to make sure they are taking their medications properly and monitoring vital signs by biometric sensors, other wearables and a “virtual” care kit that may include an iPad and sensors for use at home once they are discharged from a hospital.
One area where Mercy Virtual also wants to excel is by showing the $3 trillion U.S. healthcare system that the web, telehealth and digital healthcare delivery can be used to save money without reducing the quality of care. So far, Mercy has demonstrated cost savings in several areas, Moore says.
For example, Mercy Virtual has helped its parent health system save $9.2 million annually by using technology from software company SAP to standardize communication and terminology throughout its facilities and reduce waste of very expensive surgical supplies. Remote patient monitoring by Mercy Virtual has also helped reduce total intensive care patient days in the hospital by 90,000 over a period of a several years, which translated into savings of $50 million. “Costs are reduced by providing the right level of care at the right time,” Moore says. “Patients receive fewer resource-intensive interventions and have better outcomes. Additionally, physicians, especially specialists, do not have to travel to remote locations to treat patients, which saves time, frustration, and travel costs.”
For Moore, Mercy Virtual is demonstrating that web-enabled care combined with broader access to patient healthcare data has a role in mainstream healthcare. “The virtual care center will improve the patient experience by taking the care to the patient, instead of the patient going to the care, which decentralizes care,” he says. “It is more convenient for patients, and the health system is able to offer patients the right care when they need it.”