Using Technology to Optimize Care Delivery: The Role of A Virtual Care Communication Platform at Trilogy Home Healthcare January 2019 Confidential
Agenda • Role of Virtual Care in Home Health • Trilogy’s Objectives for Virtual Care • Patient Interest in Virtual Care • Success Stories and Lessons Learned • Testimonials • Future Use Cases 2 Confidential
Context • Home Health Care agencies may spend more time driving to/from patients vs. treating patients • At-home / at-risk patients - the “sickest of the sick” rely on EMS and/or the ER when a Home Health team member is unavailable or a clinician cannot be present • Virtual care can bring compassionate care closer to the patient – and in a more convenient, cost-effective, and collaborative manner for a Home Health Care agency 3 Confidential
• Established in 2016 by industry experts with over 30 years in home healthcare operations • Spanning 30+ counties throughout the state of Florida • Strives to provide the most optimal care to patients in a fun, forward- thinking environment • Offers a mix of services – SN, PT, OT, Speech, MSW, HHA – complemented by cutting-edge care and education to our licensed clinicians • Emotional and Behavioral Health with our Psych Nursing • Biofeedback for Bladder Incontinence and Pelvic Pain • Chemotherapy, IV Hydration, Antibiotic and Respiratory Therapy 4 Confidential
“We are dedicated to delivering compassionate care to our patients and we were interested in introducing technology to get desired patient outcomes and reduce hospital readmissions… With Synzi’s platform, our clinical staff can better connect with our clients, giving us more touch points with them while improving patient engagement.” -- Dale Clift, Executive Chairman of Trilogy 5 Confidential
Training Trilogy Staff 1. Referred to it as a “Communication Platform” • Engages the patient • Helps the patient feel less isolated • Brings in remote family members into the virtual visit 2. Highlighted the intuitive user experience 3. Conducted role-playing exercises 4. Started with 1 location before expanding thru Florida 5. Received feedback and responded quickly 6 Confidential
Virtual Care Implementation at Trilogy • Address Trilogy’s top diagnosis codes for hospital readmission • Use the Synzi platform to engage these patients to take the appropriate action (e.g. take their medication) • Focus initially on specific patient populations: • Owners of smart devices; comfort level with technology • Chronic conditions including CHF, COPD, and/or Diabetes • Structure core program across conditions • Allow for customization by condition, Trilogy office location, and provider group • Leverage multiple channels (e-mail, SMS/text and virtual visits) • Factor in patient preference on communication modality 7 Confidential
Reflecting Patient Interest in Virtual Care Critical for Reducing Readmissions Source: Advisory Board Virtual Visit Consumer Choice Survey 8 Confidential
Example Engagement Programs MI and Heart Failure 15% Readmission Rate for In-person Daily Required SMS on Supplemental In-person Medication Non-Adherence Discharge Medication 48 Hour Patient Education Virtual Program Visit Reminder Virtual Visit Visit Completion Visit Pneumonia 20% Readmission Rate for In-person Medication Non-Adherence In-person Daily Required SMS on Supplemental Program Discharge Medication 48 Hour Patient Education Virtual Completion Visit Visit Reminder Virtual Visit Visit COPD 20% Readmission Rate for Respiratory Issues In-person In-person Required Required SMS on Supplemental Program Discharge 24 Hour 48 Hour Patient Education Virtual Completion Visit Visit Virtual Visit Virtual Visit Visit THA/TKA 4% Readmission Rate for Medication Non-Adherence In-person Daily Required SMS on Supplemental (Infections) In-person Discharge Medication 48 Hour Patient Education Virtual Program Visit Reminder Virtual Visit to for Wound Care Visit Completion Visit 9 Monitor Infection Confidential
Engaging Patients Based on Risk High Risk 30 Days In-person Virtual Virtual Secure Virtual Visit Visit Visit Message Visit Moderate Risk 60 Days In-person Secure Virtual Email or Virtual Visit Message Visit SMS Visit Low Risk 90 Days T elephone Email or Secure Email or SMS Secure Call SMS Message Message Flu Reminder Monitor patient engagement and compliance; optimize staffing 10 Confidential
Benefits to Key Stakeholders No Care Team Transportation Collaboration Required Patient Resource Preference in Utilization Modality Retained Revenues and Eyes on the Improved Patient, Clinical Plus the Home Measures 11 Confidential
Trilogy Success Story #1 Use Case: Male Patient • Limited mobility due to breathing difficulty. • High blood pressure for the past five years • 3 Emergency room visits in the past five months • Recently diagnosed with COPD Typical Action • Respiratory Therapist drives to patient house for education. • Agency incurs costs / liabilities associated with drive time and in-person visit (respiratory therapy is non reimbursable) Virtual Visit Results • Emerging situation easily determined during virtual visit • 2 hour time savings for each virtual visit • 1 ER visit averted Benefits • Productivity gains : Respiratory Therapist can care for 4 more patients virtually in the 2 hours time savings • Cost-effective care delivery : Healthcare system saves $1,917 (cost of average ER visit per Health Care Cost Institute report). The AQHR estimates the average cost of a readmission for a patient as $13,800. Agency realizes savings from reduced windshield time • Patient satisfaction : Feedback was positive due to convenience, quick delivery of care, and overall favorable to future use of the technology 12 Confidential
Trilogy Success Story #2 Use Case: Patient’s Remote Family Member • Patient has had a health decline and is moving from her independent home into an assisted living community. Her daughter is very active in her care but lives remotely Typical Action • Daughter has concern and guilt for not being able to be part of mom’s care • Daughter travels from New Hampshire to be able to part of mom’s transitional care • There are communication discrepancies between mom and daughter in regard to what took place during her home health visit Virtual Visit Results • Family more involved in patient care • Medical Power of Attorney role facilitated by virtual visit • Daughter feels more engaged with mother’s care. Benefits • Transportation savings : Remote family member can avoid travel expenses such as lost wages, flights, car rental, hotel, etc. • Quicker care decisions : Remote family member can be more aware of the care continuum and approve next steps in the transition of care on a more timely basis • Patient satisfaction: Patient feels less isolated 13 Confidential
Lessons Learned • The most surprising bi-product of Synzi was patient satisfaction 1. Feelings of depression decreased 2. Feelings of isolation minimized • Soft roll outs to branch offices doesn’t work • Having a virtual care liaison in each office is essential for success • Education to different departments should be limited to a need- to know basis 14 Confidential
Patient Testimonials “Thanks for the great and compassionate care that I received, when I was with Trilogy. Your nurses and appointment and medication reminders through text were key in my recovery” Louis Libby “Just knowing that in one call, I can have a nurse there to answer my questions or look at my wound by video, gives me piece of mind” Nancy Palmer 15 Confidential
Staff Testimonials “ Synzi has been a great tool in keeping us in the forefront of a very competitive market” Sarah Trantham- General Manager in Estero “I can’t help but wonder if being progressive with technology and virtual care helped position us to become a preferred provider with a very large account” Holly Crider- Naples Sales Manager “It has been nice to be able to provide solutions to hospital case managers, who have complex patients” Stephanie Walczak-Home Health Coordinator 16 Confidential
Trilogy’s Future Expansion in Virtual Care • Virtual care is going to be instrumental in Trilogy’s upcoming patient discharge program, BEAT (Better Engagement After Transition) • January of 2019: Virtual Care will be rolled out into 3 additional branch offices • By the end of Q1: every branch will have been exposed to Synzi • By the end of Q2: Synzi will have the reach of 42 FL Counties 17 Confidential
Building Awareness with Referral Sources Started with the Press Release Resulted in Media Interest for Interviews Continued with Media Coverage and Pick-up and Articles 18 Confidential
Measuring Success Time to Consult Fulfillment Diagnostic Accuracy Patient Adherence Readmissions Rate Staff Utilization and Satisfaction Rates Patient Satisfaction Rates Agency Brand Equity, Loyalty, and Referral Stream 19 Confidential
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